A resident also was not receiving the "sitz" baths ordered by her surgeon. The surgeon wanted her hips and buttocks soaked in salt water three times a day to relieve the discomforts of surgery.

Employees apparently stopped giving her the baths when they decided that her surgical wounds were healed, according to the report. However, they did not notify her physician.

Termination from the Medicare program occurs somewhere in Virginia about once a year, said Stephen Morrisette, president of the Virginia Health Care Association, the trade group of nursing homes and assisted-living facilities.

The termination comes after six months of visits and revisits by state inspectors, who check 200 areas of concern, Morrisette said.

"Perfection is what they're looking for," he said. "There is very little forgiveness in the survey process."

After each inspection at Carriage Hill, MediCorp officials offered the state a "plan of correction," showing how they would improve operations at the home.

Officials promised added training and education for the staff, closer monitoring by nurse supervisors and better review of patient charts.

"In the past two weeks, we have made and continue to make significant changes to bring Carriage Hill back into regulatory compliance as soon as possible," said Kathleen Allenbaugh, MediCorp spokeswoman.

MediCorp officials assured residents last week that they can continue to live in the home and would not have to pay the costs now covered by Medicare or Medicaid.

Jim Hall: 540/374-5433
Email: jhall@freelancestar.com