The News Desk is a collection of news, notes and breaking items affecting the Fredericksburg community.
Carriage Hill on short list of troubled facilities
BY JIM HALL
The Carriage Hill Health & Rehab Center remains the worst-rated nursing home in the region, according to a recent update to the federal rankings.
Carriage Hill is the only “Special Focus Facility” in the region and one of three in the state. The Centers for Medicare and Medicaid Services, or CMS, maintains the Special Focus list for homes with a history of substandard care.
Carriage Hill was placed on the Special Focus list in January. In CMS’ latest update, published June 21, the home is described as “one that has not shown improvement.”
These are homes “that have failed to show significant improvement despite having had the opportunity to show improvement in at least one survey after being named as a SFF nursing home,” according to CMS.
Andrea Bagwell, administrator at Carriage Hill, said in a statement Wednesday that the home did not have a history of problems and was not typical of the homes found on the Special Focus list.
“Carriage Hill is continually confirming its commitment to quality of care and quality of life for its residents, and as part of that effort, is working with regulators to ensure that it will ‘graduate’ from the SFF program and will not be designated as a SFF in the future,” the statement said.
Avante at Harrisonburg, and Continiumcare of Weber City are Virginia’s other SFF homes. Envoy of Williamsburg is a recent graduate of the program.
Carriage Hill is part of Commonwealth Care, a Roanoke-based nursing home chain. Commonwealth Care purchased the home from Mary Washington Healthcare in 2008.
The home is one of the largest in the region, with 150 beds. During recent state inspections, it had 128 to 142 residents. It is on State Route 3 in Spotsylvania County.
Special Focus homes have at least twice the number of deficiencies of other homes, according to CMS. Their problems are usually more serious than problems at other homes, and the problems have persisted, usually for three years prior to being included on the list.
“It’s a combination of a lot of factors that gets a facility to be Special Focus,” said Connie Kane, director of the Division of Long Term Care for the Virginia Department of Health.
The Virginia Department of Health and CMS work together to regulate and monitor the state’s nursing homes.
Most homes are subject to annual inspections. Special Focus homes, however, are inspected more often.
Inspectors visited Carriage Hill in June 2011, and in March and May of this year. The latest inspection occurred this week. Visits are unannounced and can last several days.
The inspectors have found a number of problems at Carriage Hill, according to their reports. Because of these problems, CMS fined the home $7,500 last June.
The deficiencies cited in last June’s inspection report and in the March inspection report have been corrected, according to Nursing Home Compare, the CMS website. The website does not mention the May deficiencies.
One of the incidents described by inspectors occurred in June 2011.
The case involved a resident who used a wheelchair and needed assistance in transfers, dressing and hygiene.
The man also was a pack-a-day smoker who went outside in his wheelchair to smoke. Staff members had told the man that smoking was not allowed, and they offered him nicotine patches. But the man continued to smoke.
Early on June 3, 2011, the man went outside alone. He dropped a lit cigarette in his lap and set his sweat pants on fire.
The man said later that his pants were aflame and that it took awhile to get the fire out. The man was able to get out of his chair and roll on the ground.
A nursing assistant saw the man on the ground and went to help him. The man told the staff member, “Just get me up and let me finish my cigarette.”
The man was taken to the hospital with second- and third-degree burns on his knee, leg, foot and fingers. He was later transferred to a burn unit.
Inspectors cited the home for failing to consistently enforce its no-smoking policy and for not providing proper supervision to a resident to prevent injury.
Other problems found during the inspections included:
Some residents had not received the medicines that their doctors had ordered for them.
Some residents had not seen a doctor for at least 60 days.
The home had not done the required quarterly or annual assessments of some residents.
The home had failed to offer treatment to a patient who was admitted with a pressure ulcer on the left foot.
The home had not revised a resident’s care plan after the resident fell four times.
The home did not notify the state after it discharged two residents for using illegal substances at the home.
The home allowed CPR to be administered to a 78-year-old patient, even though the resident had a do-not-resuscitate order. The order could not be found in the patient’s file.
Jim Hall: 540/374-5433
CARRIAGE HILL STATEMENT
In response to a Free Lance–Star request for an interview, Andrea Bagwell, administrator at Carriage Hill, provided this statement Wednesday:
“The CMS designation of a nursing center as a ‘Special Focus Facility’ is a complex process that, per CMS S&C–10–32–NH, traditionally identified facilities with a ‘track record of substandard care.’
“Although Carriage Hill was designated a Special Focus Facility (SFF), Carriage Hill does not have a track record of substandard care and has not shown a ‘persistent pattern of poor quality’ on recent surveys.
“The SFF Program is meant to identify facilities with a history of severe and persistent quality of care problems and repeat deficiencies. Since 2008, Carriage Hill has enjoyed a good survey history and has not experienced the type of issues typically associated with the SFF designation.
“However, CMS has exercised its discretion under complex selection criteria to name Carriage Hill as a SFF.
Carriage Hill is continually confirming its commitment to quality of care and quality of life for its residents, and as part of that effort, is working with regulators to ensure that it will ‘graduate’ from the SFF program and will not be designated as a SFF in the future.”