A Winthrop nursing home with a history of federal fines has been placed on a national list of facilities with ‘serious quality issues’ after two residents wandered off in separate incidents last year. The second time, the resident was hit and killed by a car.
Heritage Rehabilitation and Living Center, a 28-bed nursing home, was listed as a “specialty facility” earlier this year by the US Centers for Medicare and Medicaid Services (CMS). This means Heritage will be subject to twice as many inspections and could face penalties if it fails to improve.
“Our nursing homes are caring for a very vulnerable population of people (so) protecting quality of care and quality of life is so important,” said Brenda Gallant, Maine’s long-term care ombudsman. . “The regulations are there to protect residents. Thus, when there are deficiencies of a serious nature, they must be corrected, and then improvements must be made to protect residents.
Heritage is owned by North Country Associates, Maine’s largest long-term care provider. Neither Heritage’s administrator nor North Country Associates responded to requests for comment.
Reasons for Special Focus Designation
On a rainy November night, police found a Heritage resident without shoes wandering along the road about a mile from the facility, according to a Report from the Department of Health and Social Services.
When police brought the resident back to the facility, staff “had no idea the resident was missing or how long the resident had been gone,” the inspection report said. Heritage was fined $109,600.
Less than a month later, on December 6, another Heritage resident wandered off and was hit and killed by a pickup truck half a mile away on Highway 202.
Donna Driscoll, 56, was recovering from a broken leg and was about to be transferred to a memory care center in Falmouth before she died, her family said. WGME at the time. She had a history of wandering and wore an ankle monitor that was supposed to prevent doors from opening if she tried to leave.
The ankle monitor was how police learned she was a Heritage resident, according to a DHHS report. When police attended the facility, staff first assured the officer that all of their residents were there. But when the police asked them to check, they noticed that a resident was missing.
The wandering guard should have prompted the doors to lock if she got too close. A company then checked the system and found that it was working properly.
There were 24 residents and four staff present at the time, including the director of nursing.
Heritage was also cited for failing to have a written transfer agreement with a local hospital and for failing to ensure staff members had undergone training on abuse, neglect, exploitation and misappropriation. resident property and dementia care.
The incidents contributed to regulators’ decision to list Heritage as a special facility, DHHS spokeswoman Jackie Farwell confirmed. The decision was based on a “persistent low-quality pattern of a facility’s last three standard inquiries and complaints”, rather than a single event.
Nursing homes must meet national standards
Nursing homes are required to follow federal regulations on all aspects of care, including staff, medications, activities and food, said Gallant, the long-term care ombudsman. Managers send a report to the establishment on how it can improve, and the establishment must respond by explaining how it will correct these problems.
Citations for “failures” of various severity levels during an annual inspection are common. The national average number of impairments for a nursing home is six or seven, according to CMS.
Nursing homes that have more problems, more serious problems, or a pattern of problems over a long period of time are placed in the Special Focus Facility program. These facilities are then inspected more frequently — every six months.
CMS is using increasingly stringent enforcement measures to bring the facility into compliance, an agency spokesperson told the Maine Monitor. If the facility has not corrected its noncompliance after three months, CMS is required by law to withhold Medicare payments for new resident admissions. If he still does not comply after six months, CMS is required to terminate his participation in Medicare and Medicaid.
But a nursing home doesn’t have to be a specialty facility to face penalties for deficiencies, Gallant said.
Most nursing homes improve the quality of their care within two years, but about 10% end up being terminated by Medicare and Medicaid.
“The Centers for Medicare & Medicaid Services is committed to improving the quality of care and quality of life for all nursing home residents,” the spokesperson said. “Patient health and safety, access to reliable, high-quality care, and the treatment of all nursing home residents with dignity and respect are the top priorities in all of our efforts.”
Heritage was placed on the federal list in February. It is Maine’s only retirement home currently listed as a specialty facility.
The Marshwood Center in Lewiston was an institution specializing in December 2019 but made enough improvements to be removed from the program.
To “graduate” from the program, a facility must complete two consecutive inspections with evidence of improved quality of care, with no citation indicating harm or potential for serious harm to residents, Farwell said.
Gallant said families often have to make quick decisions during a crisis about where to send their loved ones. They may be unaware of resident protections and publicly available facility information.
Inspection reports and ratings for all Maine facilities are available at the CMS website. It includes scores for health inspections, staffing and quality metrics, as well as information on COVID-19 vaccination rates, fire safety inspections and penalties.
Gallant also encouraged families to ask nursing home administrators about the shortcomings cited and what steps they are taking to address them. And they can tour the facility to observe staff interactions with residents.
Residents and family members are often hesitant to complain for fear of retaliation from the facility, Gallant said, but she has never seen any kind of retaliation. They are able to solve problems in a “respectful” way.
“It’s a good thing that the focus is on care and quality improvement. And for residents, it’s important that we do all we can to ensure that the elderly and disabled who are served in nursing homes receive the highest quality of care – quality of life – possible. This is what we would want for our loved ones or for ourselves.
Rose Lundy is the health care reporter for The Maine Monitor. She can be reached by email at rose@themainemonitor.org.