A Winchester nursing home has been placed on the federal government's list of troubled facilities in the United States, joining nursing homes in Lexington and Pikeville on the roster.
Fountain Circle Health and Rehabilitation in Winchester has been on the list more than two months, according to the federal Centers for Medicare and Medicaid Services.
Bluegrass Care and Rehabilitation on Pimlico Parkway in Lexington had been on the roster for 13 months as of Aug. 18, when the list was updated. Parkview Nursing and Rehabilitation in Pikeville had been on the list for eight months. Both were categorized as not having improved.
Bernie Vonderheide, founder of Kentuckians for Nursing Home Reform, said having three of the so-called "special focus" facilities in Kentucky was "shameful."
"It is a reflection on two groups — one, the people who run these facilities and have little regard or respect for the human beings they are supposed to be taking care of, and two, the state's enforcement people and their programs, which obviously must be significantly expanded and improved," he said.
Fountain Circle received a Type A citation from the state in July. That's the most serious citation given by the Cabinet for Health and Family Services' Office of Inspector General for a violation of state regulations.
On July 2, employees at Fountain Circle left a severely cognitively impaired resident alone outside after a supervised smoke break, the citation alleged. A half hour later, people in the community began reporting that an elderly person was "rolling down the highway" in a wheelchair, according to the citation issued July 19.
Nursing home staff and police found the resident three-tenths of a mile from the nursing home. The administrator and the director of nursing told investigators the facility had not conducted an assessment to determine whether the resident was safe to be left unsupervised, the citation said.
"It was determined that the facility failed to adequately supervise residents to ensure their safety, placing residents in imminent danger and creating substantial risk that death or serious mental or physical harm would occur," the citation said.
Fountain Circle was cited for two federal deficiencies in March that were considered causing minimal harm or risk of harm in food preparation and in following a resident's care plan, according to the Medicare Nursing Home Compare Web site.
The list of troubled nursing homes compiled by the federal Centers for Medicare and Medicaid Services is known as the Special Focus Facility List.
A special focus facility is a nursing home with a history of serious issues found by state or federal inspection teams. Nursing homes on the list are required to fix their problems. If they don't, they can receive federal civil fines or be terminated from Medicaid, the federal and state health care program for the poor and disabled, and Medicare, the health care program for people 65 and older.
Officials at Fountain Circle issued a statement Wednesday that said "resident care and safety is our number one concern."
"We are committed to continuing to improve the quality of care we provide at our nursing center. We recognize that tools used by regulatory agencies are important metrics for measuring quality, but those tools often do not include the entire picture."
"On more direct measures of quality care, Fountain Circle ranks better than the state average of several key quality measures according to the Medicare Nursing Home Compare Web site," the statement said. The parent company of Fountain Circle is Louisville-based Kindred Healthcare, according to state records.
Once facilities are on the special focus list, they are included in a program in which they are inspected twice as often as other nursing homes.
Parkview administrator Tiffany Cox said her facility has made strides, despite its classification. A February inspection cited problems with the procedures followed when a resident was released and with the lack of social services the resident received.
"While our center remains listed as a special focus facility under the 'not improving' category, I do not believe that listing reflects the ongoing positive strides we have made and continue to make at our facility," Cox said in a statement.
She said citations from a recent inspection "related to an environmental deficiency which has already been corrected and was not related to direct patient care in any way. Nonetheless, we continue to make positive enhancements, both in patient care, as well as improvements to the facility."
The parent company for Parkview is Centennial Healthcare in Atlanta, according to state records.
Among the problems found at Bluegrass Care and Rehabilitation in Lexington during a January inspection was the alleged failure to follow physicians' orders and to follow a written plan for residents, according to state and federal inspection records. The documents show that Bluegrass made a plan of correction. Bluegrass referred questions to the nursing home's parent company, Signature Healthcare in Louisville. Signature officials did not return two telephone calls asking for comment.