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Nursing home patient lost 87 pounds in 19 days

State and federal agencies have filed numerous sanctions against the Winchester Centre for Health and Rehabilitation since August, when a patient lost more than 87 pounds in 19 days and the nursing home failed to call a doctor, according to records obtained by the Herald-Leader under the Open Records Act.

At the end of the 19 days, the patient was found unresponsive and was taken to the hospital, according to a Type A citation from the Kentucky Cabinet for Health and Family Services.

The unnamed medical director at the Clark County nursing home is quoted in state records as telling an investigator that the patient did not receive good care: "It was not a good experience during his three-week stay, and I think he suffered for it."

The facility's problems have continued, with the federal government and the inspector general's office for the cabinet notifying the nursing home that it did not meet the requirements to serve patients receiving Medicare and Medicaid.

The federal Centers for Medicare and Medicaid Services is threatening to pull the facility's funding in February and has warned that the facility could be fined up to $6,050 a day if conditions don't improve, according to correspondence between the nursing home and the federal agency.

No plans to close

Officials with Kindred Healthcare in Louisville, which owns the Winchester nursing home, say the facility is correcting its problems and has no plans to close. If the funding is cut off, the patients who receive Medicaid and Medicare will be sent to other facilities that meet the requirements.

There are 166 patients at the facility.

The nursing home received a Type A citation, the most serious the state can give, in August, when it did not contact a physician or monitor a patient being treated for swelling and other problems. The patient lost more than 87 pounds, dropping from 197 pounds to 109.4 pounds, in 19 days

When the patient was admitted to a hospital, a physician there told state investigators, "I would never want anyone to lose weight that fast. That is too fast."

A second Type A citation was issued Jan. 12, after a patient received the wrong dosage of an anti-seizure medication for 40 days in November and December, an error that wasn't discovered until the patient suffered a seizure. The patient was supposed to have received a daily dose of 450 milligrams of extended-release capsules by mouth, but the nursing home staff gave 400 milligrams through a feeding tube, which altered the medication's effectiveness.

The facility didn't have a system to make sure that medications were administered properly, according to the Jan. 12 citation.

Doctors not notified

Records of state inspections and investigations since August show that physicians were not notified when patients' conditions deteriorated and doctors' orders weren't followed for patients with serious medical conditions. Inspections since 2007 also have turned up problems with cleanliness, disrepair and the temperature of food served to patients.

In one case in September, the nursing home did not notify a physician when a patient's bedsore worsened and the patient had to be hospitalized as a result. The physician told state investigators that the problem should have been detected sooner and that the patient did not receive "the best of care" at the facility.

Beth Fisher, a spokeswoman for the cabinet, said the Centers for Medicare and Medicaid Services typically gives a facility six months to fix its problems, as has been the case with Winchester Centre for Health and Rehabilitation.

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