Lexington nursing home joins government's list of troubled facilities

A Lexington nursing home has been placed on the federal government's list of 132 chronically troubled facilities in the United States, bringing the total from Kentucky to three.

Investigators found 22 federal deficiencies at Bluegrass Care and Rehabilitation on Pimlico Parkway in fiscal year 2010, more than three times the average number of federal deficiencies for Kentucky nursing homes.

Additionally, the facility received a Type A citation from the state in 2009 and again this year. That's the most serious citation given by the Cabinet for Health and Family Services' Office of Inspector General for violation of state regulations.

Staff members at Bluegrass attached inappropriate lyrics to photos of residents and sent them as text messages to other employees, according to the 2009 citation. The newest citation in March 2010 involved a 2009 incident in which a resident wandered away from the facility.

Special focus facilities

The roster 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 recent history of persistent poor quality of care, as indicated by the findings of state or federal inspection teams. Based on inspection findings for the last three years, CMS designates nursing homes with the worst repeated inspections as special focus facilities.

Carl Young, the new administrator at Bluegrass, said a new management team is in place, and its goal is to get off the list within seven months, which is the earliest time frame allowed. Young said only six or seven federal deficiencies were found during the annual inspection, which took place two weeks ago, and measures have been taken to keep residents from wandering off.

Bluegrass was on the federal list as of July 22.

Once facilities are on the list, they are included in a program in which they are inspected twice as often as other nursing homes.

The average number of federal deficiencies found at a nursing home in Kentucky is seven, and the average number of federal deficiencies for a nursing home nationwide is eight, according to CMS.

Elsewhere in Kentucky, Arbor Place of Clinton in Hickman County, which has been on the list for seven months; and James S. Taylor Memorial Home in Louisville, which has been on the list for six months, are categorized as showing no improvement.

Arbor Place of Clinton received 20 federal deficiencies in fiscal 2010 in all of its inspections, said Beth Fisher, spokeswoman for the state Cabinet for Health and Family Services. In addition, Arbor Place received one Type A citation from the state in 2009, and two each in 2008 and 2010.

The facility has been cited for residents wandering off, for a medication problem that sent a resident to a hospital, and for not having backup emergency power.

The nursing home was cited when a patient who had been warned not to smoke started a small fire and when the facility failed to properly monitor and treat a resident who kept trying to escape from his wheelchair. The man tipped forward in the wheelchair, hit the floor and was later pronounced dead in a hospital.

Officials with Benchmark Healthcare, the Missouri corporation that owns Arbor Place of Clinton, said the facility is under new management, has made $1 million in improvements and has implemented improved procedures. The facility is now in compliance with federal regulations, and its recent good inspections are not reflected in CMS reports, said Lynn Bushor, vice president for clinical services.

James S. Taylor Memorial Home in Louisville received 23 federal deficiencies in fiscal 2010, Fisher said. The facility also received a Type A citation from the state in November 2008 when a mechanical lift broke, and a resident fell and had to be hospitalized. Administrator Stephanie Mathis declined to comment Wednesday.

State wards in residence

Several state wards live in the three nursing homes on the federal list. Under Kentucky law, once someone is declared disabled by a district court jury and appointed a state guardian by a judge, that person, as a state ward, is no longer allowed to control his or her property or living arrangements or make health decisions.

One state ward lives at Bluegrass Care and Rehabilitation, said Emily Moses, a spokeswoman for the Cabinet for Health and Family Services. Famed equine photographer Tony Leonard, who was a ward of the state from August 2009 through May, formerly lived at Bluegrass. He now resides in an assisted living facility.

The state has placed 12 wards at James S. Taylor and seven at Arbor Place of Clinton. Moses said officials in the Cabinet's Department for Aging and Independent Living do not plan to move the wards.

"The department believes that policies and procedures are in place to ensure all residents in these facilities receive appropriate care and remain safe," she said.

Typically, a state guardian is required to meet with the ward only quarterly but, under a policy that took effect Monday, state guardians with wards living in special focus facilities are required to visit at least once a week, Moses said.

Additionally, she said, officials from the State Long-Term Care Ombudsman program are visiting weekly to evaluate the facilities.

Off the list

Meanwhile, the July 22 federal list showed that Madison Manor in Richmond — officially known as Richmond Health and Rehabilitation Complex-Madison — has improved enough to leave the special focus facility program.

The Kentucky attorney general's office filed criminal charges against three people in connection with abusive conduct caught on a video camera placed in the Madison Manor room of Armeda Thomas, 84, in 2008. All three have pleaded guilty.

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