Newspaper article Sarasota Herald Tribune

Nursing Homes on a Watch List

Newspaper article Sarasota Herald Tribune

Nursing Homes on a Watch List

Article excerpt

MONITORING: Problems at two more in area subject them to extra scrutiny

Two Southwest Florida nursing homes have been added to the list of facilities where state inspectors have found problems severe or persistent enough to single them out for extra monitoring.

Both nursing homes are appealing the state's decision.

At Signature Healthcare of Port Charlotte, according to a state report, an 85-year-old quadriplegic was found unresponsive and no attempts were made to revive him -- despite a policy calling for all possible life-saving measures unless a resident has a directive on file refusing them.

The Woods at Manatee Springs in Bradenton was added to the list because of an incident in which a resident fell face-forward leaving his bathroom, inspectors wrote. He was hospitalized for a shoulder fracture nine hours after an aide found him lying in the doorway to his room.

Florida maintains an ongoing register of nursing homes that have raised serious concerns in the past 30 months. It identifies facilities that are operating under bankruptcy protection or have met criteria for a "conditional status" -- meaning their license to operate could be revoked.

The Nursing Home Watch List -- intended to help consumers evaluate facilities -- is updated every three months. A nursing home can appeal the decision and try to be removed from the list, or it will drop off after 30 months if follow-up inspections find no new or continuing quality issues. High-level infractions can result in fines, and a conditional status that ranges from a few days to several months, but there is no additional penalty for being on the list.

The state Agency for Health Care Administration takes any failure to honor a resident's end-of-life directives very seriously. Signature received 62 days of conditional status for the June 7 death of the resident who had been discharged from Fawcett Memorial Hospital three days earlier.

According to his hospital records, the man had been treated for sepsis that affected his brain function, and was also diabetic. The record called him "a functional quadriplegic as he cannot feed himself, toilet himself or get out of bed." At Fawcett, his status was "Full Code," meaning that he should have cardiopulmonary resuscitation to revive him if necessary.

When the man was found without a pulse, the nursing supervisor on duty told state inspectors, she decided against trying CPR "because he was too far gone."

The administrator of Signature noted on the state report that it is the nursing home's policy to administer CPR if a resident has no Do-Not-Resuscitate Order on file.

"The staff involved chose not to follow the facility expectations regarding this incident even after voicing that they understood each of the policies," she wrote. The nurses responsible were terminated and reported to the state licensing board, she added; several aides received written warnings for failing to report the incident. …

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