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The News-Sentinel regularly brings you information on the results of Allen County nursing homes’ annual surveys or inspections. Today’s surveys are from the seven nursing homes inspected during the fourth quarter of 2005, the most recent quarter available.

Although the Indiana State Department of Health’s long-term care division releases a quarterly list of facilities that have received zero deficiencies, The News-Sentinel’s health reporter read through results from all Allen County nursing homes inspected in the fourth quarter so that readers can glean the most information possible.

Information contained in our reviews comes from the surveys that are open to the public, from the state health department’s Web site and from ISDH staff.

In the fourth quarter of 2005, 116 of the state’s 520 nursing homes were inspected. Twelve of them had deficiency-free surveys; two of the seven Allen County facilities were deficiency-free.

Explanation

Nursing homes are given deficiencies according to ratings set by the federal government. Although there are A-C ratings, they are the least serious deficiencies and are not tracked in News-Sentinel reports. Levels D-L have the following meanings, with D being less severe and L indicating the most serious deficiency. Levels G-L are particularly cause for concern:

D: Isolated/minimal harm or potential for actual harm – A less serious deficiency and isolated to the fewest number of individuals; results in minimal discomfort or has the potential to negatively affect a resident’s ability to achieve his or her highest level of functioning.

E: Pattern/minimal harm or potential for actual harm – A less serious deficiency affecting more than a limited number of individuals; results in minimal discomfort or has the potential to negatively affect residents.

F: Widespread/minimal harm or potential for actual harm – A less serious deficiency that is widespread; results in minimal discomfort or has the potential to negatively affect residents.

G: Isolated/actual harm – A more serious deficiency isolated to the fewest number of individuals; negatively affects the resident’s ability to achieve his or her highest functioning.

H. Pattern/actual harm – A more serious deficiency affecting more than a limited number of individuals; negatively affects residents.

I. Widespread/actual harm – A more serious deficiency that is widespread and/or has the potential to affect a large number of residents.

J. Isolated/immediate jeopardy – The most serious deficiency, although isolated to the fewest number of residents, staff or occurrences; has caused or is likely to cause serious injury, harm, impairment or death; immediate corrective action required.

K. Pattern/immediate jeopardy – The most serious deficiency affecting more than a limited number of individuals; has caused or is likely to cause serious injury, harm, impairment or death; immediate corrective action required.

L. Widespread/immediate jeopardy – the most serious deficiency and widespread throughout the facility; places residents in immediate jeopardy, causing or likely to cause serious injury, harm, impairment or death; immediate corrective action required.

Note: Federal Quality Initiative scores are from September 2005.
— Compiled by Jennifer Boen, jboen@news-sentinel.com

The Cedars

Address: 14409 Sunrise Court, Leo

Phone: 627-2191

Owner: Cedar Creek Retirement Home Inc., Indianapolis

Officers: John Klopfenstein and David Bertsch

Most recent change in ownership: None

Status: Nonprofit

Administrator: Larry Watkins

Hire date: Sept. 13, 1993

Beds: 50

Census: 47 as of Oct. 25, 2005

Most recent annual survey: Oct. 28, 2005

In substantial compliance? No

When compliance met: Nov. 23, 2005

Deficiencies found in Levels D-L**: 2D, 1E

D Level:

♦Failed to give pain medication according to doctor’s orders for a patient who had recently had surgical insertion of a feeding tube into her stomach.

♦Failed to have monitoring system in place to prevent a resident from falling out of her wheelchair and down stairs; resident also wandered within the facility, although there was no documentation that she was prone to do so.

E Level:

♦Multiple staff members, including three nurses and four nursing assistants, failed to follow proper infection control policies by washing their hands for at least 20 seconds before giving hands-on care to residents, including giving one resident eye drops.

Substantiated complaints in 2005: None

Previous year: None

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

The Cedars: 1 hour, 7 minutes

Statewide average: 2 hour, 18 minutes

National average: 1 hour, 12 minutes

For nursing assistants:

The Cedars: 2 hours, 7 minutes

State average: 2 hours

National average: 2 hours, 18 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score, the better)

The Cedars: 38

Statewide average: 139

State licensure actions this quarter: None

Federal actions imposed: None

Golden Years Homestead

Address: 8300 Maysville Road

Phone: 749-9655

Owner: Golden Years Homestead Inc., Fort Wayne

Officers: Dale Dean, Gary Martin, Mark Tullis, Michael Carpenter and Thomas Garman

Most recent change in ownership: None

Status: Nonprofit

Administrator: Thomas Garman

Hire date: July 1, 1973

Beds: 105

Census: 96 as of Nov. 14, 2005

Most recent annual survey: Nov. 18, 2005

In substantial compliance? No

When compliance met: Dec. 16, 2005

Deficiencies found in Levels D-L**: 6D, 1F

D Level:

♦Facility failed to follow its policies related to use of restraints. One resident was clothed in a one-piece jumpsuit-type garment to keep the resident from defecating and urinating in inappropriate places, but staff failed to see the garment as a type of restraint, even though the garment limited the resident’s ability to toilet herself.

♦There was no medical reason for the above-mentioned resident’s restraint garment, and restraints were not part of the resident’s care plan.

♦Failed to keep one resident with degenerative disc disease free of pain.

♦Failed to serve food that was attractive and at acceptable temperatures; nine of 11 residents questioned by surveyors said food was not hot.

♦Failed to keep trash receptacles covered in order to maintain sanitary conditions.

♦Failed to ensure staff washed hands properly to prevent spread of infection.

F Level:

♦Failed to ensure staff used gloves when giving insulin injections and during administration of medicine into a resident’s feeding tube; staff also failed to follow protocols of giving medicine through a feeding tube and to properly dispose of loose medications.

Substantiated complaints in 2005: None

Previous year: None

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

The Cedars: 1 hour, 16 minutes

Statewide average: 1 hour, 18 minutes

National average: 1 hour, 12 minutes

For nursing assistants:

The Cedars: 2 hours, 38 minutes

State average: 2 hours

National average: 2 hours, 18 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score, the better)

The Cedars: 75

Statewide average: 139

State licensure actions this quarter: None

Federal actions imposed: None

Lutheran Home

Address: 6701 S. Anthony Blvd.

Phone: 447-1591

Owner: Lutheran Homes Inc.

Officers: Lawrence Moeller, John Peterson, Robert Meyer and Craig Linnemeier

Most recent change in name: Oct. 7, 2005; formerly was Lutheran Homes Inc.

Status: Nonprofit

Administrator: William Langschied

Hire date: Feb. 26, 2001

Beds: 377

Census: 188 as of Dec. 13, 2005

Most recent annual survey: Dec. 16, 2005

In substantial compliance? No

When compliance met: Jan. 15, 2006

Deficiencies found in Levels D-L**: 9D, 1E

D Level:

♦Failed to release restraints on two residents to enable them to sit close to the dining table.

♦Failed to investigate alleged abuse of one resident by another; records showed during one night, a male resident several times touched a female resident’s body while she was sleeping, scaring her so much she “hid in the hall bathroom.”

♦Failed to assess and implement a care plan to treat and manage one resident’s decreased bowel and bladder continence and another resident’s nutritional needs.

♦Failed to ensure that nursing and trained medication staff properly administered medications to residents, and failed to ensure doctor’s orders for monitoring food and drink intake and output of another resident. In one case, a qualified medication aide, or QMA, attempted to give one resident a medication by mouth that was to be given only through the resident’s feeding tube. The QMA said she was from a staffing agency and had worked in the facility only three days.

♦Failed to ensure infections were accurately and thoroughly assessed for two residents with infections; in one case, no documentation was given for four days regarding care of a sore on a resident’s foot. The resident later required admittance to a hospital for the infection. In another situation, a resident with visible pus around his urinary catheter went almost 24 hours without change in treatment because the doctor did not return nursing staffs’ phone calls. After the new medication was ordered, there was no further documentation regarding the infection.

♦Failed to follow policies and procedures to manage increased urinary incontinence of one resident.

♦Failed to ensure one resident with dementia and significant aggressive behaviors was given needed psychosocial services to adjust to the facility.

♦Failed to adequately monitor and document several residents’ responses to psychiatric medications.

♦Failed to ensure licensed staff prevented medication errors. Surveyors found staff caused medication errors for more than one of every 20 administrations.

E Level:

♦Failed to provide care plans that addressed moods and behaviors for 20 residents in a secured dementia unit; social services staff frequently documented no mood or behavior changes noted, even though nursing staff documented such things as hitting, pinching, wandering and refusal to take medicine. In one case, a male resident with paranoia and a habit of pulling his pants down and exposing his genitals had no regular documentation for addressing his moods and behaviors; in another case, a resident with a history of suicidal attempts and thoughts had no documentation of weekly visits and observations by social services staff. One resident slept in a chair in the lounge because she said her room was “haunted,” yet the unit coordinator for that resident was unaware of the situation.

Substantiated complaints in 2005: None

Previous year: 4

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

Lutheran Home: 1 hour, 44 minutes

Statewide average: 1 hour, 18 minutes

National average: 1 hour, 12 minutes

For nursing assistants:

Lutheran Home: 3 hours, 46 minutes

State average: 2 hours

National average: 2 hours, 18 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score the better)

Lutheran Home: 156

Statewide average: 139

State licensure actions in past year: None

Federal actions imposed: Federal civil money penalty of $150/day imposed Feb. 7, 2005, ended April 20, 2005

Miller’s Merry Manor

Address: 5544 E. State Blvd.

Phone: 749-9506

Owner: Miller’s Health Systems Inc., Warsaw

Officers: V. Richard Miller, R. James Miller, Barbara Miller, Gregory Spaulding, Patrick Boyle, Lori Haug and Beverly Marshall

Most recent change in ownership : None

Status: For profit

Administrator: Alan Grossnickle Jr.

Hire date: Jan. 6, 2003

Beds: 77

Census: 73 as of Nov. 7, 2005

Most recent annual survey: Nov. 10, 2005

In substantial compliance? No

When compliance met: Dec. 12, 2005

Deficiencies found in Levels D-L**: 8D, 1G

D Level:

♦Failed to assess whether a resident with Parkinson’s disease who had trouble swallowing was allowed to give herself her own medications; a nurse left the medicine with the resident and resident’s spouse, although there were no doctor’s orders for self-administration.

♦Failed to promote care in a manner and environment that maintains each resident’s dignity. A nurse pulled back a resident’s covers and pulled up her shirt, then gave medications in the resident’s feeding tube without ever speaking with the resident. When the nurse left the room, she left the resident’s shirt pulled up.

♦Failed to revise the care plan for two residents with psychiatric needs. A psychiatrist recommended socialization for one resident, but there was no plan put in place for at least five months after admission; in another case, a resident with a large bed sore did not want to turn in bed, as was on the care plan, to allow the sore to heal. A psychiatrist’s evaluation stated staff should work with her to set mutual goals, but no such behavioral intervention was found in the chart.

♦Failed to ensure use of a hand splint as prescribed by a doctor for one resident. Five months after the resident’s care plan called for use of the splint, the staff said the splint was lost and was not being used.

♦Failed to weekly and monthly monitor use of antidepressant medications and symptoms of depression for one resident.

♦Failed to provide large-handled eating utensils for a resident with Parkinson’s disease, although the resident’s care plan called for the adaptive equipment.

♦Failed to ensure staff washed their hands for at least 15 seconds, as is the facility’s infection control policy, after direct contact with residents; in one situation, a nurse failed to wash her hands before donning gloves to give medication through a feeding tube.

♦Failed to accurately and completely document doctor’s orders for a resident’s change in insulin dosage.

G Level:

♦Failed to ensure one resident received the correct dosage of insulin. The error caused severe low blood sugar and use of emergency medication. When the resident’s roommate’s insulin dosage was changed by a doctor, that change was written on the other resident’s chart. Instead of getting 6 units of insulin, the resident who had a low-blood-sugar crisis had received 70 units.

Substantiated complaints in 2005: None

Previous year: One

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

Miller’s: 1 hour, 14 minutes

Statewide average: 1 hour, 18 minutes

National average: 1 hour, 12 minutes

For nursing assistants:

Miller’s: 2 hours, 1 minute

State average: 2 hours

National average: 2 hours, 18 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score the better)

Miller’s: 101

Statewide average: 139

State and federal licensure actions this quarter: None

Transitional Care Unit of St. Joseph Hospital

Address: 700 Broadway

Phone: 425-3940

Owner: St. Joseph Hospital/Lutheran Health Network

Officers: James Shelton, Donald Fay, Robert Frutiger, Michael Silhol and Burke Whitman

Most recent change in ownership: July 1, 1998; formerly Ancilla Systems Inc.

Status: For profit

Administrator: Rebecca M. Henry

Hire date: Nov. 6, 1989

Beds: 21

Census: 9 as of Oct. 19, 2005

Most recent annual survey: Oct. 21, 2005

In substantial compliance? Yes

Deficiencies found in Levels D-L**: None

Substantiated complaints in 2005: None

Previous year: None

2005 findings:

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

TCU of St. Joe: 7 hours, 41 minutes

Statewide average: 3 hours, 30 minutes

National average: 2 hours, 36 minutes

For nursing assistants:

TCU of St. Joe: No nursing assistants used

State average: 2 hours, 36 minutes

National average: 2 hours, 36 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score the better)

TCU of St. Joe: 5

Statewide average: 139

State licensure actions this quarter: None

Federal actions imposed: None

Towne House Retirement Community

Address: 2209 St. Joe Center Road

Phone: 483-3116

Owner: Baptist Homes of Indiana Inc., Zionsville

Officers: Richard Keenan, James McDaniel, Roger Miller, Margaret Larr and Marjorie Pauszek

Most recent change in ownership: none

Status: Nonprofit

Administrator: B. Daniel Carr

Hire date: Nov. 11, 1985

Beds: 6 of 107 comprehensive care beds are licensed as Medicare beds; none is licensed for Medicaid; all but the six are private pay and do not fall under federal nursing home regulatory guidelines.

Census: 6 (of 6 Medicare beds)

Most recent annual survey: Oct. 27, 2005

In substantial compliance? Yes

Deficiencies found in Levels D-L**: None

Substantiated complaints in 2005: None

Previous year: None

2005 findings: None

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

Towne House: Not available

Statewide average: 3 hours, 30 minutes

National average: 2 hours, 36 minutes

For nursing assistants:

Towne House: Not available

State average: 2 hours, 36 minutes (Medicare beds only)

National average: 2 hours, 36 minutes (Medicare beds only)

National Nursing Home Compare Score (based on three years of data):

(the lower the score the better)

Towne House: 0

Statewide average: 139

State licensure actions this quarter: None

Federal actions imposed: None

Regency Place of Fort Wayne

Address: 6006 Brandy Chase Cove

Phone: 486-3001

Owner: Kindred Nursing Centers Limited Partnership, Louisville, Ky.

Officers: M. Suzanne Riedman, Richard Lechleiter and Richard Chapman

Most recent change in ownership: May 1, 1998; formerly Hillhaven/Indiana Partnership

Status: For profit

Administrator: Susan K. Ebbing

Hire date: Oct. 13, 2000

Beds: 160

Census: 144 as of Nov. 29, 2005

Most recent annual survey: Dec. 6, 2005

In substantial compliance? No

When compliance met: Jan. 1

Deficiencies found in Levels D-L**: 1D, 1E

D Level:

♦Failed to properly administer an aerosol medication to a resident with chronic obstructive pulmonary disease.

E Level:

♦Failed to have care plans to address four residents’ behaviors. In one case, a woman with dementia had a history of inappropriate sexual behaviors and was also at risk for running away from the facility. She had, on more than one occasion, stroked the hands of visiting men, including spouses of patients, but the facility had no written plan as to how to intervene to decrease these behaviors. Another resident had asked a nursing assistant to sit on his lap so he could “feel her all over.” He made the same request of another staff member. He grabbed a nursing assistant’s breast and put his hands between another assistant’s legs, yet for nearly four months after admission to the facility, there was no written plan to address the behaviors.

Substantiated complaints in 2005: None

Previous year: None

Federal Quality Initiative scores:

Staffing hours per resident per day for licensed nursing staff:

Regency Place: 1 hour, 10 minutes

Statewide average: 1 hour, 18 minutes

National average: 1 hours, 12 minutes

For nursing assistants:

Regency Place: 1 hour, 53 minutes

State average: 2 hours

National average: 2 hours, 18 minutes

National Nursing Home Compare Score (based on three years of data):

(the lower the score the better)

Regency Place: 52

Statewide average: 139

State licensure actions this quarter: None

Federal actions imposed: None