Albany -- Health officials say county facility's policies fail to prevent patients from falling and getting hurt

By CATHY WOODRUFF, Times Union Staff writer

First published: Friday, December 28, 2001

State inspectors have found lapses in patient care at the Albany County Nursing Home that they say have led to serious injuries of some residents and are endangering others.

As a result, the nursing home's executive director has resigned.

In a letter delivered to County Executive Michael Breslin on Dec. 21, the state Health Department cited five deficiencies in the nursing home's policies and procedures for determining whether patients were at risk of falling and for preventing them from taking falls.

From its findings, the department declared patients to be in "immediate jeopardy'' and requested immediate correction of the deficiencies.

Because of the nursing home's failure to carry out proper preventive procedures, the Health Department found, at least four residents fell, including one 75-year-old woman who died on Nov. 24 after she was hospitalized for injuries sustained during a fall six days earlier, said Health Department spokesman John Signor.

Breslin announced Thursday that Donna Brown, the executive director of the county's two nursing homes, has resigned at his request.

"The safety and health of the residents of our nursing home must come first,'' Breslin said in a statement. "The residents, their families and the public must have confidence in the management team, and it has become clear to me that a change is necessary.''

State monitors remain at the 460-bed nursing home, completing a survey begun last month as a result of a complaint. They will issue within two weeks a full, formal statement of deficiencies found, Signor said.

The state has recommended suspension of Medicaid and Medicare reimbursements, starting Dec. 26, for new patients at the Albany Shaker Road facility in Colonie until the immediate jeopardy finding is corrected, and a fine is likely to be imposed when the state's survey is complete, Signor said.

A spokesman for Breslin said the county hired an outside consultant, as required by the Health Department, on Monday and began in-house efforts to correct the deficiencies on Dec. 21.

Breslin requested the resignation from Brown on Wednesday. Brown, who has been executive director of operations at the county nursing home and the 175-bed Ann Lee Home since 1996, resigned from her $80,000-a-year job on Thursday, said James Plastiras.

Thomas Coffey, the nursing home's administrator, was appointed interim executive director, and the county has begun a nationwide search for Brown's permanent replacement.

A county source said the state's notification last week capped a series of complaints about inadequate management at the nursing home and apparent inaction by Brown. Those complaints have included concerns about unsupervised patients wandering away from the building or from familiar parts of the building, the source said.

The county nursing home was found to have problems after a routine inspection in February. At that time, state health officials cited the facility for "corrections needed,'' in the area of dietary services, quality of care and resident rights.

During a follow-up inspection in May, the facility was in compliance, according to state records.

Since beginning their current survey of the nursing home on Nov. 27, state inspectors found that the nursing home was not assessing new patients to determine whether they were at risk of falling, perhaps because of weakness on one side or a history of falls, Signor said.

There also was no effort after patients fell to determine why they fell, and precautions weren't taken to prevent initial or repeat falls, he said.

In their letter to county officials, investigators noted four incidents that could have been prevented with proper procedures. In the case of the woman who died, no evaluation was done to determine whether she was likely to fall. Thus, she did not have adequate supervision when her neurological symptoms worsened, the department found.

In another case, a resident twice sustained broken bones in recurring falls, according to the Health Department, and two other residents sustained minor injuries in falls.

The county has hired a Long Island-based health care consultant, Myra Peskowitz, to help correct the immediate problems, protect patient safety and minimize any losses from suspended Medicare and Medicaid reimbursements for newly admitted patients, Plastiras said.

Medicaid payments average $140 a day per patient, and Medicare payments are triggered by the individual medical treatments and therapy sessions received by a patient. In an average week, the nursing home receives six new patients, about five of whom might be eligible for Medicaid.

"We have a plan in place to address the deficiencies, and we're hoping the period without payments will be brief,'' Plastiras said. In the meantime, he said, the county will not turn away any new patients.

The Albany County Nursing Home is at 85 percent capacity with 360 beds filled, Plastiras said. The Ann Lee Home has just over 20 empty beds.

Brown was hired by the county in the summer of 1996 after Breslin chose not to approve continuation of the nursing home's former longtime executive director, Robert J. Lynch. Brown most recently had been vice president for geriatric and support services and nursing home administrator for Wayne Community Hospital in Wayne County. She also was administrator of the Blossom View Nursing Home in Sodus, also in Wayne County.

source:  Albany Times Union