Officials have cut federal assistance to new patients at the Robbinsdale Rehab and Care Center because of the errors and failure in care that included those that led to two patient deaths.
In a potentially devastating move, state regulators have cut off Medicare and Medicaid funding for all new patients at a Robbinsdale nursing home after inspectors discovered critical treatment errors, including neglect that culminated in the deaths of two residents.
Robbinsdale Rehab and Care Center must fix its problems by Jan. 7 or regulators will extend the funding ban to all patients, a move which has forced other nursing home operations out of business. Six facilities in Minnesota were hit with temporary funding restrictions in the last year.
"This is a very serious situation," said Darcy Miner, director of the compliance monitoring division at the state Department of Health.
Amy Wiffler, the home's acting administrator, said that she believes she has addressed the government's concerns.
"Our utmost concern is the care and safety of our residents," said Wiffler, regional operations director for Extendicare, which owns the 123-bed facility.
Inspectors have visited the facility three times since a July survey turned up 29 deficiencies, including failing to respond to signs of distress in two residents who later died. It has been fined $3,000 and denied federal reimbursement for new patients since Oct. 7. Regulators have also sought federal approval for imposing an additional $24,300 in fines for six days in which residents were in immediate jeopardy of being harmed by medication errors.
The nursing home caters to a mostly younger population with mental health and substance abuse problems, as well as traumatic injuries.
In October, the state cited Robbinsdale Rehab and Care Center for failing to discharge a healthy patient who was being kept in the home against her wishes. Isabelle Jessich, 56, who was the subject of an August report in the Star Tribune, was released Dec. 1 after spending more than a year at the facility.
Jessich was originally hospitalized for treatment related to chronic alcoholism, but her court-appointed guardian wouldn't let her go home, even after Jessich's doctor said it was safe for her to leave the facility.
"We regret that this court placement took so long to resolve and are pleased the resident has continued her recovery," Wiffler said.
Jessich didn't know the home had been penalized until informed by a reporter Friday.
"Everything was ignored totally for months and months and months," said Jessich, now at home with her 17-year-old daughter in Edina. "This could drive somebody crazy over there."
History of violations
Robbinsdale Rehab has far more violations than most Minnesota facilities, which were cited for an average of 10 deficiencies in 2008. Inspectors found 19 violations at Robbinsdale Rehab in 2007, 25 in 2008 and 37 so far in 2009. Some of this year's violations harmed residents, inspectors concluded.
The most serious problems involved two unnamed residents who died after mistakes were made by nursing home employees.
A female resident was showing signs of a possible heart attack, including increasing back pain, low blood oxygen, low blood pressure and cold clammy skin. But staff members failed to quickly notify her doctor, even though the facility's medical director acknowledged that the resident was displaying four "red flags" of distress. The resident was found dead in her bed on Feb. 2.
More critical errors occurred on July 2, when a male resident in the dining room was found "shaking" and unresponsive in his wheelchair. Alarmed staff members immediately reported the incident to nurses, but no one called an ambulance for five hours. He died on the way to a hospital.
Despite warnings, administrators have failed to correct many of its problems. In October, regulators noted that 10 deficiencies noted in July had not been addressed, and they found another critical violation related to the mishandling of narcotic painkillers involving seven residents.
One of those residents was taken to the emergency room on Sept. 22 after a nursing home employee mistakenly gave him dangerously high doses of painkillers. In the days before his hospitalization, the resident was showing obvious signs of distress, including feeding an imaginary dog from his plate, seeing bugs crawl up the walls and wondering aloud where he was.
A subsequent investigation determined that 120 tablets of Oxycodone were missing from the nursing home's allotment for the resident.
Miner said Robbinsdale Rehab should be able to correct its problems. Asked whether residents are in danger, she responded: "At this point, all I can say is I certainly hope not. That's why our staff is there."
Staff writer Warren Wolfe contributed to this report.