Rock Haven still not in compliance

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Wisconsin Department of Health Services-Division of Quality Assurance officials visited Rock Haven Nursing Home Tuesday and again found compliance issues.

This comes after the home voluntarily suspended admitting new residents until the inspection team clears it.

In a decision he deemed “fiscally responsible,” Rock County Administrator Josh Smith said the state could have opted not to reimburse the nursing home the $300 a day, or 60 percent of costs, for new Medicaid and Medicare residents admitted after the initial survey. According to state officials, it isn’t unusual for homes to wait until being cleared before admitting new residents.

“We will deny admissions until the state clears us,” said Rock Haven Administrator Sue Prostko. “At this point, the state is not going to reimburse us for new residents. The only pay source we could admit is private pay.”

The home was cited on seven different deficiencies including notifying procedures for injury, health decline or change in room. The surveyors found issues with the home regarding consent for giving medications with black box warnings, such as Xanax and Prozac. However, that issue has been resolved, Prostko said.

The law states that anyone who is given these medications must provide written consent from the resident or a person acting on behalf of the resident, on a department form. Consent for medication must be updated when medication dosages are changed or every 15 months.

The deficiency that remains unresolved is treatment and prevention of pressure sores.

In a previous plan of correction filed with the state, the Rock Haven officials proposed using pressure reducing devices for chairs, pressure relief mattresses, pressure relief boots, repositioning every two hours, barrier cream with each brief change in its plan to address the problem. All licensed and certified staff have been trained to follow this care plan.

Proskto said Rock Haven’s average for residents with sores is 10 percent, while the national average is at 11 percent.

“We did have provisions in place to prevent that issue. The state felt we should be doing more or something different,” Smith said.

Proskto said she thinks the underlining issue remains with documentation of services. Rock Haven is looking into hiring a consulting firm to help gain approval.

“It’s a process that we’re still working on with the state,” Prostko said.

The home will submit an Informal Dispute Resolution, which states the disagreement with citations. If found not in compliance following further review, the home would need to submit a corrective action plan to the state before another visit can be scheduled. State surveyors have now visited the home three times over the last three months, beginning Aug. 17.

The home will be fined, once cleared by the state for every day it was not in compliance. The fine could be as much as $800 a day from Sept. 3 until compliance.

Smith said not admitting new residents doesn’t have a large impact financially on the facility at this time.

“In the short term, it’s not a huge impact,” Smith said.

There are only seven empty beds in the facility which holds 126.

“We don’t budget for it being entirely full,” Smith said. “(In the proposed) 2014-2015 budget, we have budgeted for 124 beds being used.”

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