Monday, October 27, 1997
Coronado Nursing Center disputes punitive action
By BETH HALLMARK Staff Writer
When state officials cut off Coronado Nursing Center's Medicaid
and Medicare coverage last month, it was a substantial blow to
the Abilene nursing home.
Citing Coronado's failure to meet minimum health and safety
standards, the Texas Department of Human Services announced in
September that the center would lose the benefits for at least
30 days.
Though Coronado's coverage was reinstated this month after
a site visit revealed "substantial compliance" with
standards, the nursing home lost two weeks of Medicaid and Medicare
payments - a sizeable amount with about 85 percent of its 235
beds covered by the programs.
"We felt like it was an unfair punishment," said
Cyd Lane, center administrator. "It was very extreme."
DHS first recommended that Coronado lose its coverage in June
when a site visit recorded numerous deficiencies. DHS observers
noted several patients with pressure sores, understaffed nurses
and inadequate infection control precautions, records show.
Though the problems were found to be satisfactorily corrected
at a follow-up visit, other deficiencies were noted and the center's
coverage was terminated, said Charline Stowers with DHS' long-term
care unit in Austin.
"Once you're on a termination track, you're not taken
off just because you corrected the more serious problems,"
Stowers said.
Most of the state's nursing homes are certified for Medicaid
and Medicare patients, Stowers said, and homes failing to correct
deficiencies can lose coverage.
"It's the most effective punitive tool we have,"
Stowers said. "Our goal is to ensure proper care."
But Lane contends the new deficiencies found at Coronado were
minor, involving mainly "paperwork on a policy and procedure
relating to infection control."
"It had nothing to do with the quality of care,"
Lane said.
Coronado appealed the termination and settled with the Health
Care Financing Administration in early October to reduce the amount
of time the center would lose Medicaid and Medicare reimbursements.
However, Coronado will not recoup the two weeks of payments
it lost. And Lane said the state's action contributes to the public's
poor view of nursing home care.
"The image people have of nursing homes is very negative,"
Lane said. "It's very discouraging and it lowers our employee
morale. We need to have good homes recognized."
Jewell Pierce, whose 80-year-old husband has been a patient
at Coronado for three years, was surprised the facility was the
subject of scrutiny.
"I was concerned, of course," Pierce said. "But
I was also upset that this happened to the nicest, cleanest nursing
home in town. It's the best place I could have my husband.
"How could they pick them out to pounce on?" she
said.
J.C. Gibson admitted his 84-year-old mother to Coronado last
month after looking around at other homes.
"The last thing I wanted to do was put my mom in a nursing
home," Gibson said, "but it had to happen.
"I couldn't ask for better care than she's had at Coronado,"
he said. "She's improved a lot since she has been there,
it's a noticeable difference."
And there are other satisfied customers. James Lacey's mother-in-law
has been at Coronado for five years.
"We've been very happy with the care she's received there,"
Lacey said. "We've never had any problems other than minor
things that could happen anywhere."
But compared to other nursing homes in Abilene, Coronado has
had significantly more complaint allegations filed with DHS in
the past year.
Though Lane characterizes the number of allegations as "excessive,"
she counters that most are found to be unsubstantiated. And because
Coronado is twice the size of most nursing homes, Lane said it
has more complaints because it has more clients.
Bob Strauss moved his mother out of the Coronado this summer.
Strauss said his 87-year-old mother, who suffers from Alzheimer's,
incurred several head injuries while at the nursing home.
Strauss also said the nursing center's staff failed to notify
him after one of the injuries and gave him conflicting accounts
of what caused the head wounds.
"I felt like I couldn't leave her there," Strauss
said.
Out of 179 complaint allegations filed against Coronado in
the past year, DHS substantiated 38 deficiencies. None were problems
that placed residents in immediate jeopardy, records show.
DHS' long-term care unit investigates complaints of regulatory
violations reported by family members, residents or nursing home
staff.
But other state offices can also take action against the industry.
In 1996, Texas Attorney General Dan Morales sued Coronado for
deceptive business practices.
Morales' suit alleges Coronado misrepresented itself in a promotional
brochure, which stated the center protected the rights of patients
without admitting that DHS had found deficiencies.
The suit was one of 20 the attorney general's office filed
against nursing homes across the state last year. Though some
of the cases have been settled, Coronado's case, filed in 42nd
District Court, remains pending.
State attorneys have "done virtually nothing," on
the case, said attorney Carla Cox, whose firm represents Coronado.
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Abilene Reporter-News / Texnews / E.W. Scripps Publications
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