While Montana State Hospital in Warm Springs has been singled out for failing to meet federal standards, another state-run healthcare facility is also facing challenges.
The Montana Mental Health Nursing Center in Lewistown remains rated by the Centers for Medicare & Medicaid Services as a two-star facility, which is below average. The Medicare.gov website notes that the facility has received two federal fines in the past three years totaling $166,875.
A CMS spokesperson said the Lewistown facility has not topped the two-star rating since 2018. In 2017, the state announced in a press release that the facility was rated five-star, the highest possible CMS rating.
State officials said in 2018 that one of the reasons for the lower rating was due to federal changes to nursing home requirements and said at the time they were confident in the administration of the establishment.
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The Department of Public Health and Human Services, which runs the 117-bed facility, had no comment.
A special committee meeting will be held on Friday to discuss the immediate danger status of Montana State Hospital in Warm Springs. The federal government recently issued an advisory to Montana State Hospital Administrator Kyle Fouts that it has until March 13 to correct noncompliance issues or it could lose funding. federal.
DPHHS is finalizing a $2.2 million contract with a third party to temporarily take over management of its health care facilities, including the state hospital and the Montana Mental Health Nursing Care Center. The Department of Contract Works plan lists challenges at the Lewistown facility, such as recent changes to federal long-term care certification requirements and labor issues related to the rural nature of the facility. ‘establishment. According to December figures from DPHHS, 30% of Lewistown’s 145 full-time positions are vacant.
The contractor will directly oversee the Lewistown facility, located at 800 Casino Creek Drive.
The Montana Mental Health Nursing Center is the only licensed residential facility in the state for the long-term care and treatment of people with mental disorders who require a level of care not available in the community, but who cannot benefit from the intensive psychiatric treatment available. at Montana State Hospital. Dianne Scotten is listed as an administrator.
However, the Montana Mental Health Care Center did not earn two stars in each of the three categories. It is rated five stars, or well above average, for staff and quality of resident care. But it gets one star, well below average, in health inspections, according to Medicare.gov.
The most recent inspection report posted online, dated August 4, 2021, revealed several shortcomings at the center, all of which were deemed to have a minimal level of harm and affect few residents.
Shortcomings included failing to provide effective infection control and prevention for COVID-19, failing to ensure residents were receiving prescribed regimens, failing to furlough an employee while a complaint for abuse was being investigated, failing to ensure that paid caregivers have the training they need and serving meals on disposable dishes.
The CMS website noted 11 health violations, indicating that the average number of violations is 8.1 in the United States and 6.1 in Montana.
According to the website, the health inspection star rating is based on each nursing home’s current health inspection and the two previous inspections, as well as the results of the last three years of complaint inspections and three years of infection control inspections.
The CMS spokesperson said there had been an immediate danger citation at the facility since 2018. The citation occurred during an inquest conducted on March 18, 2021. The previous inquest on February 4 2021 also identified an abuse citation at the facility, which it noted had a population of 74. An immediate hazard is a situation in which the supplier’s failure to meet requirements “has caused or is likely to cause serious injury, harm, impairment or death to a resident”.
The total civil fine assessed against the state-run facility for the two investigations was $146,875, the CMS spokesperson said. This fine was issued on February 4, 2021. However, the Medicare.gov website notes that there was also a $20,000 fine issued on August 3, 2021.
A status of immediate danger was filed against the center in March 2021, noting that a resident who had low blood sugar did not meet professional standards of care by nursing staff.
“The facility failed to immediately have backup glucose available for use in emergent critical situations involving blood glucose and hypoglycemic events,” the report states.
Staff started and then stopped cardiopulmonary resuscitation because the resident had a non-resuscitative status, the report said.
The center submitted a plan that included assessing the individual needs of all residents with diabetes, training nurses, and equipping all medication tables with 8 ounces of glucose and eight glucose tablets.
In February 2021, an investigation into the complaints was completed, which found that the center had failed to protect residents from abuse by another resident.
This included thrown cups and continued disruptions in the living room four to six days a week. A staff member said that when the resident had behavioral issues, all other residents were removed from the lounge instead.
The report noted that the resident would place his arms through the spokes of his wheelchair so that staff could not remove him to prevent him from endangering others. He would antagonize other residents almost daily, staff said.
Staff noted that the resident threw himself out of his wheelchair on December 15, 2020 and broke his ankle. A staff member refused to complete the necessary paperwork to use restraints.
A staff member told the investigator that she did not have the necessary training to deal with the resident.
“All the locals are walking on eggshells not to upset him,” she said.
Two other nursing homes in Lewistown, the Central Montana Nursing and Rehabilitation Center and Valle Vista Manor, both received five stars and remain well above average, according to the medicare.gov website.
Seaborn Larson of the Montana State News Bureau contributed to this story.
Associate Editor Phil Drake can be reached at 406-231-9021.