Carson Care Home Faces Loss of Funds

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A Carson City care home where six patients died Dec. 9 should get no Medicare reimbursement for new patients after Jan. 17 because of a failure to address six problems by a reinspection, state officials recommended.

The problems at Evergreen at Mountain View included an infection control matter that had the potential to do more than minimal harm to patients, said Diane Allen, state health facilities surveyor supervisor.

The Nevada Health Division's Bureau of Licensure and Certification recommendation must be approved by the federal Centers for Medicare & Medicaid Services to take effect, Allen said.

The bureau's routine annual Oct. 17 inspection of Evergreen turned up 24 deficiencies under federal law and five deficiencies under state law.

Reinspections on Dec. 9 and 10 showed Evergreen failed to fix six problems, including ones involving quality of patient care, resident behavior, facility practices and infection control.

"They have made significant improvement, but they are not in compliance," Allen told the Reno Gazette-Journal.

Doug McCoy, regional operations manager for Evergreen, said the December reinspection showed no substandard patient care and no violations that threatened lives.

The facility is developing a plan to fix the six problems, he said.

"We believe we will be in compliance with all the federal regulations before Jan. 17," McCoy said.

The federal Centers for Disease Control and Prevention has been investigating the cause of the six Dec. 9 deaths at Evergreen.

There has been no link made by investigators to any of the problems identified in the October inspection.

State epidemiologist Randall Todd thinks as many as four of the six deaths could be influenza-related.

McCoy said Evergreen has addressed the problems brought to its attention, and no one has died there since Dec. 11.

"The actions we have taken coupled with the recommendations from the CDC have basically at this point prevented any further ilness from occurring," McCoy said.

Among other problems, the October inspection found that some patients were not receiving appropriate treatment for pressure sores, and there was no program to assess bowel and bladder problems.

The facility also was accused of failing to follow its own policy to monitor involuntary weight loss by patients, and of failing to provide adequate fluid to properly hydrate four of 26 patients used in the sample.

McCoy said a fly problem around ovens and a garbage can has been fixed.