Nursing Home Fined; Admissions Barred

By Walter F. Roche Jr.

A Nashville nursing home has been fined $15,000 and barred from admitting any new patients after an inspection showed multiple violations of state and federal laws and regulations.
Records show that dozens of patients of the facility needing critical maintenance medication went multiple times without getting doses of drugs for diabetes, hypertension and convulsions.
The fine  and admissions freeze was imposed on the  Nashville Metro Care and Rehabilitation, formerly know as Crestview Health and Rehabilitation, located at 2030 25th Ave. in Nashville.
The action was announced by Tennessee Health Commissioner John Dreyzehner. The nursing home has 111 licensed beds. The suspension followed an on-site inspection from Aug. 21-28.
Dreyzehner said a special monitor has been appointed to oversee the operation of the facility in the interim.
The state inspectors found violations in three general areas; physician services, nursing services and medication administration.
The 65-page inspection report cited multiple sanitation and maintenance problems including  pervasive urine smells.
One nursing home worker told an inspector, "The urine smell is between (room) 204 and 205. It's not as strong as it usually is."
The report shows the home had long term staffing problems and at times only a single registered nurse was on duty for an entire shift. It often relied on staffing agencies, but home administrators could not produce a contract with those agencies.
The staffing shortage, inspectors found, led to multiple missed medications for dozens of patients on life sustaining drugs.
When a nursing home administrator was asked about the persistent staff shortage, the response was, "I feel like you caught me with my pants down."
The report cites the home for failure to respond when an unattended patient fell out of bed. The patient's hip fracture was not detected until several days later. According to the report the facility failed to notify the patient's doctor or his legal representative.
The nursing home employee who discovered the patient on the floor told inspectors she didn't know how to enter the incident into the computer system.
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