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State fines Brian Center

BY NATASHA ASHE
SALISBURY POST

The penalty already has exceeded $13,000.

Because of the problems, the state won’t authorize Medicaid funding for any new patients for the center on Statesville Boulevard, Denise Rogers-Murray, of the state’s Licensure and Certification Section, wrote in a letter to the Brian Center on Aug. 20.

In that letter, Rogers-Murray said the center has until Sept. 2 to submit a plan for correcting the problems. If the center doesn’t substantially comply by Oct. 11, the center could stand to lose all Medicare and Medicaid funding for its patients.

State officials said they had received complaints and found problems on two unannounced visits on April 12-14 and June 9-10. In a third visit on Aug. 9-10, state inspectors found some of the same problems.

In the Aug. 20 letter, Rogers-Murray said the Brian Center had not corrected previous violations. The letter continues: “However, based on our revisit conducted Aug. 9-10, we found the most serious deficiency in your facility to be isolated deficiencies that constitute actual harm that is not immediate jeopardy...”

The report said six of 13 complaints were substantiated.

In a written statement sent to the Post on Friday evening, Brian Center Administrator Deborah Mathis said: “The BrianCenter of Salisbury has taken a number of steps to make the necessary improvements here and to address the regulatory concerns reported in the state’s surveys.”

The report, included in the Aug. 20 letter, documents the day and approximate time of surveyors’ visits to residents’ rooms. In some cases, they noted a problem at one time and found the same problem when they returned several hours later.

Some of the deficiencies in the report noted that many of the residents exhibited “dirty” nails and neglect of patients’ hygiene. For instance, the inspectors said some residents laid in their waste for several hours, and beds remained unchanged, which caused some to smell.

One resident commented: “I wear a diaper, but they don’t come to check on me every two hours during the day. All that I know is that I’m soaking wet by the time they get here. I don’t like being wet, but I don’t have a choice. I just feel bad.”

The report also said the Brian Center did not always provide adequate “Quality of Care” to a few of its residents. The state defines Quality of Care as necessary services — good nutrition, grooming and personal and oral hygiene — for a resident who is unable to carry out activities of daily living.

The report gave specific examples based on 11 of 20 sampled residents. Several residents possessed long, dirty fingernails, including one resident who had a “brown dried substance” underneath his finger nails, before and while he ate.

In another instance, the lips of at least two residents were dry and cracked and remained that way from 12:55 p.m. until 5:47 p.m. when officials returned. And still another resident’s lips were in the same condition, and inspectors noted a “white matter” on the side of his mouth and face.

Several of these residents were those who were totally dependent on staff for care. Staffers reported to the state officials that some of the residents refused care, but in at least one of those cases, the staff did not properly document the refusal on paper.

Some residents complained that several employees of the Brian Center “have an attitude” when they come to take care of them and spoke to residents in harsh tones, the report states.

There were also problems cited when residents used their call bells to get employees’ attention for help.

One resident indicated when she rings the call bell, some of the staff say they can’t hear it. Or they hear it but don’t respond promptly. In one case, “it was determined that the light above the door that should light up when the call bell is pushed was not operating,” the state report said. As a result, the report said, in a few cases patients lay in their own waste for periods of time.

A Plan of Correction must be submitted to the Office of Licensure and Certification-Division of Facility Services by Sept. 2.

The state says the Plan of Correction must contain:

• How the center will correct problems for each resident cited.
• How the center will identify other residents who might be affected by the same deficient practice and what corrective action will be taken.
• What measures will be put into place or what systemic changes will be made to ensure that the deficiencies do not recur.

Mathis says the center is already working on steps to resolve the state’s concerns and have implemented several plans including:

• Weekly meetings with residents conducted by administrative staff.
• Daily interviews with residents conducted by caregivers.
• Creation of a “Quality Improvement Team,” which is working on improving call bell response time.
• Administrative nursing staff is working with caregivers on certain shifts.
• Supervisory rounds are done twice per shift by all department management and licensed nurses.
• Refurbished the east unit of the facility.

“We are committed to taking whatever steps are necessary to meet the standards our residents, employees and our senior management team demands,” Mathis said. “Compliance with the regulations is not enough; we need to meet our own, higher standards.”