By Rebecca Rider
rebecca.rider@salisburypost.com

SALISBURY — The Brian Center is seeking a review from the N.C. Department of Health and Human Services regarding recent alleged non-compliance with federal standards, Brian Center spokesperson Annaliese Impink said in a Friday e-mail.

Thursday, the Post received a public notice from the U.S. Centers for Medicare and Medicaid Services that the long-term care facility would be cut off from program funding beginning Sept. 11. The notice cited non-compliance with particular standards as a reason for the break.

While Impink did not specify which standards the center allegedly failed to meet, she said that staff at the Brian Center have worked to correct the issue. The center requested that the Centers for Medicare and Medicaid Services approve a review and inspection visit by the N.C. Department of Health and Human Services.

“The center is currently awaiting that visit,” Impink said.

A change of remedy imposition notice obtained from the Centers for Medicare and Medicaid cited several alleged instances of non-compliance which caused “immediate jeopardy to residents’ health and safety, and substandard quality of care.”

Three compliance surveys, filed March 11, April 11 and May 6, detail specific incidents, which were compiled into a single report resulting in the center’s loss of funding. The notice also mentions a June 17 compliance survey, which is identified as the straw that broke the camel’s back. The Post has requested a copy of the survey from the Centers for Medicare and Medicaid Services.

The March report details two incidents. In one, a female resident was left sitting on a bedpan for more than an hour. When no nurse came to remove it, the resident tried to do so herself and spilled the contents on the bed and herself. According to the report, it took more than 30 minutes after for someone to come help her clean it up.

The other incident involved one resident sexually assaulting a female resident who was cognitively impaired. The accused resident was a registered sex offender — a fact which, according to the report, was not given to the Brian Center by the transferring hospital until after the resident had been admitted to the facility.

According to the report, he had exhibited several inappropriate sexual behaviors towards staff and residents before being found in “a sexual altercation” with the female resident.

The notice also lists an April incident where a nurse call button was not placed within easy reach of a resident, and a May event in which a resident was discharged from the Brian Center without a Home Health care provider, and without proper instruction on how to care for his tracheostomy. Five days later, he was seen in the emergency room for complications resulting from lack of medical care for his tracheostomy.

Also cited in the May report is an incident in which a cognitively impaired resident escaped from a locked unit in the Brian Center by climbing out the window.

According to the Centers for Medicare and Medicaid site, all non-compliance issues were addressed and corrected — a fact noted in the imposition notice.

“While corrective action taken by your facility removed the immediate jeopardy, conditions in your facility remained out of substantial compliance with program requirements,” it reads.

The Sept. 11 funding cut-off date is based off of the March 11 report.

“We must terminate the Medicare provider agreement of any facility that remains out of substantial compliance six months after its initial survey identifying noncompliance,” the notice reads.

The Brian Center has also been paying a civil money penalty since Feb. 25, according to the notice. Penalties began at $10,714 per day between Feb. 25 and March 10, before being reduced to $6,394 per day between March 11 and May 5. On May 6, the fine was $205 per day, before spiking back up to $6,394 per day on June 12. On June 17, it reverted to $205 per day.

“This (civil money penalty) will continue to accrue until the facility corrects the deficiency and achieves substantial compliance or is terminated,” the notice said.

According to the notice, all penalty fees are being held in an escrow account. The Brian Center has also been under instruction since April 20 to deny Medicare and Medicaid payments for new admissions.

Now, the facility waits for a state review — one management hopes will be positive.

“The management and staff of the Center have worked diligently to correct the alleged violations and we believe that the Center will be found in substantial compliance during the next visit by the State regulators,” Impink wrote.

Should the state rule that the facility is within compliance, the Brian Center will get the green light to continue providing Medicare and Medicaid. And if it’s not?

“If we are not found to be in compliance, we may be decertified and we would have to decide at that point how to proceed,” Impink said.

Contact reporter Rebecca Rider at 704-797-4264.