It’s been a week since the State of Alaska took the rare step of assuming control of Prestige Nursing home in Anchorage. State inspectors found dozens of violations during a visit to the facility. And the state says the nursing home had plenty of prior warning that it needed to improve.
Over the past two years, state inspectors have spent a lot of time inside Prestige Care and Rehabilitation Center of Anchorage. The facility has logged four times the number of complaints as Providence Extended Care, a similarly sized nursing home in the city.
So for the nursing home’s annual recertification review earlier this month, state and federal inspectors decided to show up on a Sunday morning, unannounced. Margaret Brodie is the state’s director of health care services.
“We typically don’t go in on a Sunday but we did in this instance, because anything that was wrong would show on a Sunday,” she says.
The inspectors talked to administrative staff, they pored through patient records and interviewed every single one of Prestige’s 98 residents. The investigation took about a week. And the results were alarming. Brodie says inspectors found 50 violations, eight in the most severe category: immediate jeopardy.
“We were surprised at the number,” she says. “It was extremely high.”
At the end of the inspection the department decided to take the unusual step of assuming temporary management of the facility. The inspection report is not yet public. In the past, Prestige has been cited for things like inadequate nursing care, failing to provide medication to patients, and for numerous problems with call lights and call light response times. Given the volume of complaints against Prestige the health department has investigated over the past two years, Brodie says the company had plenty of warning to correct problems before they escalated to the point of state management.
“What’s happened with Prestige is we write up what their issues are, they put in a corrective action plan, and they work it for a while, and then they kind of stop and then they go right back to where they were,” she says. “And I think the reason for that is that they bring in outside help to correct all the deficiencies and then the outside help leaves.”
Prestige Care is a for-profit corporation based in Washington state. They own 36 nursing homes across the western U.S. and 42 other senior facilities, like assisted living and independent living homes. They bought the Anchorage facility in 2009, after the state took over management from RainDance Healthcare Group following an inspection that likewise revealed potentially dangerous conditions.
Buffy Howard oversees ten nursing homes for Prestige Care in the west. She wouldn’t address whether the company was concerned about the number of complaints the facility has received over the last two years.
“There’s not a way to say that there were more complaints than normal but it’s something we continue to look at in quality improvement,” she says. “Each state is different in the amount of citations that are average. Each building is different on what is a normal amount of ‘tags’ so I can’t really comment on the specifics on that.”
Prestige has already corrected five of the eight violations the recertification inspection uncovered in the ‘immediate jeopardy’ category. The company has until June 4 to correct the other three, which Howard describes as “overarching” administrative problems. She is confident Prestige will meet the deadline.
“We do take these findings very seriously and the safety and welfare of our residents is our priority; it’s always our number one,” she says. “This is a big deal and we understand, and we’ve heard the state and we’re working together, very closely together, to fix and improve.”
Margaret Brodie, with the state, says one thing inspectors found is that Prestige didn’t have enough staff to adequately care for patients. In response, she says the company has added another nurse at night. Overall, she’s pleased with the progress Prestige is making. So is Noel Rea, the interim administrator hired by the state to oversee the facility.
“Prestige has marshaled a lot of resources in here in terms of training and education and that’s been impressive. And I’ve seen a very clear and visible response to the survey and the decision to put in interim management,” he says.
Prestige will be subject to state and federal fines and is paying for Rea’s salary.
Brodie and her staff want to ensure the changes Prestige puts in place to get its full license back won’t evaporate when corporate leaders return to Washington. They’re focusing on making sure local staff are adequately trained to maintain high quality care.