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* This article first appeared in The Times Herald-Record on July, 18, 2001. Used by permission.



Health department cracks down on nursing home

GOSHEN: Residents of a county-run nursing home are in danger, according to the state Department of Health.

By Beth Quinn
The Times Herald-Record

The 520 people living at the Orange County nursing home where a 94-year-old woman was scalded to death two weeks ago are in "immediate jeopardy."
The state Department of Health reached that conclusion after an investigation into the June 29 scalding of Frances Thein of Port Jervis at the county's Residential Health Care Facility on Quarry Road. She died July 4 as a result of being placed in 180-degree water during a bath.
The "immediate jeopardy" designation means that the nursing home "has deficiencies that have caused or are likely to cause serious harm, injury, impairment or death if not immediately rectified," according to the DOH.
At a press conference yesterday, County Executive Joseph Rampe assured legislators that steps would be undertaken right away to fix the problem.
"We have a situation that places residents in harm's way," said Rampe. "It needs to be rectified immediately."
While residents can remain at the nursing home for the time being, Medicaid and Medicare payments for new admissions will be denied as of today, according to the DOH.
If the dangerous water heating system isn't repaired to the DOH's satisfaction by Aug. 8, Medicare and Medicaid payments for all residents will be terminated. In effect, that means the nursing home would be shut down because the majority of residents are covered by one of the two federal insurance programs.
The DOH investigation showed that, despite the knowledge that dangerously fluctuating water temperatures have long been a problem, nursing home staff failed to inform the maintenance department or administrator Carl Kelly.
Nurses and aides, however, maintain that they tried repeatedly to draw attention to the problem. But Rampe said no repair requests turned up in the investigation.
Even so, at least one legislator said he could not understand why Kelly was unaware of what appears to have been a long-term problem.
"I'm not yet calling for anyone's scalp," said Middletown Democrat Jeff Berkman, "but you'd like to think that the director of a facility knows what's going on inside."
The problem has its origins in the fact that the water heating system was not built in accordance with original design requirements. The plumbing also did not meet specifications when the Couser building, where Thein lived, was modified in 1997, according to Michael Muray, a Fair Lawn, N.J., engineer hired last week to inspect the plumbing.
As a result, 180-degree water used in the kitchen and laundry was able to pass through a valve into residential bathing areas.
Muray outlined nine steps the county needs to take to ensure residents' safety, including the installation of a new hot-water circulation pump, an expansion tank, a variety of shut-off and mixing valves and an alarm system.
Rampe said eight of the repairs would immediately get under way. He estimated the cost would be $200,000. In addition, the county is purchasing nine new bathtubs with anti-scalding devices for about $94,000.
Rampe said the ninth recommendation in Muray's report to completely separate the kitchen/laundry hot water system from the residential system is being studied.
"That one would be costly and would involve the closure of the building while it's being done," he said.
Rampe said it is also likely that "some disciplinary action will be taken" after he's finished "reviewing who should have done what and didn't."
One nurse has already been fired because the DOH investigation showed that, as a result of a paperwork delay, she's not licensed by the state. She was the unit supervisor on the floor when the scalding took place but was not at her post at the time. Another LPN answered the call for help, instead.
A separate investigation by the state police on behalf of county District Attorney Frank Phillips is not yet complete. But Phillips said there appears to be "no reasonable likelihood that criminal charges will be brought in the case."
Nursing home workers have said that their jobs are more difficult because the facility suffers from short staffing and rapid turnover.
Kelly said yesterday that of the 350 nursing and aide positions at the facility, 27 jobs 19 aides and nine nurses were technically unfilled yesterday. However, 10 aides have recently been hired and are expected to begin work any day.


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