COLONIAL HEIGHTS, Va — Colonial Heights Rehabilitation and Nursing Center faces new enforcement actions from health regulators after an updated inspection resulted in additional citations involving care and safety issues.
In March, inspectors with the Virginia Department of Health (VDH) paid another visit to the nursing home to follow up on a previous inspection from December and January that resulted in 340 pages of violation findings, which revealed excessively low staffing at the facility, inadequate wound care, and medication errors.
In a letter announcing the results of the follow-up inspection, VDH said it expected the nursing home to come back into regulatory compliance, like the facility claimed it had done, but the agency's revisit discovered otherwise.
At the time of the March inspection, the number of residents living at the facility was 139, a decline from 186 residents recorded just three months prior when Colonial Heights Police charged more than a dozen employees with crimes in connection to an elder abuse investigation.
During the inspection, health officials said five complaints were investigated, and all of them were substantiated. Here are some of the findings:
Inspectors said the nursing home failed to report an allegation of abuse in a timely manner after a resident and nurse aide got into an argument and the staff member allegedly pushed the resident so hard he fell off the bed. The resident told inspectors he felt "helpless" and cried about the incident the next day.
Another staff member who witnessed the resident crying said they reported the incident to the administrator but said "no one had done anything" about it. The administrator told inspectors she felt at first there was "nothing to report." However, after the resident made a complaint to police, she notified law enforcement and state authorities.
Prosecutors told CBS 6 no charges were filed. The inspection noted the resident was not injured.
For another resident, the facility was cited for failing to ensure he received physician ordered treatments for worsening pressure ulcers. The patient, who had six pressure ulcers on his body, told inspectors he preferred that two nurses to do his treatments due to how many wounds he had but claimed they would refuse to get assistance. The resident alleged nursing staff would argue with each other to avoid changing his wound dressings.
But staff, including the medical director, reported the resident refused care on multiple occasions. One staff member reported that the doctor wanted to send the resident to a hospital because of the worsening conditions of the wounds and "possible sepsis," but the resident did not want to go. The medical director stated staff tried to obtain a medical emergency custody order so he could receive advanced care, but it was denied.
In another case, a resident sustained two falls, yet inspectors said the facility failed to develop and implement resident-specific interventions. The facility documented that it would provide the resident with a reacher, however there was no reacher observed in the resident's room and the resident reported he did not know what a reacher was. The report stated that staff also inaccurately documented that they had made contact with the resident's family member to alert them of the falls, however inspectors said they never made contact with the family member. Facility staff reported they attempted to, but the family member's phone line had been disconnected for months.
The facility was also cited for failing to maintain one-on-one supervision of a resident with mental health impairments and a known history of making unwanted sexual advancements on other residents. The man in question was documented to have put his hand up a resident's gown and touched another resident's breasts and asked for a kiss, among many other reported incidents. Facility staff said they've been trying to find a new placement for the individual but said it's been difficult.
Facility spokesperson Mindie Barnett told CBS 6 in a statement that these latest violations were lower level in terms of severity and did not place residents in immediate jeopardy or actual harm. VDH described the severity of the citations as "a pattern deficiency that constitutes no actual harm with potential for more than minimal harm that is not immediate jeopardy."
"In each case corrective action was taken and submitted to the Virginia Department of Health for its approval. Approval was given and the corrective actions were completed. Corrective action plans included resident referral for guardianship, various types of resident audits, education and re-education of staff, notifications to healthcare providers, residents being placed on one-to-one supervision, and the reporting of allegations to law enforcement. While Colonial Heights and many other skilled nursing facilities strive for perfection people are human and do make mistakes," Barnett said. "The importance is that no harm occurred, corrective action was taken, and the dedicated staff of Colonial Heights continues to work both hard and competently to provide for the health, safety, and welfare of its residents in the face of intense scrutiny."
The Centers for Medicare and Medicaid Services (CMS), the federal regulator of nursing homes, said in a letter it began fining the facility $1,295 per day starting in December and would begin denying Medicare and Medicaid payments for new admissions if it did not come back into regulatory compliance within three months. According to the CMS oversight database, an enforcement action of mandatory denial of payments has been entered into the record but Barnett said the facility has not received any such notice at this time.
However, Barnett said a denial of payments would have no impact as the nursing home voluntarily stopped accepting new residents after most of its nursing staff were arrested in an effort to "consolidate its resources and support its unwavering commitment to care for its residents."
"It is believed that Colonial Heights is in substantial compliance with all regulations and is awaiting its resurvey to confirm," Barnett said.
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