Rock Haven nursing home expects to pay $92,827 in fines

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Catherine W. Idzerda
January 5, 2015

JANESVILLE—State regulators have fined Rock Haven $136,350 for failing to meet state standards during two inspections last fall.

That amount likely will be reduced to $92,827, and perhaps even more if an appeal is successful, Rock Haven Administrator Sue Prostko said.

The fines arise from two state inspections at the nursing home in September and October

At the time, surveyors cited Rock Haven for issues including failure to document certain kinds of medication changes, failure to protect residents' dignity and failure to follow proper hand-washing procedures.

The most serious offenses involved what state surveyors saw as a lack of treatment for a pressure sore on a large toe that became severely infected and eventually had to amputated, according to a report from the Department of Health Services.

The patient was being seen at a wound care clinic, and Rock Haven employees were following the clinic's instructions, Prostko said.

For more than a month last fall, Rock Haven did not admit new patients while staff worked to fix deficiencies, and those lost patient days will impact its budget, as well, county staff said.

In a memo to Prostko dated Dec. 9, Rock Haven finance director Dave Sudmeier estimated that lost revenue from empty beds would amount to, at most, about $250,000.

Prostko said the fine amount will be reduced from $136,350 to $92,827 by the simple expedient of signing a wavier. Regulations allow a nursing home to appeal a fee at the federal level. By agreeing not to do so, a nursing home can have its fines reduced up to 35 percent.

Prostko plans to appeal the fine at the state level on a hardship basis. Because Rock Haven is supported by county tax dollars, she felt it was important to do so, even though it's unlikely she will win.

For 2015, the tax levy for Rock Haven was $4.18 million.

The money for the fines will come from the Rock Haven fund balance, a kind of rainy-day fund that is used to offset costs at the home. In years when the nursing home does well, money goes into the fund.

The fund has an estimated $2.7 million, finance director Sherry Oja said.

Prostko and her staff have put new procedures in place to prevent future problems.

Changes include more audits of patient charts, additional training for staff and more patient education on the risks and benefits of certain treatments.

When a resident refuses a basic treatment, such as being moved every two hours or taking a medication, he or she will be told the benefits of receiving the treatment and the risks of refusing it.

“We want the residents to be able to make informed choices,” Prostko said.

If a patient continues to refuse the treatment or care, he or she will be asked to sign a statement to that effect.

“It's a fine line,” Prostko said. “We want to make sure residents know exactly want the risks are, but we have to honor the residents' rights to make decisions.”

Those decisions must be documented.

Rock County Administrator Josh Smith said he believes Rock Haven has the right leadership and staff in place to do the job.

“I don't want to down play the importance of this,” Smith said. “And yet we do think that we have a quality facility.”

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