Surprise Valley Healthcare District
 Day of Reckoning

By Barbara March

The head nurse and a licensed vocational nurse at the Surprise Valley Health Care District (SVHCD) have been fired in the wake of a blistering state health department survey charging the district’s skilled nursing facility with failure to comply with both state and federal regulations.
   
“It is our opinion that the administration of this facility is inadequate to guarantee the health, safety and well being of the residents of the skilled nursing facility,” Yvonne Mulcahy of the California Department of Public Health informed district board members, hospital administration staff and members of the public at the conclusion of the state’s review of the hospital’s skilled nursing facility in May.    
   
Board members present were Bunne Hartmann, Jim Laacke and Cindy Linker.

Immediately following the report, Director of Nursing Audrey Wood and LVN Laura Gorzel were terminated and charged with violating district policy and failure to comply with federal and state regulations.
   
Mulcahy and her team cited the skilled nursing facility with negligence and failure to provide a safe environment for residents, staff and the public. Resident patients were not being treated with respect and dignity in their personal care, there was a failure to establish a conservator for a patient, failure to have a registered nurse sign and certify that a patient’s assessment was accurate and complete, and failure to revise a patient’s health care plan to accurately reflect treatment.    
   
Specifically referring to patients’ bed sores, the critical report charges that health care plans were not revised to include a change of condition or the ordered treatment of a dressing change every three days. Weekly skin assessments were not completed for all residents.
   
In addition, the state team said the skilled nursing staff failed to administer medications and treatments as ordered for several residents.
   
Mulcahy read a precise list of patients’ identifying numbers and the specific violations for each patient, making it clear to the district board that closure of the skilled nursing facility was a valid possibility, according to a member of the public present at the interview who requested anonymity based on the sensitive nature of the subject.
   
The state health department’s findings are the result of 10 investigations of the skilled nursing facility last year and another three earlier this year.
   
The hospital district’s administration was put on notice last year by the state to correct the same deficiencies that they are being told to rectify this year -- that’s why the state is threatening closure, according to sources familiar with the investigation.
   
Ignored or down-played in the past by the district administration, the state’s review far exceeds patient care and includes poor food handling, infection control, sanitation, deteriorated decking on a patio used by skilled nursing residents, floors in need of repair, duct tape as a replacement for a faucet handle, improper storage of combustible materials, penetrations in the ceiling of the boiler room, failure to hold or document disaster drills, failure to test or document testing of the sprinkler system, failure to document inspection of kitchen hood fire suppression, use of portable space heaters, an inaccessible exit, and improper use of extension cords and power strips.
   
Required by the state, the district has submitted two plans of correction, one for the skilled nursing facility and the other for health, safety and fire regulations.
   
If the plans are accepted the survey team will return to ensure the plans are being carried out according to state regulations. If the plans are not satisfactory the hospital risks closure.
   
“We damn well better have things fixed and programs underway toward a solution before then,” said Laacke. “Health and safety come first.”