ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Thursday, March 13, 1997 TAG: 9703130057
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
DATELINE: CLIFTON FORGE
SOURCE: SANDRA BROWN KELLY THE ROANOKE TIMES
By next week, the home should get its license cleared of deficiencies and be able to take in new residents. Seven are on the waiting list. The home also expects to be recertified to receive reimbursement from Medicaid.
Inflatable Easter bunnies lounge in chairs outside Shenandoah Manor Nursing Home, and, in the dining room, sisters Ida Harlow, 86, and Clare Johnson, 89, exchange a little good-natured ribbing while tracing tulip blooms on red and yellow construction paper.
"Yes, we've always gotten along right well," Harlow said when asked about being roommates at this stage of their lives.
"But some time, you get so mad you just don't know what to do," she adds, and grins.
"I've had to lend her a lot of money," Johnson responded.
"Well, when are you going to give me some more?" Harlow replied.
All thoughts at this 60-bed facility are good-spirited these days and not just because it's nearly spring. It appears Shenandoah Manor will be able to stay in business.
By next week, the home should get its license cleared of deficiencies and be able to take in new residents. Seven are on the waiting list. The home also expects to be recertified to receive reimbursement from Medicaid, which pays part of the cost for 16 of the 26 men and women who currently live there.
In November, the state Department of Health yanked the 6-year-old home's license after it failed a series of inspections. Twenty employees were laid off, and the current owner, Lenox Healthcare Inc. of Pittsfield, Mass., said it's losing about $80,000 a month.
And with only 26 residents, the facility could never be profitable, administrator Angela Baldwin said.
Baldwin has been in charge since July, coming from a Lenox facility in Hot Springs "that hardly ever got deficiencies" in surveys, she said.
The inspection Shenandoah Manor passed this month was its best in five years, Baldwin noted.
"We have a beautiful home here," said Lucie Lawson, a retired teacher who moved to Shenandoah three years ago. She is 85 and regularly goes outdoors to walk.
Lawson said relatives who visit her from New England and New Zealand rave about the home.
"I've never been mistreated," Lawson said.
Money seems to be at the root of the home's woes.
Lenox took over Shenandoah Manor at the request of the bank that backed bonds issued for construction of the intermediate-care facility. The home filed for bankruptcy reorganization and is waiting for the plan to be accepted. Lenox then hired Colonial Care management of Roanoke to straighten out the problems.
The facility had suffered for years from a lack of operating cash. Payroll checks bounced. It was a tribute to the staff that they kept working with no pay, Baldwin said.
"We stuck through it for the residents," said Martha Workman, a certified nursing assistant at the home for six years. "We knew it would get better."
When the paychecks bounced, employees even had to pay banks $3 to handle the bounced checks, Elizabeth McDaniel said. Like many of her co-workers, McDaniel is a native of the area. She's from Covington and started work as a certified nursing assistant four years ago, at age 68.
"It's going good now at the home," McDaniel said. "We just love our little administrator."
Baldwin, a native of Clifton Forge, just smiles at the reference to her diminutive stature, and also perhaps her age - 25.
Baldwin has a degree in health services administration from James Madison University. She took the job with Springs Nursing Center in Hot Springs because it was close to home.
"I'm here to stay," she said. "But I've learned a lot in eight months."
The facility was on probation and waiting for the results of its most recent survey when she arrived. Generally, nursing homes are inspected annually, except when there are problems. Then they're visited every three months.
When the survey results came in, the home was still out of compliance. It was cited for excessive use of restraints, for lack of activities and for inadequate documentation of nursing care. It also was told it could not accept new Medicaid patients.
"The first thing I had to do was to write a plan of correction," Baldwin said.
The home was reinspected in November.
"We were pretty confident we were going to pass that one," she said.
But Shenandoah didn't pass.
In November, it lost its Medicaid certification and was given one more chance to rectify problems or lose its license completely. The facility had 48 residents at the time, and 21 moved out because they were afraid the home would be closed and they wouldn't be able to find new quarters.
Activities director Joann Anderson's mother was one of the residents who moved. She's now on a waiting list to return.
Nellie Layne, a resident for two years, stayed through the problems. She'll be 93 in September and had lived alone for many years "until I started falling and breaking everything," she said.
Layne has broken her knees, wrists, ribs and shoulder, but not her spirit; she refused further surgery to correct the shoulder problem because it's working "pretty well" the way it is.
"I feel like I'm at home," she said.
In her private room, she is surrounded by her books and mementos.
Down the hall, Robin Brown was reading a book about Alzheimer's disease and preparing for next Wednesday's support group meeting. She is 79 and has a heart condition that made it difficult for her to live alone.
Brown's late husband suffered from Alzheimer's, and she holds group discussions on the disease for residents and relatives the third Wednesday of each month.
Brown misses her roommate, though. The woman moved when the home got the November inspection that threatened its closure.
The inspection report gave the home deficiencies for:
Failing to contact the physician of a resident who fell and fractured her toe.
Using siderails on the beds of two residents.
Improper posting of a previous plan of correction.
Failing to document that one resident was treated for head lice that she got from a staff member.
Baldwin and consultants wrote another plan of correction outlining plans to lower the siderails or lower the beds of residents in danger of falling. Also, futon-type beds were to be placed on the floor beside one bed to cushion the resident in case she fell. The plan also called for staff training to emphasize documentation policies.
A week ago, the home was reinspected, and Monday, Baldwin got the results.
The home was no longer classified "substandard" because of continuing problems, but it had two deficiencies. A visitor complained that he had been barred from the facility after a disagreement with a family member who was a resident, and response was too slow to an alarm designed to alert staff when a resident with a fractured hip tried to get up.
The new plan of correction will include the schedule for training all staff on answering personal alarms, Baldwin said. Also, a member of the ombudsman team from the LOA Area Agency on Aging will counsel the family member and resident, and Baldwin will get involved.
"I don't know how to act now," Baldwin said after learning the home passed inspection. "Everybody here has been so stressed."
LENGTH: Long : 142 lines ILLUSTRATION: PHOTO: JANEL RHODA THE ROANOKE TIMES. 1. Ida Harlow (left) andby CNBher sister Clare Johnson (right) help Shenandoah Manor's activities
director, Joann Anderson, make tulips and other spring decorations
for residents' rooms at the Clifton Forge nursing home. Spirits are
high at the 60-bed facility, which should remain in business now
that the administration expects to have deficiencies cleared from
the home's license. 2. Nellie Layne naps peacefully in her room at
Shenadoah Manor. 3. (headshot) Baldwin. color.