Evergreen Mountain View Health Care had other problems before four patients died of an alleged respiratory illness Dec. 9.
On Oct. 17, an inspection by the State Bureau of Licensure and Certification found 25 deficiencies, including: n Based on record reviews, four of 26 patients did not receive proper hydration.
n The facility failed to ensure appropriate treatment to prevent urinary tract infection or to restore as much normal bladder function as possible for five of 26 residents.
The number and type of deficiencies resulted in a second inspection on Dec. 10-12, said Diane Allen, the supervisor responsible for Medicare compliance at Nevada's Bureau of Licensure and Certification.
"When we conducted the reinspection Dec. 10, we found just six deficiencies, so the facility had improved significantly," Allen said. "After the first inspection, Mountain View implemented a number of changes, but they're still not in compliance."
The final report from the December inspection won't be out until January, but Allen said no deficiencies were found that could directly link the deaths to Group A beta-hemolytic streptococcus.
The organism was found in cultures taken from a number of Mountain View patients with upper-respiratory infections. It is the common denominator linking the deaths of at least two of the four patients.
Health Division officials have been in contact with Mountain View officials several times a week following the inspections. On-site monitoring will continue through Thursday, Allen said.
"We will have to do another survey," she said. "Mountain View will have to be compliant six months after the first inspection was completed (Oct. 4), or lose their Medicare reimbursements."
Doug McCoy, regional operations manager for Evergreen, said none of the deficiencies were life-threatening.
"Those identified in the October survey have been corrected, with the exception of a few isolated issues," he said.
Based on observations, interviews and medical record review during their October inspection, state health officials reported Evergreen failed to have sufficient staffing.
McCoy said staffing was not identified as a problem in this month's inspection. Health-care staffing is a concern in Northern Nevada, and the company has been aggressively hiring and recruiting over the past several months.
Allen agreed.
"This is a true nursing shortage, documented over and over again, and it's not just Evergreen," she said. "These are 24-hour operations, not clerical positions. The work is difficult and demanding, and the pay is minimal. It's very hard to recruit and retain (certified nursing assistants)."
Contact Susie Vasquez at svasquez@nevadaappeal.com or 881-1212.
