Omaha World Herald
3/8/08

Agency: Beatrice is out of chances

#The state-run care center was given an extra year to clear up problems, federal officials say.

By Martha Stoddard
WORLD-HERALD BUREAU
LINCOLN — Federal health officials say they have bent over backward to try to keep the Beatrice State Developmental Center from losing $28.6 million in Medicare and Medicaid funding.
"We have gone significantly above and beyond" in working with the facility, said Jennifer King, a regional administrator for the U.S. Department of Health and Human Services' Centers for Medicare and Medicaid Services.
Though most institutions are given six months to comply with federal care standards or risk losing federal funds, King said, federal officials had given the Beatrice center 18 months — since September 2006 — to comply.
Still, the center had failed to meet four of eight federal standards by Friday's deadline.
Federal funding continues only because the state filed an appeal. No date for an appeal hearing had been set, King said. But Nebraska officials contended Friday that they had made a good-faith effort to improve the facility for people with mental disabilities and that the institution was in substantial compliance with federal standards.
Chris Peterson, chief executive officer of the Nebraska Department of Health and Human Services, said she believes a federal inspection completed this week showed that the state-run institution is headed in the right direction.
"Our goals are both the same: the safety See Beatrice: Page 2


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Beatrice: Cutting off funding is rare, officials say

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and quality of life of patients," she said of the state and federal governments. "Where we are in the process, we might have disagreements on."
Bruce Mason, litigation director for Nebraska Advocacy Services in Lincoln, disputed state officials' assertions of improvement.
Mason said his independent nonprofit group has been monitoring conditions at the Beatrice center and continues to see residents suffering serious injuries and fractures. The center also continues to have a significant number of worker vacancies.
"They don't seem to have a handle on it," Mason said of HHS. "They're appealing the (funding) decision to buy more time. The problem is, they've had years to bring it into compliance, and they've yet to do it."
The federal inspection concluded that the Beatrice center had failed to meet the federal standards on client protection, facility staffing, active treatment services and governing body and management.
The inspection team also found three cases of "immediate jeopardy," a citation used when there are risks of serious harm, injury, impairment or death that call for immediate action.
Such risks may have occurred in the past or present or are likely to occur in the very near future. All three citations were corrected by Thursday afternoon.
King said it was "very uncommon" for the federal government to cut off funding to an institution such as the Beatrice center. It's so uncommon, she said, she didn't know exactly how the process would be carried out.
Federal officials gave more flexibility to Nebraska and the Beatrice center because of the number of people who live there and the difficulties that would be created by the loss of federal funding.
The Beatrice facility has 308 residents with developmental disabilities. Many of the center's residents also have physical disabilities.
The number of residents is down from 329 in December and from about 370 in September 2006.
John Wyvill, developmental disabilities director for HHS, said the goal is tomove 100 more people out of the institution by the end of this year.
Gov. Dave Heineman has been kept informed about the situation but is leaving the matter to HHS officials to handle, said his spokeswoman, Jen Rae Hein.
"The governor has confidence in his directors and the employees that are working diligently to solve what the feds refer to as 'failures,' despite the continual bashing they take," Hein said.
"The governor recognizes that this is a long-term challenge and is counting on the (Beatrice) team to keep the focus on providing quality care for the residents."
Hein referred to a July statement in which Heineman said improvements in care at the Beatrice center were among his top 10 priorities for the newly reorganized HHS.
That followed a "very frank discussion" he held with the chief executive officers of all staterun, 24-hour care facilities in October 2006. The meeting was called after the Beatrice center and the veterans home in Omaha both failed federal inspections.
"I wanted them to hear directly from me the leadership I expect from them and their facilities," Heineman said at the time.
State Sen. Norm Wallman of Cortland defended the Beatrice center and said federal inspectors have been "picking on" the century-old institution.
Wallman said Beatrice employees have been doing a good job, especially considering the number of vacancies and the amount of overtime they have been required to work.
The center could be headed for even more difficulties in coming months: It is under investigation by the U.S. Justice Department.
Mason said litigation on behalf of Beatrice center residents also was a possibility.
"The governor has confidence in his directors and the employees that are working diligently to solve what the feds refer to as 'failures,' despite the continual bashing they take."
Jen Rae Hein, spokeswoman for Gov. Dave Heineman

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Copyright (c) 2008 Omaha World-Herald 03/08/2008


Recent troubles at Beatrice
The State Developmental Center houses about 300 people with mental retardation and other disabilities. Violations include: Cited for three "immediate jeopardy" violations in September 2006 and one in May 2007. The violation means there are risks of serious harm, injury, impairment or death.
Failed to meet four of the eight federal requirements for receiving Medicare and Medicaid funding in November 2007:
# Protecting clients from harm.
# Providing active treatment services for residents.
# Having sufficient staffing.
# Providing adequate governance and management.
Failed to meet same four standards last month.
Cited on three more cases of "immediate jeopardy."