Mt. Juliet nursing home faes 43 citations

A Mt. Juliet nursing home ordered to stop accepting new patients has been cited for a total of 43 deficiencies in its last two state inspections – far above the number of infractions found at other facilities of similar size in the area, records indicate.
Mt. Juliet Health Care Center on Mt. Juliet Road was cited for 21 deficiencies in its most recent inspection by the state health department, which was conducted last April. In its 2002 inspection, the facility was cited for 22 infractions, according to reports compiled by state and federal agencies.
The 43 deficiencies cited during the two-year period seems to be far above the number of infractions found during the same time period at other area nursing homes of comparable size, according to the figures.
The 106-bed Mt. Juliet Health Care Center was ordered by the state to stop accepting new patients on Thursday amid an inquiry into resident care, including a case in which a diabetic patient died, officials said.
A spokesperson for a management company which apparently oversees the facility said Friday officials are "considering all the options" as they prepare a response to the state's findings, which is required by law. The company is considering an appeal of the decision barring it from accepting new residents, the spokesperson said.
The facility's 43 infractions over the two-year period seem to compare poorly with nursing homes of similar size in several nearby towns. As an example, the 100-bed Beverly Healthcare in Gallatin received only 23 infractions during the same two-year period, the same number cited at the 100-bed Boulevard Terrace Nursing Home in Murfreesboro. A 100-bed Westmoreland facility received 21 deficiencies during the same two-year period while a 112-bed Portland nursing home was cited for just 10 infractions over the two-year time span.
Though the facility has clearly experienced problems with its state inspections over the past couple of years, the issue of its ownership is somewhat hazier.
Mt. Juliet Health Care Center Inc. is listed as the owner of the facility in state records but "management and consulting services" are provided by Tennessee Health Care Management of Parsons, according to the company's general counsel, Jeff Parrish.
Parrish would not identify the principals of Mt. Juliet Health Care Center Inc., describing it only as "a private corporation with stock owned by another corporation which is not subject to the state surveys or anything related to it."
He said Tennessee Health Care Management provides management and consulting services to several other nursing homes in the Midstate but declined to identify any of them. He said he didn't want the company's other clients linked to news reports about the Mt. Juliet facility.
Parrish did not respond directly when asked to explain the seemingly high number of deficiencies at the Mt. Juliet facility in comparison to other area nursing homes, though he noted Mt. Juliet Health Care Center has employed "three different administrators" over the past two years.
"I'm not in the operations department and they could better explain that," Parrish said. "I do know there has been three different administrators there in that time, and in each instance, none of the new administrators was brought in because a prior administrator had been terminated."
Under state law, Mt. Juliet Health Care Center is required to file a response to the state inspection findings, including a corrective plan of action. The plan can either be accepted or rejected by state officials, who have already imposed a $3,000 penalty against the facility in addition to recommending federal fines of $3,050 per day until problems found in the recent inquiry are corrected, officials said.
A state health department spokesperson has said the "complaint investigation" of the facility which was recently completed focused primarily on patient care including whether four diabetic patients received proper treatment. One patient later died, the spokesperson said.
"There was one patient who died," the state health department's Diane Denton remarked Thursday.
In addition, the inquiry also touched on instances of "physicians not being informed of patient condition changes" as well as cases where nursing home workers failed in "following physicians' orders" when treating patients, she said.
A state-appointed monitor will review activity at the facility while the nursing home prepares its response, Denton said. She added that if corrections are not made by April 23 the facility could lose its certification to receive Medicare and Medicaid funding – generally the death knell for nursing homes "unless they have a large number of private paying patients."
Parrish said officials of his company were "still reviewing" the state's inspection report yesterday but emphasized that many of the findings may later be discounted by state officials.
"It's quite possible that when we file our plan of correction we will be found to be in compliance on a number of these issues," he said.
He said officials have already started work on its plan of correction and pledged its submission to the state "will be timely" though he could not speculate on a time frame for the report's completion.
"There are several different steps we could take and one of the steps is relatively short, this could all be completed in a couple of months," Parrish said.
The inspection scores at Mt. Juliet Health Care Center first came to light in a 2003 investigation into area nursing home inspections by The Lebanon Democrat which identified the facility as one of the area's most-cited such facilities, one of two in Wilson County that seemed to be cited for infractions at a higher rate than other comparable nursing homes.
In response to that article, the facility's then-administrator, Sam Brasili, expressed confidence that Mt. Juliet Health Care Center would fare much better in future inspections and pointed to a $100,000 renovation then underway as proof of the facility's commitment to its residents.
Parrish confirmed yesterday that Brasili is no longer the administrator of the facility but said he remains employed by Tennessee Health Care Management.