Diversicare of St. Joseph
The Missouri State Health Department and the Centers for Medicare and Medicaid Services (CMS) enforce regulations enacted by state legislatures and the US Department of Health and Human Services (HHS). When egregious violations and serious safety deficiencies are identified, the nursing home is placed on notice to make corrections quickly or suffer the financial consequences.
Sometimes, the underlying conditions causing many life-threatening deficiencies make it nearly impossible for the Administration and nursing staff to improve the problems significantly. Some nursing homes with months or years of safety issues and dangerous hazards are designated a Special Focus Facility (SFF) and placed on a Federal watch list with another hundred or so nursing centers nationwide. Information on this undesirable designation is publicly available, so families can determine where to place a loved one who requires the highest level of care.
In early 2017, the CMS and the state of Missouri designated Diversicare of St. Joseph as a Special Focus Facility. The Home’s addition to the federal Medicare watch list means the facility will need to make specific much-needed improvements to policies and procedures and how the nursing staff provides care to the residents. Likely, the nursing facility will remain on the list for years because they have yet to show substantial improvements, adjustments, and corrections as required by law.Diversicare of St. Joseph
The Long-Term Care Center is a 180-certified bed Facility providing cares and services to residents of St. Joseph and Buchanan County, Missouri. The “for profit” Home is located at:
3002 N. 18th St.
St. Joseph, MO 64505
In addition to providing short-term and long-term Skilled Nursing Care, the facility also offers:
- Short-term rehabilitation
- Respite care
- Hospice care
- Complex medical care
- Adult Daycare
- Life steps rehabilitation program
Regulatory agencies working for the federal government and the state of Missouri routinely issue monetary penalties to nursing facilities with identifying serious deficiencies and regulatory violations. Over the last three years, Diversicare of St. Joseph received a $21,100 fine issued on November 6, 2015. Additionally, on February 4, 2016, Medicare denied a request for payment from the nursing home due to substandard care.Current Nursing Home Resident Safety Concerns
The CMS and the state of Missouri routinely update the national Medicare.gov website with information gathered through surveys, inspections, and investigations on every nursing home in America. This data involves opened investigations, filed complaints, dangerous hazards, health violations, safety concerns, and incident inquiries. Also, the site provides a star rating summary system that can be used as an analysis tool to compare the level of care facilities provide in the community.
Currently, Diversicare of St. Joseph maintains a below average two out of five stars overall rating compared all other facilities in the US. This ranking includes one out of five stars for health inspections, four out of five stars for staffing, and five out of five stars for quality measures. Some of the safety concerns and health violations involving this facility are listed below.
Failure to Protect Residents from Staff Members Using Verbal Abuse
In a summary statement of deficiencies dated September 15, 2017, the state investigator noted the failure of the facility “to ensure all staff treated residents with dignity and respect when a Licensed Practical Nurse [LPN] continually treated residents rudely and disrespectfully in front of staff, other residents, and family members.” The investigator also noted the facility had failed to “ensure they respected the dignity of [one resident] when staff failed to assist the resident in obtaining [mastectomy] supplies.”
The investigator conducted a Group Interview on the morning of September 12, 2017, where residents told the surveyor that the Licensed Practical Nurse is “rude.” One resident stated that they were helping their “roommate to eat in the dining room [when the LPN] said in a bad and hateful tone that [they] should not help [their] roommate.” Another resident said that they had gone to “the nurse’s desk in severe pain and asked for pain medication.” The allegedly rude LPN “was not at the desk so [they] asked someone else. Later [the verbally abusive LPN] yelled at [them] and said from now on, you come to me and not ask anyone else.”
Another resident stated that the abusive LPN “usually works on days [and] is disrespectful, rude and very hateful when [the verbally abusive LPN talks] to residents.” A fourth resident stated that they were “trying to help another resident one day” when the verbally abusive LPN stated that “it’s none of [their] business to help others.” A sixth resident stated that the verbally abusive resident “has a bad attitude and is rude.”
An observation of the allegedly abusive LPN was conducted at 7:45 AM on September 13, 2017, while the nurse “sat in the assist dining room next to a resident while talking with another staff member across the table and not interacting with the resident.” The LPN “began talking very politely, cueing the resident, and interacting with other table residents upon… seeing the surveyor.
The investigator interviewed the facility’s Administrator that same morning who stated that “a lot of staff say [the allegedly abusive LPN] is mean to them.” The Administrator also stated that the LPN had fought with a Certified Nursing Assistant, caused him to punch a door, and he was sent home.”
The investigator reminded the facility of their January 2017 Service Standards Policy that read in part:
- “We exemplify teamwork and respect for relationships.”
- “We reflect a professional impression through appearance and behavior.”
- “We foster positive communication with our customers.”
- “Team members should be respectful of residents whether or not we agree with them or share their beliefs.”
- “Team members should be ethical by following all guidelines, service standards, loss, ethical business practices, and behaving in a manner that brings credence to the facility and the people we serve.”
Failure to Maintain a Safe, Clean and Comfortable Environment
In a summary statement of deficiencies dated September 15, 2017, the state investigator noted the facility’s failure “to maintain a clean, comfortable and homelike environment in the resident shower rooms.” It was also documented that the facility “did not have a policy for cleaning showers.”
An observation was made of the 200, 300 & 400 Halls shower rooms during the tour with the Director Nursing on the afternoon of September 13, 2017. Notable observations included:
- A very strong odor of fecal material;
- A bedside stand [with] a gallon jug the body wash sat on a towel saturated with body wash;
- A trash can holding four bags of soil briefs;
- A laundry hamper full of used linens;
- The shower floor felt sticky and damp.
- A very strong damp odor;
- An overflowing laundry hamper; a laundry hamper half full of used linens.
The surveyor interviewed a Certified Nursing Assistant a few minutes after the tour who stated about the shower room that they were “to clean the shower after each resident use.” The CNA stated that they “did not have time to do [their] work and clean the shower too.
Failure to Provide Incontinent Care at Acceptable Standards
In a summary statement of deficiencies dated September 15, 2017, the state investigator noted that the facility failed to “provide complete and proper perineal care for [two residents who are] dependent on staff for incontinent care.” Observations were made of a Certified Nursing Assistant on September 12, 2017, at 8:15 AM who failed to provide appropriate perineal care by the facility’s policies.
An additional observation was made of another CNA providing a different resident perineal care at 4:10 PM on September 13, 2017. The investigator noted that during observations of the CNA, the staff member failed to follow protocols and procedures to clean the resident correctly when providing perineal care. During an interview with the Director of Nursing on the afternoon of September 14, 2017, the Director said that “staff should clean in between the perineal folds and wash all areas which had been wet with urine.”
Failure to Provide Cares and Services to Prevent Urinary Tract Infections
In a summary statement of deficiencies dated September 15, 2017, the state investigator noted the facility’s failure “to ensure staff provides appropriate treatment and services to prevent a urinary tract infection [for a resident] with an indwelling catheter and a history of increased risk for developing a UTI.” The investigator also noted the staff’s failure “to obtain the laboratory results in a timely manner for the urinalysis and culture and sensitivity… tests to determine the type and amount of bacteria in the urine and medication to effectively treat the infection.”
The failure of the nursing staff to provide an appropriate level of care “resulted in a two-day delay in starting the appropriate medication to treat the urinary tract infection.”
Failure to Provide Every Resident Environment Free of Accident Hazards
In a summary statement of deficiencies dated September 15, 2017, the investigator noted the facility’s failure “to ensure staff and transferred [a resident] in a manner to prevent injury or the possibility of injury.” This deficiency occurred “when [they] failed to safely use a gait belt (a special belt placed around the resident’s waste to provide a handle during a transfer).”
An observation was made of a Certified Nursing Aide transferring a resident at 9:15 AM on September 13, 2017, after completing “perineal care on the resident and then set the resident on the side of the bed and transferred [them].” The CNA was observed wheeling “a wheelchair next to the bed and did not apply the brakes [nor apply] a transfer belt to the resident.”
At that time, two Certified Nursing Aides “assisted the resident to a standing position by holding onto [their] arms [who] stood and pivoted toward the wheelchair.” While the Aide assisted the resident during the transfer by holding and pulling upon the resident’s arms, the wheelchair began “to roll backward.” One Certified Nursing Aide quickly placed their “foot behind the unlocked wheelchair so it would stop rolling, and the resident assisted to the wheelchair.”
During an interview with the Director of Nursing on the morning of September 14, 2017, the Director stated that “staff should follow the caregiver information sheet when providing care and transfers for the resident.” The Director said the staff must “use a gait belt for fall risk residents when transferring [and] should not transfer a resident by [their] arms, waist or pants.”
Failure to Develop a Program That Investigates, Controls and Keeps Infection from Spreading
In a summary statement of deficiencies dated September 15, 2017, the state investigator noted the facility had failed to “ensure staff followed infection control protocols to prevent the spread of infection when staff did not wash her hands between blood changes during resident care.”
Failure to Provide Care to Residents Requiring Assistance with Eating, Drinking, Grooming or Personal Hygiene
In a summary statement of deficiencies dated April 10, 2017, the surveyor noted the facility failed “to provide perineal care in a timely manner to prevent [one resident] from lying in urine-soaked brief with urine-soaked washcloths an atoll inside the brief.” The investigator stated that “this put the resident at increased risk for skin breakdown and caused the resident to have a strong odor of urine. Staff also failed to assure residents received showers or bass according to their personal preferences in their plans of care.” This deficiency “affected six residents.”
In a separate summary statement of deficiency dated January 3, 2017, it was noted that the facility had failed to “assist three residents with brushing her teeth. This deficiency had the potential to affect any resident [who] requires assistance from staffed with oral care.” It was also noted that the staff “failed to put the call light [within] reach for [two residents].”
The investigator interviewed the Director of Nursing a 4:00 PM on January 3, 2017, who stated that “she expected staff to place the call light in an accessible place for residents to use and be able to call for assistance with activities of daily living when needed.” The Director also stated that “staff should brush or assist every resident with brushing their teeth daily when they wake up in the morning and as needed” to “provide good oral hygiene.”
If you were injured by abuse and neglect while you were a resident of Diversicare of St. Joseph, or any Missouri nursing home, you have the legal right to obtain financial compensation for your damages. Consider hiring a personal injury attorney who specializes in abuse and neglect cases. A Missouri nursing home negligence lawyer working on your behalf can protect your rights and ensure all the necessary documentation paperwork is filed promptly in the appropriate county courthouse before the statute of limitations expires.
Nursing home abuse and neglect cases are handled through contingency fee agreements. This arrangement provides immediate legal representation without the need for making upfront payments. All legal services are paid when the case is resolved through a jury trial or negotiated out of court settlement.
If you are looking for information on local facilities or an attorney who has experience with nursing home negligence matters in your area, please look at the pages below: