At 55 years old, Theresa Squire probably is not the person who naturally comes to mind when people think of a nursing home resident.
But a series of strokes and the threat of more serious health problems left her dependent on others at a relatively young age. And with two children living more than six hours away in western Kansas and Colorado, taking up residence in a nursing home became Squire's only real option.
"You lose all of your independence," Squire said when asked what it's like moving into a nursing home. "You lose part of your dignity in a lot of areas."
Until this past September, the place Squire called home was the Royal Terrace Nursing Home and Rehabilitation Center in Olathe - a facility that lost its Medicaid and Medicare certification in July, after the home was found to be out of substantial compliance with regulatory requirements governing nursing homes.
"It was really, really bad. Very neglectful," Squire said, referring to the quality of care at Royal Terrace. "You'd push a call light on and the response time was maybe 45 minutes to an hour before anybody came to help you."
In February, government officials conducted an annual inspection of Royal Terrace and ended up flagging the facility with 21 deficiencies.
Those deficiencies were health and safety problems that included issues such as failing to develop comprehensive care plans for numerous residents, not properly monitoring pain and the administration of pain medication, failing to prevent falls and the risk of falls, failing to prevent the spread of infectious disease and failing to provide a clean environment for residents. According to government reports, Royal Terrace also failed to keep the home free of pests such as cockroaches.
"Roaches in the hallways, roaches in the bedrooms, roaches everywhere," Squire said. "It was just horrible. I always had at least two or three cockroaches in my room at night."
Margaret Farley, an elder law attorney and leading expert on nursing home regulation, is the president of Kansas Advocates for Better Care, a not-for-profit organization working to improve nursing home care for senior citizens in Kansas.
"All of these things really affect a resident's daily life," Farley said, addressing the problems inspectors uncovered at Royal Terrace. "Many of these deficiencies were very serious deficiencies."
Explaining how the inspection process under federal and Kansas law works, Farley said nursing homes are typically given a chance to cure their deficiencies when the facility is found to be outside of regulatory requirements.
Inspection surveys obtained by KCTV5 through an open records request show that Royal Terrace was given three chances to cure the 21 deficiencies originally found in February. While Royal Terrace staff apparently fixed some of the problems at the home, government records indicate that inspectors flagged new deficiencies after returning to the home in April and June.
In July, when inspectors showed up for their final visit, the total number of health and safety problems identified at Royal Terrace stood at 28. That is three times the average number of deficiencies found in nursing homes across Kansas, according to Medicare.org, and four times the national average. Eventually Royal Terrace got a letter notifying the home that federal funding was being pulled.
When something like that happens, Farley said the state licensing authority usually also revokes the nursing home's license to operate. Much to her surprise, the agency charged with overseeing nursing homes in Kansas, the Department for Aging and Disability Services (KDADS), has made no such move against Royal Terrace.
"Many of our state regulations are modeled after the federal regulations in large part," Farley said. "I don't know how they [Royal Terrace] continue to operate with that number of deficiencies. It can only be lax enforcement."
KCTV 5 contacted KDADS seeking an interview and an update regarding the licensure status of Royal Terrace. But Angela de Rocha, the agency's spokesperson refused, to go on camera saying, "I have a face for radio."
A day after that conversation KCTV5 spoke with Jennifer Trapp, vice president of corporate communications for Consulate Management, which owns and operates Royal Terrace. Trapp said the home had recently regained Medicaid certification but was still in the process of getting Medicare back on line.
When asked if someone at Consulate Management would go on camera and provide proof of the steps taken to bring Royal Terrace back into compliance with regulatory requirements, Trapp said no. According to her, company lawyers feared an interview might jeopardize Consulate Management's relationship with the state of Kansas.
"It's simply they are not wanting to put the money into taking care of the residents," Farley said about the problems at Royal Terrace. "You have to wonder what they [Consulate Management] are thinking. You have to wonder if they really know how to manage a facility."
Squire still has friends at the home and believes state officials could make life better for everyone living at Royal Terraces if they shut the place down.
"I hope they close the doors forever." Squire said. "These are human lives they are dealing with, you know? Not rocks on the road. They're human individuals."
Ultimately Squire worries that someone will get seriously injured or die at Royal Terrace if the state doesn't take more aggressive action against the home. Considering the history of deficiencies at the facility, Farley says Squires fears aren't without justification.
"I don't know why that facility is still open." Farley said. "Because you could simply make the argument that if it's [living conditions at Royal Terrace] not good enough for Medicare and Medicaid certification, how can it be good enough for state licensure?"
Copyright 2012 KCTV (Meredith Corp.) All rights reserved.
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