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Wednesday, October 13, 2004

Sanctions may result in probe of center

Brandy Slagle News-Bulletin Staff Writer; bslagle@news-bulletin.com

After a month-long investigation of the Los Lunas Community Program, Secretary Designate of Health Michelle Lujan Grisham said problems in client care, oversight and fiscal management could result in sanctions affecting the Department of Health (DOH).

Grisham said in a previous interview that the investigation began after the DOH saw that financial records indicated the LLCP was "woefully over-budget." The DOH had also received numerous anonymous phone calls from clients and employees.

The DOH's internal investigation was conducted in conjunction with representatives from social service agencies such as the Agency for the Aging, Children, Youth and Families and Adult Protective Services.

"Although we likely will take some hits because of our oversight of the program, eventually we will come out ahead because we will have assured that we've identified deficiencies and addressed them, held responsible parties accountable for any shortcomings and improved relationships between consumers and the department," said Grisham in a recent press release.

Findings in direct care to clients include:

  • Staff performing duties for which they are untrained, such as inserting feeding tubes.

  • The administration of client medications were not recorded making it unclear whether they received them.

  • Clients lost weight in circumstances where it should have been prevented.

  • Speech, occupational and physical therapy received at the center was not reinforced in their homes.

  • Patients in need of communication devices did not receive them.

  • Plans of action did not exist for clients with medical conditions that could require emergency intervention like heart disorders or seizure swallowing.

  • Clients' Individualized Service Plans were not current. These plans identify clients' needs and tracks if they are being met.

    Findings in oversight include:

  • Supported living homes staff did not have access to current, complete client records needed to ensure clients receive the proper care and support.

  • Failure to track licensure of staff nurses and therapists.

  • Failure to ensure staff received required training, including first aid and CPR.

  • Confidential client files were found lying in random stacks around shelves, sinks and laundry bins.

  • Criminal background checks were not completed on 73 employees and 18 contracted care providers. One employee was fired due to a criminal history.

    "This is particularly egregious because the Department of Health is responsible for administering the Criminal History Screening Program," said Grisham.

    Employees of hospitals and long-term care facilities who provide direct care to patients must go through a background screening.

    Fiscal findings include:

  • Violations of the state's anti-donation clause, allowing individuals to live on the program's campus rent-free.

  • Violation of state procurement code with programs that used space on the campus to pay bills directly to vendors instead of rent. Some of the purchases might not have been approved by the DOH if done through the proper process.

    The Human Services Department will review possible fines based on failures of the program to meet state standards. The DOH will pay any fines into the state's General Fund if they are assessed.

    "We are holding ourselves to the same standards that we hold private facilities," said Grisham. "We are facing difficult financial times in the department, but I intend to go through with the fines because it is the right thing to do." DOH will manage the facility while the investigation takes place.

    Department of Health Public Information Officer Kay Bird said the review process might take some time and that fines have not yet been determined.

    "It's our first priority to give the people who receive care at that facility the best care and treatment possible. That's our main concern," said Bird.

    She also said that the DOH has addressed any wrongdoing or shortcomings of the staff at LLCP, put them through due process or found a more suitable position for them.

    Matt McCune, director of the Los Lunas program, resigned last week after he took three weeks of administrative leave during the investigation.

    Bird said the DOH wants a new director to be in place during the next two months. Until that time, John Foley is acting as director.

    Foley served as the director of the Arc of New Mexico for over a decade. The Arc is an advocate for the developmentally disabled.

    Of the approximately 200 clients receiving services from LLCP; about 99 percent are on Medicaid.

    Paul Nixon, a spokesman for Attorney General Patricia Madrid's office, said they are also conducting an ongoing investigation for possible Medicaid fraud and exploitation.

    "Our research will continue as we are made aware of other issues," he said.

    Nixon said Madrid is pleased by the co-operation of the DOH in the investigation.

    "Representatives from Medicaid fraud have met with representatives from the Department of Health and they have said we would have their full support in the investigation," said Nixon.


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