Final report cites 37 deficiencies at Western Horizons Care Center

Western Horizons Care Center was cited by the North Dakota Department of Health with nearly 40 violations. Bruce Pritschet, the Division Director for the Division of Health Facilities, said the facility has already made progress on fixing some of the issues.
(Record File Photo)

Complaints to the North Dakota Health Department in late spring prompted surveyors to inspect the conditions at Western Horizons Care Center in Hettinger from May 30-June 7. The subsequent survey resulted in a 147-page report outlining 37 violations to the Health Department code.

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And furthermore, the reported also stated that the facility failed to maintain compliance with 10 areas cited in the Oct. 27, 2016 survey.

The latest report—that was dated July 11—said an “unannounced onsite complaint survey, prompted by four complaints…” and that the findings resulted in Immediate Jeopardy was declared on June 5, at 10:03 a.m.

Immediate Jeopardy is the most severe designations, and the facility needed to correct the errors within 23 days, or their facility would have lost their medicare/medicaid certification.

In conversations with Bruce Pritschet, the Division Director for the Division of Health Facilities, the facility has already made strides in improving the situation, and Wester Care Horizon Center is no longer in Immediate Jeopardy, though they still need to make improvements.

Pritschet told the Record that the final deficiency report considerably large compared to others they’ve filed in the past.

“It’s probably one of the larger ones we’ve done in the last year,” he said.

Among the first deficiencies mentioned was the lack of adequate staffing, stating that “the prolonged shortage of staffing placed all residents in jeopardy for serious harm…” And what put them into Immediate Jeopardy was the absence of Director of Nursing coverage from May 1-June 5, and the lack of Registered Nurse coverage from June 1-5 this year.

When asked if the lack of staff support attributed to the deficiencies, Pritchett said he nor his department would speculate that cause.

“We identify that [the violations] are there, that would be a question you could refer to the facility,” he said. “We’re not going to speculate as to what cause it, we’re just asking to fix it.”

Pritchett also said that since June 7, the department has made two additional visits, and they are still working on getting back into substantial compliance.

When asked if it was because of staffing issues, West River CEO Matthew Shahan said that the numbers were fine, it was being without a RN in the building for two days.

“As we’re currently licensed we’re required to have eight hours per day of registered nurse coverage,” Shahan said. “We can apply for a waiver but we did not have that waiver in place so it’s kind of irrelevant.”

He also said that they didn’t have a director of nursing after their previous one had resigned. Shahan told the Record that they had been in contact with a number of traveling companies and couldn’t find anyone to serve in that role, which also attributed to the Immediate Jeopardy designation.

When asked if finding consistent staffing in rural nursing homes was an issue all facilities face, Shahan thought it was an issue most care centers to have to deal with.

“I think a lot of nursing homes are in the same boat we are with traveling nurses,” he said. “We’ve got some fantastic traveling nurses right now, but even at times they’re hard to find.”

Mark Prischmann, COO and Administrator has resigned, but Shahan said it was related to personal issues. They are have an interim administrator and are working to hire someone permanent.

“In the meantime I’m the acting administrator,” Shahan said.

Shahan said they have also hired Judy Jung as Director of Nursing.

Pritschet told the Record that if the care center fails to get into compliance, they could risk losing their medicare/medicaid benefits.

“If they’re not in substantial compliance by Dec. 7 of this year, they will be terminated from the medicare/medicaid program,” he said “Certification will be lost.”

But he also said the department hopes the care center can regain a high level of quality care.

“The health department hopes that this facility can get back into compliance for the safety and the health of the residence that they have there,” Bruce said. “And they have made some progress, we’re hopeful.”

Shahan believes the residents are getting great care, and said that all facilities have room to improve.

“If you walk through the facility, it’s a clean facility. We believe we’re giving proper care,” he said. “But everybody always has areas of improvement and we’re not above any of that.”