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 FRONT PAGE - AUGUST 4, 1999 - COMMERCE, GA


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HEALTH CARE

State Inspection Team Report Rips Care At BJC Nursing Home
Officials Say Complaints Are Overstated, Public Should Wait Until Facility Files Its Response Before Making Judgment
Officials at BJC Nursing Home say they will contest a state inspection that ripped the facility and said its poor care and lack of cleanliness constitute "an immediate and serious threat to resident health and safety."
The scathing report documented numerous allegations in which staff failed to respond to medical needs of residents, of doctors not being notified when patients had complications, chronic staff shortages, inattention to incontinent residents, foul odors and numerous other shortcomings.


See Report Findings

The report was the result of a three-day regular inspection last week by the Office of Regulatory Services of the Department of Human Resources. The report recommends $3,000 per day fines since mid-June.
The report is a stunning setback for a facility that continues to struggle for credibility in its community. Although the inspection relates just to the nursing facility, the hospital shares in its ill effects.
Complicating the impact is the failure or inability of the administration to respond directly to the allegations spelled out in the 31-page report.
"On any case where anyone makes a complaint about patient care, we are held (by law) from discussing it," said David Lawrence, administrator of BJC Medical Center. "We are required to protect patient confidentiality."
BJC Medical Center Official Statement
Concerning statements made by the state conducting its annual survey of the nursing facility at BJC Medical Center, we at the Nursing Facility want to stress first and foremost our firm resolve to comply with and exceed state regulations relating to the quality of long-term care. We value the inspection process as a tool whereby citizens can be assured that their health care institutions are worthy of their support. Improvement of care at our nursing facility is always an ongoing process.
However, we recommend that anyone who is concerned about the quality of long term care at our Nursing Facility should reserve judgment about the facility until the inspection process is completed. We believe that certain incidents listed as deficiencies in the recent report were noted in such a way as to create an inaccurate impression of the facility, which unfairly casts the quality of care at the Nursing Facility in a negative light. We are currently reviewing the report and working on our response to the state, and we are confident that we can resolve any questions the state may have about our facility.
Lawrence and nursing facility administrator Bob Burns both argue that the facility should not be judged until its response to the complaint is completed, which will be next Monday. In fact, they say that the document is not legally a public document until their comments are attached.
"We want the opportunity to respond correctly to the survey," said Burns. "Our understanding is that we have that opportunity before the report becomes public."
But Lawrence said the nursing home is responding to the survey first by moving on the areas of patient care cited by the report.
"Our job is to do the best we can in providing patient care. We can argue (about the report) later." Lawrence said the staff is responding to correct all of the problems cited in the report.
Officials say that the report is written in such a way as to get the attention of nursing homes, but that the facility's contention of what happened in some of the specific events "will have an impact on the outcome of the inspection process," advises Oscar Weinmeister, public relations director.
"Our people have been kicking in to help with the bugs at the nursing home," Lawrence commented.
"Our employees are motivated," Burns stated. "They are proud of the nursing home and they want the community to feel the same way."
But there is no denying the hit that the facility's image has taken. The report was made public by an Athens newspaper even before BJC officials had a copy of the findings. And while the medical center's lawyers say the document is not yet a public record, the position of the Department of Human Resources is that the public is welcome to see the report.

Inspection Team Findings
Specific allegations came both from observation of the inspection team and reports from interviews with 31 residents or residents' families. Among the allegations are:
·A resident with a history of surgery for bowel obstructions was noted on July 7 by staff as having blood and blood clots coming from her rectum. The issue was reported to the nurse on duty, who ordered an enema, after which "additional blood was observed coming forcefully out of the rectum." The matter was reported to an administrative staff member, who did not inform the person responsible for the resident's condition. The condition continued to worsen until she was taken to the emergency room July 23.



After making a regularly scheduled inspection last week, the state inspection team returned Sunday to BJC Nursing Home.

·One patient with a chronic obstructive pulmonary disease turned combative June 18. Nurses attempted to contact her doctor, but got no return call. By June 21, the resident was "wheezing, with cyanotic nail beds." She was transferred to the emergency room, where she was found "unresponsive to verbal, tactile and painful stimuli," and she died June 23.
·On another patient, an area on his heel was discovered open July 25 at 5:27 p.m. Two hours later the injury was not bandaged.
·A case in which staff noted that a resident was not eating or drinking well at 9 p.m. June 18. Staff observed three days later and four days later that the resident had poor oral intake, and on June 23 it was observed that her blood pressure was low, temperature slightly low and pulse was irregular and faint and that she was "moaning out loud most of the shift." A doctor saw her at 2 p.m., had her admitted to the hospital for treatment of dehydration and a urinary tract infection. She died June 27, and the diagnosis was dehydration and urinary tract infection.
Other allegations include a case where an X-ray ordered by a physician was not done for 10 days, failure of the staff to notify a physician of a resident's painfully swollen knee for seven and a half hours (a bone was broken), persistent odors of urine observed by the survey team and reported by residents, torn, broken and soiled furniture and equipment, dirt, grime and stains, poisonous or dangerous materials stored in unlocked cabinets or rooms, repeated reports of inability to perform routine and necessary functions due to limited staffing, failure to provide bed-time snacks as required, and a complaint that it took an average of an hour and a half for staff to respond to the "call" button.
In addition, the committee claimed that shortcomings pointed out in a June inspection had not been addressed. The June survey had also indicated staffing as an issue, along with timely notification of physicians of problems, and failure to provide good nursing services and services to maintain good grooming and personal hygiene.
Medical center officials say that some of the allegations are wrong, and others are overstated or mis-characterized but, citing patient confidentiality, said they could not discuss them.
"We will have a number of responses to each allegation listed," Weinmeister promised.
"We have a plan of correction and we are addressing all of the concerns," Lawrence added.



NEWS SHORTS

Extreme Heat Causes Few Problems Here
JEFFERSON -- As temperatures soared into triple digits last week, residents may have found the weather uncomfortable and unbearable. But according to county officials, there haven't been very many problems associated with the rise in temperatures.
Officials at the Jackson County E-911 office in Jefferson report no rise in the number of heat-related illnesses over the past several months. In fact, they haven't seen any.
"I can't recall any heat-related calls," said LouAnn David, E-911 assistant coordinator.
Even if the heat isn't causing medical problems, it is affecting people.
Last weekend's public safety day in Maysville was cut short because of the rising temperatures. A rodeo at Chateau Elan in Braselton also saw a lower than expected turnout, probably due to the sultry heat.
County farmers are also taking a hit, though officials say this year isn't any worse than years before.
"We always have hot and dry spells," said John Parks, Jackson County Extension Agent. "I can recall worse summers. By in large, it isn't a bad problem countywide."
Most farmers, especially chicken farmers, do have ways to combat rising temperatures. Modern chicken houses have evaporative cooling and tunnel cooling to keep the chickens cool.
"They have equipment that does a really good job at keeping it cool," Parks said. "But when the electricity doesn't work, then you have problems."
Power failure has already been blamed for one loss of nearly 15,000 chickens in Jackson County.
Countians may be in for a break from the worst of the heat. Earlier this week, temperatures fell into the upper 80's. The National Weather Service forecasts highs in the upper 80s through this weekend.
But until the sultry heat is gone for good, residents will just have to stay indoors or put up with the heat.
 
Linder To Be In Athens To Promote Tax Bill
ATHENS -- Under the billing of a "fair tax seminar," Rep. John Linder is planning a rally Wednesday afternoon at the Classic Center to promote his legislation that would remove the Internal Revenue Service and institute a national sales tax.
The event will feature Linder explaining House Bill 2525.
People interested in attending the 4:00 to 5:00 session should call 355-9909 or 335-1896 to make reservations. Space is limited.
Linder has estimated that a 23 percent national sales tax could replace all income, estate and Social Security taxes.
LOCAL GOVERNMENT

Commerce Institutes Outside Water Restrictions
Trying to manage its water resources against an increasing demand that is taxing its production capacity, the city of Commerce has declared a "voluntary and mandatory water restriction."
Implemented a week ago, the restrictions forbid outside watering of yards and plants from 4 p.m. to 10 p.m. daily. The plan also calls for a 20 percent reduction in the average daily water use for commercial and industrial water customers.
"We're not short of water," noted City Manager Clarence Bryant. "The lake is as full as it's ever been. It's probably up a half a foot."
The problem is that the city is allowed to treat 2.25 million gallons per day under its state permit. It has been selling 2.2 million gallons per day during the past two weeks of hot, dry weather.
"The plant has been running full time for seven to nine days straight," said Bryant a week ago. "Our clear well is at three feet (25 percent of capacity) and the levels in our tanks continue to fall. We've got to have some help, so we're asking for help."
Bryant says the city must keep its water tanks half full to handle a large fire or a break in a water main. Normally, after 11 p.m., the city's pumps begin gaining on filling up the tanks, but in the days just before the restrictions were handed down, the production could never catch up with demand.
The policy limits public pools to operating three days a week.
Bryant calls the restrictions "phase one," indicating that odd-even watering days could be implemented if the conditions continue, and commercial and industrial customers could be asked to curtail use by 50 percent.
The city figures that indoor use averages 1.3 to 1.4 million gallons daily, based on winter usage. That means close to 900,000 gallons per day is projected for outdoor use, largely watering grass and yards.
The situation is also affected by the fact that the city sells water wholesale to the Jackson County Water and Sewerage Authority. As part of the curtailment, the city cut Jackson County's allotment 36 percent to 350,000 gallons a day, from 550,000 gallons per day.
The curtailment comes as the city prepares to open bids on construction at its water plant that will almost double its capacity. When the work is done, the city expects to have a state permit to pump 4.4 to 4.5 million gallons a day from its reservoir on the Grove River.

Commerce News Named Best Small Georgia Weekly
The Commerce News was named Georgia's best weekly newspaper of 4,000 or less circulation when winners of the 1999 Better Newspaper Contest were announced Friday night at the Georgia Press Association's annual convention in Destin, FL.
The News captured the "General Excellence" category for 1999 papers. In addition, The Jackson Herald won general excellence to be declared the state's best large weekly newspaper. The other MainStreet Newspapers, The Madison County Journal and The Banks County News, tied for third place in general excellence in the less-than-4,000 circulation class. MainStreet Newspapers won 40 awards in all.
The Commerce News captured first-place awards for its editorial page, layout and design and religion coverage; second place for sports section or pages and third place for editorial writing. Editor Mark Beardsley won a first place for spot news photo and a second place for feature writing.
The General Excellence category is determined by a points system for other awards won in the contest.
Staffers responsible for layout and design include Beardsley, Drew Brantley, sports editor; and April Murphy. Mrs. Murphy is also in charge of The News' church page. Brantley is in charge of all aspects of the sports pages.
The Jackson Herald won 16 awards, including first-place awards in general excellence, local news coverage, lifestyle coverage, community service, spot news photo, investigative reporting and sports photo; second-place awards for newspaper promotion, business coverage, news photo, editorial page, spot news photo; third place in spot news photo, special sections and headline writing. General Manager Mike Buffington captured third place in the serious column division.
The Banks County News also won first place in community service, second in business coverage, sports writing, layout and design, photo essay and sports photo and third in sports photo and information graphics.
The Madison County Journal won eight awards, including four first place, one second place and three third place. They include first place in feature photograph, sports section, sports photograph and sports writing; second place in religion coverage; and third place in general excellence, lifestyle coverage and photo illustration.


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