A Lawrence nursing home appears to be responding to complaints about improper care of elderly residents.
Viva Hoover is understandably frail after living through every moment of this century.
But the 98-year-old Lawrence resident can play a mean game of dominoes when she puts her mind to it.
In recent times, she's complained that the black-and-white tile game wasn't enough.
"There's just nothing to do," Hoover says.
Her dwelling the past 10 years has been the nursing home on West 27th Street. The facility, just like Viva, has changed over the years.
The name of the home was switched last fall from Sterling Heights to Southwinds Rehabilitation and Care Center. It's part of an ownership and management shakeup that came on the heels of repeated violations of state regulations designed to protect elderly residents.
Ray Hoover, Viva's son, and Lea Hoover, Viva's daughter-in-law, said the quality of life for the family matriarch and about 60 other residents at the nursing home had slipped in recent years.
"It was wonderful when we took her in," Lea Hoover said. "It had a family atmosphere with lots of activities for them."
Also, in the old days, family members met informally with nursing home administrators to talk about issues of mutual concern. A couple years ago, Ray Hoover said, management discontinued that practice.
"Now, we don't know each other," Lea Hoover said. "Everything is real quiet and secret."
"It's not a home. It's a boarding house. People need more than institutionalization."
But lately, some say, conditions at the home have begun to improve. Pressure from the state may be helping.
Field inspectors with Kansas Department of Health and Environment, responsible for licensing and monitoring the state's 400 nursing homes, have pinpointed a series of problems at Southwinds.
Infractions cited by KDHE included failure to follow physicians' orders, improper treatment for bedsores, inability to meet residents' nutritional needs, neglect of general hygiene of dependent residents, misuse of a petty cash fund and lack of supervision for residents with a history of going AWOL.
The state has imposed $1,800 in fines against the home in less than two years.
Two private lawsuits alleging negligent care of residents resulted in judgments last year of at least $535,000 against former owners.
A new series of inspections at the end of 1997 resulted in a ban on new admissions Dec. 31. KDHE also temporarily banned admissions there in 1994 for a series of health and safety violations.
Don Brown, spokesman for KDHE, said a survey team was in Southwinds last week to reinspect the facility. A determination could be made this week regarding changes in the admissions ban.
"We'll continue these visits regularly until all deficiencies are corrected," Brown said.
Don Potter's 90-year-old mother, Ruth, has been a resident of Southwinds for nearly one year. He said publicity about KDHE's latest enforcement actions appear to have motivated owners of Southwinds to make improvements.
In the past, he said, the 75-bed nursing home had a distinct odor.
"Initially, when you walked in the door, it smelled like an outhouse. In the past week or two, they've started cleaning up," Potter said. "They really needed to clean up."
Potter said his mother was "content" to be at Southwinds, but "I'm not saying she's happy." In part, he said, she's still adjusting to life in a group setting.
Raymond Hoover said staff changes had been a concern of Southwinds residents and their families for some time.
"They've got a lot of people -- not all -- who just want to come in, do their work, go home," he said.
Lea Hoover said high employee turnover had been stressful for Viva.
"She's uncomfortable with new people coming in all the time," Lea Hoover said. "There was a time when the staff were her friends. Now they're not there."
Southwinds employees unfamiliar with residents rely on photographs to distinguish people, she said.
Wes Peake, vice president of Health Prime in Atlanta, which manages Southwinds for Ascend Healthcare of Topeka, said Southwinds was striving to improve the quality of residential staff.
Turnover has run at an estimated 200 percent in the two years Ascend has owned the home, Peake said. The nursing home's reputation as a "troubled facility" has made it difficult to recruit and retain employees, he said.
Potter added: "They've got some good people there, but many are minimum-wage people. You've got to do that work because you love it."
In one case, the exodus of a Southwinds employee brought relief.
Rheba Wales of Lawrence has visited a long-term Southwinds resident nearly every day for the past five years. For a time, Wales took issue with a nurse who wasn't attentive enough to medication that was to be taken by Wales' friend.
Wales said pills that were supposed to have been consumed would be found on the bedroom floor. That problem ended with the nurse's departure from Southwinds, she said.
"They're doing a good job now. I really think they've turned it around," Wales said.
Lea Hoover isn't ready to declare a reversal of fortune for residents of Southwinds. Her experiences there soured her on nursing homes in general.
"I told my kids that if I have to go to a nursing home, shoot me."