Eudora nursing home struggles to keep pace with changing role

Facility working to address deficiencies found during state inspections

Every day, Bob Lewis, 82, visits his wife, Verla, at the Eudora Nursing Center.

“My car knows the way,” said Lewis, who lives in Lawrence. “It’s a nine-mile trip – no more than a 15-minute drive.”

The care at Eudora Nursing Center, he said, is excellent. His wife, he said, is happy there.

“It’s been a blessing,” he said. “I think it’s the best place in the county.”

Not according to the Kansas Department on Aging. In March, it cited the nursing home with 25 deficiencies, including not doing enough to prevent bedsores or weight loss in residents, failure to follow doctor’s orders, awakening residents at 5 a.m. to accommodate worker schedules rather than residents’ wishes and not having enough staff.

A follow-up inspection in May resulted in 10 deficiencies. Again, the home was cited for not having enough workers.

In June, Eudora Nursing Center was fined $7,000 after inspectors confirmed a tip that a diabetic resident had been taken to Lawrence Memorial Hospital in a comatose state.

“That resident was my grandmother. Her name was Elmerine Agnes Rogers,” said Bill Holladay, who lives in Lawrence. “They took her to the hospital at about 8:30 p.m. She died around 9 p.m.”

Holladay said family members suspect conditions at Eudora Nursing Center contributed to Rogers’ death. She was 84.

“We’re talking to a lawyer,” he said. “That’s all I can say at this point.”

The Eudora Nursing Center, 1415 Maple, has come under fire from the state over deficiencies in staffing and care.

In their report, inspectors cited the nursing staff for allowing Rogers’ blood-sugar count to fall below low-normal levels for several hours on May 23 and again on May 24.

Inspectors also cited the nursing home for running out of glucagon, a drug used to raise blood-sugar levels.

Which is it?

So is Eudora Nursing Center, a great place, as some residents and their families believe? Or is it a problem-filled, bottom-of-the-barrel facility that provides poor care?

According to Kansas Advocates for Better Care, the place is probably neither.

Instead, like dozens of older, small-town facilities across Kansas, it is a place of good intentions that is poorly equipped to deal with changes that have beset the nursing home industry in recent years.

“In the old days – say, since the early 1990s – most residents could get around, dress themselves, feed themselves, toilet themselves and didn’t need help getting in and out of bed. But today these people aren’t in nursing homes – they’re in assisted living facilities. The people who are left in nursing homes need help with almost everything,” said Kansas Advocates for Better Care Executive Director Deanne Bacco.

Nursing homes that haven’t kept pace with these changes, she said, are sure to struggle.

“If you’re not in a position to meet these increased needs, then, obviously, there’s going to be neglect because there’s no way you can keep up,” Bacco said.

That’s what Betty McElhaney said she sees during her visits to Eudora Nursing Center.

“The aides all seem to be caring and compassionate, it’s just that they have their hands full,” said McElhaney, whose 92-year-old mother lives at Eudora Nursing Center.

“I don’t think they have enough help there,” she said. “I’ve seen aides trying to care for two people at the same time.”

History

Though it’s listed as a for-profit nursing home, Eudora Nursing Center was built with funds raised in and around Eudora.

“The idea was people wanted there to be a nursing home in the community,” said Eudora Nursing Center administrator Rheva Victor, “so that when somebody needed one, they wouldn’t have to leave town. They could stay here.”

The initial stockholders were paid back within a few years. Since then, Victor said, the home’s “profits” have been used to offset care costs and rate increases.

About one-third of the home’s 69 residents are on Medicaid, the government program that underwrites health care for the poor. The remaining residents are private pay.

Eudora Nursing Center celebrated its 30th anniversary in March.

Unlike some nursing homes, which are plagued by high turnover, the facility’s staffing has been relatively stable.

Sylvia Neis has been Eudora Nursing Center’s director of nursing for 28 years. Delores Stiffler has been assistant director of nursing for 24 years.

“I have 28 employees who’ve been here more than five years,” Victor said. “We’ve always taken great pride in providing quality care.”

Victor has been at Eudora Nursing Center for 18 years.

In a newsletter sent to Eudora Nursing Center residents and family members last week, Victor noted that she and her staff had been “pretty well traumatized” by the state inspectors’ findings.

“I want people to know that we’re taking all of these things very seriously,” Victor said. “Everyone is working very hard to be in full compliance with all the regulations. We’ve met with a consultant on how to go about correcting some of the deficiencies. We’ve already made some changes. I’m sure there will be some more.”

Problems adapting

Bacco said she has heard from a few Eudora Nursing Center residents’ family members with concerns about conditions at Eudora Nursing Center.

“What I’m hearing about is what I call neglectful practice,” Bacco said. “It’s what happens when, over the years, a facility doesn’t evolve to meet the changing needs of its residents.”

But Victor offered a different perspective on complaints that the center lacks enough employees or isn’t changing quickly enough. She said government regulation has made it more difficult to provide good care.

“It’s not that we don’t have enough people,” she said, “it’s that everything we do now has to be documented because if there isn’t a piece of paper in the file that something was done, it’s assumed it wasn’t done. So we have a lot of people doing paperwork instead of providing care. That’s one of the things we’re trying to fix.”

It won’t be easy.

“There’s constant pressure from both the federal and state governments to meet higher and higher standards of care,” said Debra Zehr, executive vice president at the Kansas Association of Homes and Services for the Aging, which represents the state’s nonprofit nursing homes. “At the same time, the level of scrutiny is higher than it’s ever been. It’s hard to find and keep staff and the gap between Medicaid reimbursement and actual costs is, on average, $13 per person per day. It’s an incredibly difficult task.”

But these difficulties, Zehr said, do not excuse poor care.

“There is a time of transition,” she said. “The nursing homes of tomorrow are going to be vastly different than what they are today because people have simply grown tired of the ‘good ol’ model.’ They don’t want it anymore.”

Homes that fail to recognize these changes, she said, are doomed.

“We need to be moving to a different place, a different culture,” Zehr said. “As an industry, we can’t stay where we are.”