Valley View Reels from DPHHS Inspection

Valley View nursing home (VVH) is a long-term care facility in Glasgow that provides the region with an invaluable community service. Recently, the facility received a troubling quality assurance review by the Montana Department of Public Health and Human Services (DPHHS). Specifically, DPHHS found that VVH was responsible for three immediate jeopardy deficiencies, constituting unusually serious infractions. According to Health Management Services Vice President Karl Rude, the deficiencies were related to, “resident falls, neglect and abuse, and pressure ulcers.”

Rude, whose company has been tasked with managing daily operations at VVH since October of 2014, stated that immediate jeopardy deficiencies are the most severe infractions that can be alleged by DPHHS, and are a “professional embarrassment” to his company. The allegations are severe enough to require VVH to provide a “plan of abatement.” The plan is meant to propose immediate steps for correcting the deficiencies. Copies of the review and the plan of abatement were not readily available from either VVH or DPHHS by press time.

Rude also commented on a letter from DPHHS threatening a shutdown of the facility if a plan of abatement was not accepted by May 23. Rude was quick to point out that the plan has been accepted and VVH will remain open into the foreseeable future.

The next step for VVH is to submit a plan of correction to DPHHS by June 14, addressing 30 additional deficiencies of a lesser nature, as well as the immediate jeopardy deficiencies. The facility will then be subject to a follow-up review by DPHHS. According to Rude, VVH will also be sanctioned by DPHHS to the tune of “tens-of-thousands of dollars.” They could also lose the ability to train new certified nursing assistants.

According to VVH board president Brian Fuhrman, the problems at VVH began years ago when the cost of operations overtook revenue and other funding sources. Fuhrman stated, “Medicaid and Medicare only provides about a $1.60 to $1.65 per day per resident on government assistance, which totals anywhere from 60-67 percent of the total resident population. The daily operating cost of a resident is between $2 to $3,” causing massive shortages in funding. As a result of financial difficulties, the VVH board of directors turned to Health Management Services (HMS) following a six-month interview and research period.

When asked why HMS was brought in, Rude responded by stating, “They [VVH] were hemorrhaging cash,” and were, “having issues with employee atmosphere.” When asked about employees further, Rude stated that VVH “only had to terminate about two employees,” while others left due to an “air of disgruntlement” because they were holding on to “antiquated practices” and resisting being held to a “professional standard.”

Fuhrman added, “The big thing was we were losing money and thought a fresh pair of eyes would turn things around.” He also stressed: “A core group of employees had been there, and are there, and they are great.” When asked about the disparity between his and Rude’s perspectives, Fuhrman stated, “It’s easy to ref from the bleachers. Valley View is struggling, but we’re trying to come up with solutions to provide long-term care to residents and the community.”

Despite HMS’s involvement, VVH continues to operate at a loss. Fuhrman linked this to the quality of care provided at the facility, citing that, “most every other nursing home requires two people per room while Valley View requires only one.”

When asked directly if the board liked the direction VVH has taken since HMS took over, Fuhrman said, “I think that the last state review is not what we are about, and we are taking actions to change and fix it.”