PEQUOT LAKES, Minn. - Owners of a troubled nursing home and assisted-living facility in Pequot Lakes agreed to relinquish their license to provide home care services in three locations.
The enforcement action comes in the wake of substantiated neglect leading to a client's death, a sexual assault of a resident by a staff member and a series of compliance violations spanning nearly two years.
In an agreement with the Minnesota Department of Health, Minnesota Heritage House must transfer the management of its facilities in Pequot Lakes, Adrian and Kimball to another home care provider. By Dec. 1, Serenity Living Solutions of Sebeka will assume all administration and management of client care.
Scott Smith, public information officer with the Health Department, said the arrangement would mean minimal disruption for clients living in the facilities while responding to "serious incidents involving harm to clients and a persistent pattern of ongoing correction orders."
"MDH tried to manage the situation as to not create a crisis for the residents at these locations and at other housing with services sites owned by ElderCare of Minnesota," Smith stated in an email. "By allowing Heritage House to voluntarily relinquish their license, residents can continue to live at the facility and transition to a new provider with minimal disruption. Heritage House is also cooperating with MDH to bring in a new provider of services and manage the transition."
Heritage House is not permitted to admit any new residents under its license, although Serenity Living Solutions may do so prior to the complete transition. While Minnesota Heritage House will continue to own the buildings, MDH required that current owners, administrators or managers of the license must remain at "arm's length" and cannot provide or administer care. They also may not seek any new applications for home care licenses for five years.
A worrisome record
The agreement signed last month lists a series of licensing violations identified by MDH between November 2015 and June 2017. The timeline shows while many of the violations were corrected upon reinspection, many were not and new violations continued to show up at the facilities. The MDH issued the facility a warning in March due to compliance issues, and in May it was noted ongoing complaint investigations brought renewed concern over the "health and safety of Heritage's residents."
Among those investigations was one finding Heritage House responsible for neglect in the February death of 86-year-old Ralph Ford. The investigation showed neglect through improper catheter care and an unclean environment led to Ford's death by a complex urinary tract infection. This included a failure to flush and change the client's catheter and a failure to maintain infection control on the catheter equipment.
In 2016, a complaint investigation found an employee responsible for the sexual abuse of a resident. David Erwin DeLong of Pine River was also criminally charged and pleaded guilty to fourth-degree criminal sexual conduct, the sentencing for which is scheduled next month. According to the criminal complaint filed against DeLong, he sexually assaulted a 78-year-old woman in May 2016. The woman was nonverbal, wheelchair-bound and unable to feed herself, requiring around-the-clock care, the complaint stated.
Although referenced in the agreement, details are not yet available for a third complaint investigation conducted in July, which resulted in two Level 3 violations-those that harmed a client's health or safety, not including serious injury, impairment or death.
Owners cite turnover, facility growth
Owners James and Kathy Birchem said Monday, Oct. 30, they've been cooperating with the MDH and working to address concerns at the Heritage House facilities for several months. This includes hiring Zellner Senior Health Consulting to assist in achieving compliance.
"This has been a very long process," Kathy Birchem said. "This has been the best solution that we could come up with for our residents at this point in time so they could remain in their current home."
She said none of the people employed at Heritage House facilities would lose their jobs because of the transfer.
The Birchems, Little Falls natives, purchased their first nursing home in Bemidji in 1996, according to their company ElderCare of Minnesota's website. They own 15 senior living facilities throughout the state-mostly in central and north-central Minnesota, but also four facilities near the Minnesota-Iowa border.
Smith reported the company operates under six different licenses through MDH, although only the one held for the Heritage House facilities in Pequot Lakes, Adrian and Kimball is affected.
"We are allowing ElderCare to continue to offer licensed home care services at other locations to avoid disruption of services for those residents and because those facilities did not have the same quality and noncompliance issues," Smith stated.
Kathy Birchem said although the license applies to three locations, the Adrian facility was not responsible for any of the correction orders required by MDH.
"To correct the deficiencies that we were given, they needed to be corrected at all sites," Kathy Birchem said. "Because they're located in different towns, some of the corrections weren't done that should have been done."
When asked why they believed the Heritage House facilities continued to be troubled, the Birchems cited staff turnover and facility growth.
"The systems weren't followed as closely as they should have been," Kathy Birchem said.
As owners, the Birchems receive weekly reports on their facilities and have quarterly meetings with site managers, Kathy Birchem said. Each facility has a lead nurse and an operations manager.
In the investigation of Ford's death, nurses interviewed said a sudden and recent departure by a nursing director made it "confusing for the remaining two RNs (registered nurses) to figure out when things were due."
Kathy Birchem said she wanted the families of those living in Heritage House to know they have confidence in Serenity Living Solutions.
"We'd like them to believe that their loved ones are in caring hands," Kathy Birchem said. "... We are very sad and hurt that the events happened at our facility, because we have very high standards of care for our seniors."