ST. PETERSBURG — A nursing home once recognized as one of the state's best is now on a list of the country's worst.
Federal and state health officials have designated Bon Secours Maria Manor, at 10300 Fourth St. N, in St. Petersburg, as a "special focus facility," a classification that can cost the home its Medicare and Medicaid credentials if it doesn't improve within two years.
Bon Secours was one of two Tampa Bay area nursing homes recently added to the list. The other was Heather Hill Nursing Home, at 6630 Kentucky Ave., in New Port Richey. They are two of five Florida homes on the list, and among about 130 nationwide.
The designation marks a dramatic turn for Bon Secours, which in 2002 was awarded a Gold Seal of Excellence for long term care facilities for the state.
Bon Secours is one of Pinellas County's largest homes, with 274 licensed beds. It has enjoyed a reputation for excellent hands-on care. Catholics, particularly, are attracted by its reputation and weekly Masses, and it remains 95 percent occupied.
"We were surprised we were on the list," Jim Higgins, CEO of Bon Secours St. Petersburg, said in a phone interview Thursday. "We understand the process and are committed to coming off the list in the shortest time possible."
The federal Centers for Medicare & Medicaid Services (CMS) created the special focus facility initiative in 1998 to deal with nursing homes with a recent history of serious quality problems. Homes on the list are visited twice as often as other homes — about twice a year — and reach one of three outcomes within two years: Either they improve and "graduate" from the program, do not improve and are either fined or terminated from Medicare and Medicaid, or they are given more time to show improvements.
In its most recent survey in June, Bon Secours was found to be deficient in 20 areas. That's twice the average number of deficiencies found in Florida nursing homes (10), and more than twice the average number found in homes nationally (eight).
Among the findings, inspectors determined that the home:
• Failed to provide care in a way that keeps or builds each resident's dignity and self-respect.
• Failed to make sure that each resident's nutritional needs were met.
• Failed to make sure that the nursing home area is free of dangers that cause accidents.
• Failed to provide activities to meet the needs of each resident.
Though many nursing homes make the necessary improvements, special focus facilities often "yo-yo" in and out of compliance, which reveals underlying systemic problems, according to CMS. In Bon Secours' case, some of the deficiencies found in 2009 were also found in its 2008 and 2007 surveys.
Higgins read a statement that said the survey process is one of many indicators of quality.
"On an everyday basis, we believe we are providing an excellent quality of life for our residents and by extension their families," the statement read. "We, however, like all health care facilities are not perfect and are always in a continuous state of improvement.
"We take the findings seriously and have taken action to remediate them. . . . It should be noted that the plan of correction has been accepted by the state, fully implemented and the facility has been found to be in substantial compliance."
Higgins added that Bon Secours this year hired a full-time medical director who is boardcertified in geriatrics. He said Bon Secours is one of only a few nursing homes in the state to have one.
The nursing home is owned by Bon Secours Health System, a not-for-profit Catholic health system with hospitals, nursing homes and assisted living facilities in several states. In St. Petersburg, Bon Secours offers skilled nursing, assisted living, rehabilitation and home care services and facilities.
Heather Hill Nursing Home was found deficient in 31 areas in its last survey in January of this year. Among its most severe findings: Inspectors determined the home failed to protect each resident from all abuse, physical punishment and being separated from others; and the home failed to develop a complete care plan that meets all of a resident's needs, with timetables and actions that can be measured.
An official with Heather Hill, who refused to identify herself, said Tuesday that she was only allowed to say that the facility "has appealed the findings which resulted in designation as a special focus facility and is unable to comment further."
She referred further questions to Donna Holshouser Stinson, an attorney representing the nursing home. Holshouser Stinson could not be reached for comment.
State officials say the program has been successful in turning homes around. Polly Weaver and Kim Smoak, with the Florida Agency for Health Care Administration, said that since the program's inception, nearly every Florida home on the list has successfully come off of it. Only one — Key West Convalescent Center — lost its Medicare/Medicaid credentials, in late 2008, and it closed shortly after.
Nationally, CMS estimates that about half of the nursing homes in the program significantly improve care within 24 to 30 months, while about 16 percent lose their Medicare/Medicaid credentials.
Weaver said officials at some nursing homes are surprised when they're notified of their home's special focus facility designation. "Naturally, they're not happy, but for the most part they understand," she said.
Smoak said she sometimes receives calls from nursing homes telling her what they're doing to come off the list. "When they've had a good survey, they will call," she said.
Richard Martin can be reached at firstname.lastname@example.org or (727) 893-8330