LAKE PLACID — The State Department of Health found 23 health deficiencies at Adirondack Medical Center's Uihlein Nursing Home, including nine considered severe.

A detailed report said the nine violations "posed immediate jeopardy to resident health or safety," a Level 4 deficiency, which is the most serious category.

One case involved a Nursing Home resident who died.

DEATH reported
Health inspectors began an investigation at the facility on Old Military Road after an incident last July, when an elderly man was improperly administered 10 times the normal dosage of the anti-anxiety medication Xanax.

The man was given two 1.25 milligrams of the drug instead of the prescribed amount: 0.125 milligram doses to be given at 10:30 p.m. July 24 and at 12:30 a.m. July 25.

Two nurses testified in the report that they could not wake the man up the next morning and found him cold to the touch.

Nonresponsive, the man was transported to the hospital at 11:30 a.m.

"The resident was assessed at the (Emergency Room) with a temperature of 89 degrees Fahrenheit (normal 98.6 degrees)," the Department of Health report said. "The resident was diagnosed at the ER to have had a benzodiazepine overdose with coma."

The man subsequently died at the hospital, where the death summary, according to the Health Department's report, stated "after admission, he was noted to be hypothermic with a low temperature of 89.0 degrees F."

AMC SOUGHT PROBE
Joe Riccio, spokesman for Adirondack Medical Center, said Wednesday that the hospital requested the investigation.

"In July 2008, AMC-Uihlein voluntarily triggered a New York State Department of Health review process by self-reporting an incident involving a single Nursing Home resident. At that point, AMC-Uihlein began working closely with state regulators to address the concerns identified.

"We reacted swiftly and appropriately," Riccio said.

OTHER DRUG ISSUES
The Health Department report cites several other potential problems with prescribing and administering drugs at AMC-Uihlein.

The Health Department cited AMC-Uihlein for three Level 4 deficiencies in pharmacy services, including a failure "to make sure that residents are safe from serious medication errors."

Online Medicaid reports indicate all corrections were made by Jan. 19 of this year.

"We have fully and successfully addressed all of their concerns," Riccio said Wednesday.

"Quality-improvement measures have been embraced by all Nursing Home staff across all departments, facilitywide, at AMC-Uihlein, supporting the Nursing Home's dedication to excellent resident care.

"Our highest priority remains the safety and well-being of those in our care."

Reports on Medicare.gov outline each of the 23 violations and list the date each was corrected.

ADMINISTRATION
The Health Department also found four "immediate jeopardy" deficiencies relating to the Nursing Home administration, saying AMC-Uihlein failed to "hire a properly licensed administrator," failed "to be administered in a way that leads to the highest possible level of well-being for each resident," failed "to choose a doctor to be the medical director" and failed "to set up or keep a group of people to review and ensure quality."

Riccio said AMC-Uihlein has always had a physician or a physician's assistant on hand at the facility.

"We do have a properly licensed administrator overseeing the facility."

But AMC waived its right to a hearing on the violations.

FINES
The Centers for Medicare and Medicaid Services hit the hospital with fines totaling $116,150 stemming from the Aug. 8 inspection, said Richard Mollot, executive director of the Long Term Care Community Coalition, a nursing-home watchdog agency based in New York City.

AMC paid penalties of $75,497, a 35-percent reduction because the hospital waived the right to a hearing, Mollot said, citing a Dec. 3, 2008, letter to AMC-Uihlein Administrator Michelle Byno that outlined the lowered penalty.

The Community Care Coalition monitors federal actions taken against nursing homes with FOIL requests every three months, Mollot said.

"The violation at AMC-Uihlein was clearly extremely egregious. It is very, very rare for inspectors to cite 'immediate jeopardy' because much more goes into having to substantiate it."

The investigation was conducted by the State Health Department and then reported to the federal Centers for Medicare and Medicaid Services, which oversees Medicaid payments.

TWO HOMES
Adirondack Medical Center purchased two nursing homes, Uihlein in Lake Placid and Mercy in Tupper Lake, in January 2007.

AMC Uihlein houses about 90 residents, Riccio said, and is licensed with 156 beds.

Both facilities are subject to routine and regular oversight review by the Department of Health, Riccio said.

Mercy Nursing Home was in the news last month for a different problem.

John Ette, 42, a certified nurse aide who no longer works there, allegedly hit, grabbed and punched a visually and dementia-impaired resident in October 2008. The woman suffered a broken collarbone and facial bruising.

AMC conducted an internal probe and fired Ette, who has since been charged with endangering the welfare of a vulnerable elderly person, endangering the welfare of an incompetent or physically disabled person and willful violation of health laws.

E-mail Kim Smith Dedam at: kdedam@pressrepublican.com