By Susan Levine
Washington Post Staff Writer
Friday, October 26, 2007

A Montgomery County hospital threatened with state fines and loss of Medicare funding after a patient's death from malnutrition is back in compliance with state and federal regulators.

Adventist Rehabilitation Hospital of Maryland, which has facilities in Rockville and Takoma Park, was told late last week that it no longer faces sanctions because of changes and improvements the staff had made. "The termination action has therefore been halted," the Centers for Medicare and Medicaid Services told the facility in a letter.

Though the state's most recent inspection found several lingering problems, they were considered "not sufficiently serious" to require punitive action, said Wendy Kronmiller, director of the state Office of Health Care Quality.

The scrutiny followed a mother's complaints last spring about her 29-year-old son's death after three weeks at the hospital's Rockville location. An investigation showed his stay was marked by poor communication among those caring for him and a lack of cohesive evaluation, treatment and follow-up, even as his condition visibly deteriorated. He was "profoundly malnourished" when he died in December, state officials determined.

Subsequent reviews of care also identified serious issues with other patients' dietary needs.

In late August, the hospital's director of quality management voiced confidence in its revised procedures for monitoring and documenting patients' weight. Aisha Bivens said better care also would be ensured by changes in how the medical and dietary staff communicated across departments.

The regulators' approval was welcome news, Bivens said this week. "We're very pleased that we satisfactorily corrected the deficiencies," she said.

The rehabilitation facility, which this week had 45 patients, is part of the Adventist HealthCare system.