When David J. Becker takes a visitor through the Bethesda Health Center, he points with pride to the renovations he made in recent years, and shakes his head in angry disbelief at critical reports Maryland and Montgomery County health officials have lodged against the nursing home on Grosvenor Lane.
"People come here, inspect this facility and then tell me I can't do my own damn job," Becker said Monday, hours after his lawyer had met with the state attorney general's office in an effort to keep the nursing home open. The 180-bed residence has been stripped of its operating licenses by Maryland and Montgomery County health officials who found violations of health-care regulations there during two inspections last summer.
The Bethesda Health Center will stay open with 170 patients while Becker appeals the decisions not to renew those licenses. And Becker, a feisty, 47-year-old New Yorker, remains adamant about the quality of care at the nursing home he bought more than four years ago.
"I put this in myself," said Becker, tapping the Tudor-style woodwork he made from scraps of the home's old porches. The vegetable garden, gazebo, and much of the interior are new, part of the $600,000 investment Becker said was required to upgrade the home.
County health officials already had started proceedings against the then-Wildwood Nursing Home's old management when Becker assumed control of the facility. But shortly thereafter, he, too, was cited for sanitary, nursing and health violations.
"Common sense will tell you that you can't turn things around in three years," he said. "But we've turned this facility around from what it used to be. We are every bit as good as the wealthier nursing homes. We may not be the cre me de la cre me, but every bit as good."
Last week, Becker would not respond to a reporter's inquiries about the state reports, but did allow a reporter and photographer to tour the nursing home on Monday. A 90-minute tour of the sprawling nursing home shaded by massive oaks showed spotless hall floors, a clean, well-organized kitchen, and staff rallying around its boss. But according to reports filed with the state health department last summer, the home had violated more than 100 state and federal health standards.
Last August, state health inspectors reported that the health center was infested by cockroaches and flies -- a dead roach was seen in a patient's meal, the investigators said -- and had dirty floors, poor meal plans and an inadequate nursing staff. A senior official in the county health department said conditions at Bethesda Health were the worst she had seen in her 14-year career.
State files also mentioned an ongoing police investigation into charges of patient abuse; a Montgomery County police spokesman confirmed the existence of the investigation last week.
In an action that staff members said was prompted by the inspections at the Bethesda home, the Montgomery County Council voted recently to empower health officials to ban admissions at nursing homes that do not meet health standards.
"Sure, there were problems over the summer, but 15 nurses had just left," said Becker, who fired his administrator shortly after the second survey in August and assumed the position itself. "On the day of the survey, the floors were not as clean as they should have then, but there was no roach infestation. I had Orkin exterminators in here every week during the summer saying things were fine."
On Monday, when a tiny roach scurried across a white linoleum floor, Becker cracked, "Oh, a neighbor," and smashed it with his foot.
Becker's commitment to turn the facility around -- his lawyer is confident of negotiating a correction plan to keep the licenses -- has worked wonders with a staff demoralized by less-than-favorable inspections.
"I've worked in two other nursing homes and this is the best one yet," said Virginia Dickerson, who heads the nursing home's record department. "It's unfair what they said about this facility. The staff is determined to make this a better place. They've got a stick-to-itiveness to prove the health department wrong."
Another employe called recent publicity about Bethesda Health Center "the most embarrassing thing that has ever happened here," adding, "none of those things they health inspectors said was true."
The husband of a stroke victim living at the center said he was satisfied with the care his wife receives. "You know, every place is going to have problems with the help," he said. "That's the way people are nowadays. But that's the only problem with this home. Otherwise, it's fine."
Becker said he has hired a dietitian, a physical therapist and another top nursing official for the nursing home -- positions that were left vacant earlier this year during administrative changes.
Becker also said he had no knowledge of any patient abuse at the nursing home. "I wasn't here. I don't know. I didn't see anything." And he countered the inspection finding that there was a "disproportionately high" number of patient falls by suggesting that such incidents are to be expected with patients as elderly as those at his nursing home.
The summer inspections that precipitated the state action against Becker have moved him to spruce up the nursing home even more. "I was surprised by the surveys . But, hey, that's my report card. I see the results and I say get cracking. It's gotta be better. It's gotta be the best."