The Bethesda Health Center, a nursing home Maryland health officials had threatened to close last month because of poor patient care and substandard living conditions, will be allowed to stay open under a two-year probation approved by the state's attorney general.

"The sword of Damocles is hanging over those guys -- as is the threat to revoke their license if any further slip-ups occur," said Thomas J. Kwiatkowski, an assistant attorney general. He said lawyers for the 180-bed nursing home on Grosvenor Lane in Bethesda tentatively have agreed to a consent order that places the facility on probation for the next two years.

In September, inspectors from the state health department found more than 100 violations of Maryland and federal health care regulations at the facility. State health officials wrote in reports that the Bethesda Health Center was infested by cockroaches and flies, and that patients were receiving poor care and suffering an unusually high number of falls.

Following the inspection, the state refused to renew the nursing home's license, which expired Oct. 1, and scheduled a hearing on the nursing home's appeal of that decision. The hearing was later postponed while the two sides negotiated an agreement.

David J. Becker, the nursing home's owner and administrator, said that staff changes prior to the inspection, including the departure of several top nurses, had resulted in some deterioriation in patient care. At the same time, Becker said, he was taking steps necessary to comply with Montgomery County, state and federal health guidelines.

Kwiatkowski said yesterday the nursing home staff has corrected most of the infractions cited earlier this year. The remaining violations must be corrected 30 to 60 days after the signing of the consent order, which is expected to take place next week, he said.

H. Bradley Katz, who is scheduled to succeed Becker as the nursing home's administrator, said yesterday that the order "is the preferable alternative." He said, however, that the terms of the order are not final.