Maryland state health officials said yesterday they will revoke the operating license of a Bethesda nursing home where they contend "life-threatening" conditions have resulted in "suspicious" injuries to two residents.

Adele Wilzack, secretary of the state Department of Health and Mental Hygiene, informed administrators of the Bethesda Health Center that she will revoke the facility's license in 30 days because of "life-threatening violations and other serious deficiencies" found by state inspectors earlier this year. Wilzack also said in a letter hand-delivered to the nursing home that she will recommend to U.S. officials that they ban the 173-patient nursing home from participating in the federal Medicare program.

Wilzack's letter came one day after Montgomery County Circuit Court Judge DeLawrence Beard denied her department's request that the Bethesda Health Center be placed immediately in receivership, a step never before taken against any of Maryland's 200 nursing homes.

Charles F. Chester, the nursing home's attorney, said he will appeal the state's decision to revoke the operating license and fight the attempt to place the home in receivership. The facility will remain open during the appeal process. "We're as good as any nursing home in Montgomery County, if not better," said Chester. "The state has never looked at this facility on an objective basis."

Lynn B. Guttenberger, a state health department spokeswoman, said state and Montgomery County inspectors found a variety of patient care violations at the nursing home on several visits between March and June of this year. Inspectors found that the nose of one immobile patient had been broken and an arm of another had been broken in two "suspicious" incidents, she said.

Disoriented patients had been allowed to wander off the health center's property at 5721 Grosvenor La., while other patients did not receive the help they needed to eat meals, Guttenberger said. "Meals had to be returned to the kitchen uneaten," she said.

The state also faulted Bethesda Health Center on infection control, physician services and fire protection.

Chester defended the nursing home's services, saying one patient broke his nose when he struck it against a bed rail at Suburban Hospital. The other patient's arm was broken in a "spontaneous fracture" caused by the elderly person's brittle bones and the required use of body restraints in the case, he said.

Chester added that one patient once "walked out the back door" of the nursing home but was allowed to do so by staff members because the person was not disoriented. The attorney also said inspectors once saw a meal returned uneaten because a resident's nurse had left the room to get help from another staff member.

The state health department, which has cited the Bethesda home repeatedly in recent years, "is nitpicking and unreasonable," he said. "If conditions really were life-threatening, then Judge Beard would have placed us in receivership."

After a hearing Tuesday on the receivership request, Beard set July 18 to hear additional evidence.