D.C. Village, the District's home for the elderly, suffers from such acute shortages of basic medical supplies, clothing, sanitary equipment and trained staff that the federal government has threatened to cut off its aid to the facility.
In late January, Department of Health and Human Services investors gave the city a 17-page catalogue of hundreds of "deficiencies" that must be corrected. They included a shortage of underwear for women, a lack of urinary drainage bags and the fact that physicians cannot prescribe special medications or diets for residents "due to the shortage of food supplements, medications, antiseptic solutions and antibiotic ointments." The investigators found residents inadequately clothed and infrequently bathed, and reported that supplies needed for the care of incontinent residents were unavailable.
Paul Lavigne, long-term care administrator in the District's Department of Human Services, has acknowledged in the past that D.C. Village and other city facilities are short of nurses and technicians. He said yesterday that many of the deficiencies have been corrected and that a proposal for dealing with the rest was sent to HHS last Friday. Estimates vary on how much the city would lose if federal funds were cut off, but it would be at least $1.8 million year.
DHS director James Buford said last night that he expected to fill within a few weeks 57 vacancies on the 742-member D.C. Village staff. He told a meeting of a church coalition that 48 of the 57 vacancies are in nursing positions. Buford said that the city's residency requirement for new employes had impeded hiring but that it was recently relaxed for D.C. Village personnel.
Buford also said that shortages of medicine were caused by a $2,000 limit on purchases, and will be eliminated as a result of an increase in the limit to $10,000. In addition he said that any residents needing clothing will get it.
The District is under pressure to improve conditions at D.C. Village not only from the federal government, but also from workers at the facility and their unions, who have been complaining for months about shortages of staff and supplies, and from churches throughout Southeast Washington that have adopted D.C. Village as a cause.
The church coalition, called the Southeast Vicariate, charged last month that D.C. Village "falls far short of the haven of rest which the older citizens need and would wish for. Instead, they are very often denied the simplest of creature comforts. Unnecessary suffering and deprivation are a direct result of inadequate staffing; shortages of proper medication, as well as medical and surgical supplies; insufficient clothing and sometimes a lack of heat in various parts of the hospital."
D.C. Village, a sprawling, compus like facility in far Southwest Washington near the Naval Research Laboratory, houses more than 600 elderly men and women. Its annual budget totals more than $14 million. Much of that is reimbursed through federal Medicare and Medicaid payments, but those payments could be cut off if HHS is not satisfied that the deficiencies found by its investigators have been corrected. Lavigne said that 150 of of the institution's 637 beds are already ineligible for federal funds because staffing levels fall short of federal standards. That costs the District more than $1 million a year, he said.
Last year the federal government rescinded the accreditation of Forest Haven, the District's home for the mentally retarded, after its investigators reported brutality and insanitary conditions there. That cut off about $6 million in annual Medicaid reimbursements, a heavy blow to a city government that has been grappling with a budget crisis and ran up a $105-million deficit last year.
At D.C. Village, the federal investigators found that there is only one physical therapist for the entire institution, residents are left with nothing to do, shortages of medicines prevent treatment ordered by doctors, incontinent residents were wrapped in sheets because there are no diapers or pads, a shortage of staff and supplies prevented the residents from bathing twice a week as required, men are left unshaved, residents lack adequate clothing, and "supplies necessary for the care of the guadriplegic patients were not available."
David B. Schwartz, D.C. Village's executive director, declined to comment on the specific complaints, but he said, "You have to ask yourself what kind of service you are going to provide. Do you provide the maximum service to fewer people with what resources you have, or do you stretch what you have to serve more people? It's easy to close beds, but then you play ostrich about all the shopping-bag ladies and back-room residents in rooming houses who need to come here."