A 1983 MARYLAND law gives the state health and mental hygiene department the right to put a nursing home with serious patient-care shortcomings into receivership. The law gets its first real test in the Montgomery County Circuit Court tomorrow, when state health officials renew their request that a receiver be named for the 173-patient Bethesda Health Center.
The new law offers a far more reasonable choice than the alternatives that are usually available to states: closing a substandard nursing home or doing little or nothing about its deficiencies. It would allow the state instead to give such a home new management.
State health department inspectors say the Bethesda center has serious problems in nursing services, patient supervision, infection control, dietary services, physician services and fire emergency plans. The state also says there have been a number of unexplained injuries to patients. The facility has been cited several times since it opened in 1979 for violating nursing care regulations. Attorneys for the center say there are no serious violations. But if the state has adequate evidence to prove its contentions, the home should be taken over. Competent nursing care administrators are on call, the state says.
If the state of Maryland attempts to revoke a nursing home's operating license, the home can appeal that decision in court. It is then allowed to keep operating, perhaps with the same deficiencies it has been cited for, during the appeal. The state can increase the number of inspections during that period, but the small number of inspectors available -- there are only 30 to police the state's 204 public and private nursing homes -- limits that option. Closing the facility would mean the patients would have to be moved -- no smal matter for either the state or the patients or for the growing population of aged as a whole.
But if a nursing home is placed in receivership, it does not stop operating. Other nursing homes would not have to contend with new patients. Here lies the potential value of the new law: it can ensure patients suitable care with the least additional disruption to their already unsettled lives.