By Ron VandenBoom
It was an emotionally charged atmosphere that greeted anyone passing through the doors of Prairie Vista Manor nursing home in Big Sandy Wednesday as six state employees from the Senior and Long Term Care Division of the Department of Public Health and Human Services descended on the facility to begin the process of relocating its 25 residents.
Prairie Vista's Administrator, Dave Sande, who came out of retirement in early May to help sort out problems at Prairie Vista, received word late Tuesday afternoon that the facilities Medicaid certification was being pulled by the department effective June 7, effectively closing the facility.
"We've had this place for 38 years," Sande said Wednesday while trying to hold back tears that would eventually force him to leave the room.
"They're devastated," he said, referring to the home's residents. "They're being asked questions like, Well, where do you want to go to live.'"
Sande said some of the residents answer, "This is where I live. I'm not going to leave, I want to live here."
And it has been the home for at least one resident for 21 years, he said.
Sande, who said he found it difficult to go out into the halls yesterday where he would have to confront the residents said the problems at Prairie Vista weren't created by the residents.
"If you want to get after the people at the head of the food chain, so to speak, then get after them, but why hang everybody else in the process," he said. "To me it's not fair."
The head of the food chain at Prairie Vista is currently an Oregon based company known as Northwest Senior Care Association. According to Sande, Northwest was supposed to purchase the facility from him in January.
After the deficiencies were discovered in the December survey, numerous letters and phone calls were made by the state to Northwest explaining the deficiencies and explaining what was expected.
Sande learned in late April that every time the state tried to contact Northwest, they would fail to have their calls returned and letters would be returned unopened.
"I could not believe the letters that have been written and the severity of the letters that were written to corporate office telling of their concerns," Sande said, adding that at no time did the state bother to contact him or his wife Linda with any of their concerns.
Two state surveys, the first in December 2000 and the second in March 2001, were conducted by the state where serious deficiencies in the operation of the facility were found.
Mike Henshew, administrator of Senior and Long term Care Division for the state, said in a telephone interview Wednesday that while the staff at Prairie Vista had done a lot to meet the state's Plan of Correction for the facility, when a state certification team returned on May 21 a number of areas remained deficient.
The state "monitoring team" spent several days at Prairie Vista conducting what Sande and the rest of the staff thought was a final inspection before they would be Medicaid recertified.
Sande and some of the rest of the facility's staff that met with the Daily News Wednesday said they felt they had been betrayed and even lied to by the monitoring team.
Sande said the team would make suggestions, say complimentary things and tell them they were on the right track. The team, Sande claims would tell them, "When we're here next year, things should be this way or things should be that way."
"So we were led to believe that all this work we've been doing ... really amounted to something and we were on the right track," Sande said. "We were all very positive when they left here."
Karen Parisian, a housekeeper and CNA (Certified Nurses Aid) at Prairie Vista, confirmed Sande's interpretations of the team and said that it was not the care the patients were receiving that created the problem, but paperwork.
"How can you close people down because of paperwork," she said, referring to shortfalls noted by the state in documenting treatments and other details in reference to patients.
Parisian also said the facility had been written up because one of the surveyors had noticed that a resident had chipped nail polish on one of her fingers.
Elimora O'Leary has a son in the Big Sandy facility and is not convinced that a move is the best thing for him.
He's getting very, very, good care here," she said, Wednesday. "We're here every day so we know what care he's given."
O'Leary's son has been in several other facilities around the state including a stretch in Havre and she says Prairie Vista is the only place where he has received the type of he needs.
"Now they have to start all over again," she said. "Many places won't even take him."
O'Leary said she had been on the phone all morning trying to contact Gov. Judy Martz and Sen. Max Baucus so far without success.
Carol Squires, administrative assistant and former activities coordinator at the home said that she also felt betrayed by the monitoring team. She said she had been led to believe that they were doing well in complying with the demands of the state.
Squires singled out a fire panel that had just been installed about a year ago and noted that they had updated it further to meet the demands of the state. She claimed the facility had probably spent between $30,000 and $40,000 over the last 6 months to upgrade Prairie Vista.
"Everyone in here loves these residents, we really do," Squires said.
Some of the staff also expressed concerns that moving the residents could be dangerous and even fatal to some.
Joyce DeCunzo, bureau chief in the Senior and Long Term Care Division of the Department of Public Health and Human Services, was the head of the state delegation on site and charged with the unenviable task of beginning the relocation process.
She is aware of the hardship and risk to the residents.
"We're going to move along as quickly as we can with the process partly because the quicker the move is made the less disruptive it will be," DeCunzo said. "But also because Medicaid will only pay for up to 30 days after the notice of decertification is given.
DeCunzo said she realizes that what the state is doing is not popular with a lot of people, but the state has a role and "we do the best we can with that," adding that there were several surveys taken.
"We have federal law that says we have to make this decision and money will no longer be available," she said.
DeCunzo explained that many of the residents at Prairie Vista have no family to help make moving decisions for them and decisions about what will be done have to be made prior to the end of the 30 days.
"We're trying to do the best we can to find an alternative Medicaid placement for these folks," she said. "In the safest most non-disruptive way that we can."
DeCunzo acknowledged that this is a hard situation for everyone, but she was adamant in her defense of the role of the state in doing what the state believes is best for the residents.
"There's no way for me to change what is clearly an unpopular decision," she said. "We really understand the needs of everybody that's involved here. At the same time we clearly have a responsibility that we have to make decisions and the decisions that we make are sometimes not popular."
John Gunhold, owner of JG's Food Farm in Big Sandy said the closure of Prairie Vista would have serious economic consequences for the town.
"If that's not an impact on a town that has maybe 250 workers," Gunhold said. "you know that's more than 100 percent that's got to hurt real bad."
Prairie Vista employees 20 full-time people and 11 part-time people with an average monthly payroll of about $15,500 or just under $200,000 a year. According to Squires, the home also generates about $500 a month in fuel costs, $300 a month in maintenance and supply costs, and about $1,000 a month is spent locally for groceries.
Gunhold's business is one that will feel the pinch.
"They've bought quite a bit here since Prairie Vista has been Prairie Vista...," he said.
Gunhold said he didn't believe there were any other jobs in Big Sandy that could take up the slack. "There's just not an abundance of jobs that's all there is to it," he said.
Big Sandy has, over the last five or six years, lost a bakery, a clothing store, Montana Power Company, a grocery store and a drug store. The closing of Prairie Vista will only continue the downward spiral by also impacting the Big Sandy Medical Center.