On a scale of 100,
"From the report," said
But on a recent tour, a reporter stepped into its kitchen only to be mistaken by an employee for the exterminator who'd been summoned.
"They want to shut down the kitchen," the employee, a woman named Angela, explained. She pointed to a mouse hole at the base of a wall. "We can't get rid of them."
Told he was a reporter, she replied, "Oh, my!"
Bala's abysmal HUD score was mostly based on the physical safety of the building and its residents. An examination of the nursing home's overall quality of care, using city, state, and federal health inspections, revealed 20 years of chronic violations and modest fines for failing to give residents sufficient food, allowing rodents to roam unabated, not having enough staff to prevent harm, and other failings.
Medicare, which has a five-star rating system for the thousands of nursing homes across the country, gives Bala an overall two-star rating -- well below average, but above the agency's lowest-rated homes in
Bala's troubled history also raises a larger question about
"There's no incentive to provide adequate care when the enforcement agency is not going to penalize you," said lawyer
Fines did pick up again in 2015, and have soared in the last four months. Since 2015, 14 homes in
Miller disputed HUD's findings, saying the agency improperly used higher safety standards to evaluate the nursing facility, ones typically applied to apartment buildings. The businessman did acknowledge he missed the 30-day deadline to appeal the findings but would not detail why he believed inspectors were mistaken.
"I can't throw HUD under the bus because we haven't cleared" the 58 violations, he said.
The Miller family at one time operated two nursing centers and 16 residential homes for the mentally ill in
In 2000, federal officials temporarily cut off Medicare and Medicaid funding for its
Among the problem: residents with bedsores, patients receiving insufficient food or water, some who were supposed to participate in therapy three times a week but had sessions only twice a month, and people who suffered from dementia being allow to smoke cigarettes without supervision.
In 2002 and 2008, regulators found more deficiencies and levied several fines.
When HUD inspected
HUD inspects only a sliver of the nation's 15,662 nursing homes because the vast majority have private insurance. Of the 139 nursing homes HUD inspected in the last five years, the only one that had a score near Bala's, a HUD spokesman said, was a facility in
Since 2011, state and city officials have cited Bala for an array of health violations. During the last year, for example, city public health workers have cited Bala for having rodents or insects in the kitchen on four consecutive inspections, records show.
One specific concern that Miller raised about the most recent HUD inspection involved citations for windows that could not be used as emergency escapes. HUD had labeled these as "life-threatening" defects, a finding that decimated the home's ranking.
But Miller said the nursing home purposely installed stops on the windows to prevent them from being opened wider than six inches. He said staffers needed to prevent elderly residents from climbing outside. He said he never intended the windows to be used for emergency escape.
The report said that the woman's bed was unsafely elevated to its highest position, although aides were supposed to keep it close to the floor. The report said Bala workers blamed the woman, saying she would inadvertently elevate her bed by rolling in her sleep on top of an electronic remote control.
Although the Medicare report did not identify the patient, a lawsuit filed last month in
The complaint said she died of a brain injury caused by repeated falls from her bed at Bala Nursing. The suit also said Gillard endured other indignities while she lived there. In
After she fell twice from her bed in
She was discharged to a suburban nursing home, where she stayed until she died
Miller did not respond to requests for comments about the lawsuit. Gillard's son, Darryl, 53, of
Accompanied by lawyer
That may be happening already, Brooks, the legal services lawyer, said.
In October, the
A year earlier, the state
Although enforcement is improving, Brooks said it's still too early to tell if more frequent fines will result in better care at the subpar nursing homes.
Federal inspectors have scheduled a reinspection for
Nursing home resources
Find a facility's federal rating and see its inspection reports at: www.medicare.gov/nursinghomecompare/search.html
Get advice, ask questions or file a complaint about nursing homes at state ombudsmen's offices for the elderly:
Use the federal Eldercare Locator at www.eldercare.gov to find nursing homes by types of services and by location.
Background a single facility or a nursing home chain through 60,000 inspection reports at ProPublica, the nonprofit news site: projects.propublica.org/nursing-homes/
Visit Philly.com at www.philly.com
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