Citations pile up for Concord Care

PERKINS TWP. Concord Care and Rehabilitation Center could pay more than $4,000 as penalty for a
Sandusky Register Staff
May 24, 2010



Concord Care and Rehabilitation Center could pay more than $4,000 as penalty for an abuse citation issued to the nursing home by the Ohio Department of Health.

The citation, along with recent violations for failing to notify a guardian of a resident's health changes and another for giving a resident unnecessary drugs, is one more to add to a list of a half dozen violations discovered at the nursing home by state investigators in January.

The abuse citation stems from the same allegations against former nurse John Riems that he raped a male patient. Riems, 50, is criminally charged with one count of gross sexual imposition and three counts each of rape, sexual battery and patient abuse.

Those charges allege Riems, while working as a nursing supervisor at Concord Care, abused two men who resided there. Police said that during questioning Riems recalled abusing nearly 100 residents during his more than 20-year nursing career.

Investigators from the state suspect 16 residents were abused by the nurse, identified in the report as "RN #1," but only one abuse case was confirmed through the investigation, the report stated.

In an interview, the nurse allegedly told police detectives "there were repeat victims, male and female, and that he wanted to be a nurse on the night shift because there was no administration around ... he looked for victims who did not have bowel movements for several days and then would digitally stimulate the rectum of those residents."

The abuse citation states the nurse also then held a male resident's genitals for a few minutes, the report said.

The nurse said "when he went home after his shifts he would fantasize about his actions at the facility" and stimulate himself, the report said.

Concord Care submitted a plan of corrective action in the report, signed by nursing home administrator Jessica Short.

"We do not necessarily agree with the citations for which we were cited," the response said. "However, the law requires us to prepare a plan of correction for the citations whether or not we agree with them."

Responding to the abuse citation specifically, Concord Care officials noted that "we do not agree that our facility should have been cited at all."

"We did not suspect, and should not have suspected, that this incident would take place -- we could not have prevented it from happening," the response said.

The citations for failing to notify a change and unnecessary drugs were discovered as a result of investigating the abuse complaint, said Sara Morman, ODH spokeswoman.

As a penalty for the citation, ODH workers recommended the nursing home pay a one-time fine of $4,050.

"Because of the scope and severity of the citation for abuse... we would recommend some enforcement remedies and we have done that," Morman said.

Additionally, they recommended Concord Care pay $100 per day, retroactive to Jan. 20, she said.

Civil penalties are instilled "if a citation has actual harm to it or potential for harm," Morman said.

The penalty orders are under review by the Centers for Medicare & Medicaid Services.

"They're still working through that process to determine an end date for that," she said.

Meanwhile ODH also conducted a follow-up survey March 18 and recommended the nursing home be re-certified. Its certification was drawn into question after the citations were issued.

"We conduct a follow up survey every time we have a citation to make sure the facility is back in compliance with state and federal rules," Morman said.

CMS is also reviewing that recommendation, but it could be a few months before penalties are finalized, Morman said.

They have given initial notice to Concord Care that they are in agreement with the penalty recommendations, she added. The suggested penalty amounts can be appealed and could change, Morman said.

Deb Ifft, chief executive officer for Concord Health Care, released a typed media statement Tuesday in response to the ODH investigation.

"Concord of Sandusky is happy that the investigation of recent allegations is complete," the release stated. "The department concluded that there were not and are not any ongoing risks to our residents of the type that have been incorrectly attributed to our facility by disgruntled ex-employees and some media sources."

Citations issued to Concord Care in January ranged from improper use of physical restraints, pressure sores on a resident and improper hydration of a resident. There are no other pending state investigations of Concord Care right now, Morman said.

In regards to the nursing home's former employee, Riems remains on $500,000 bond at the Erie County jail. He has pleaded not guilty to his charges and is set for trial in September.

List of citations

Ohio Department of Health citations against Concord Care of Sandusky


* Abuse: the facility failed to prevent a male nurse from sexually abusing a resident.

* Notification of changes: the facility failed to notify the attending physician and guardian that a lab test on a resident's stool tested positive fro blood.

* Unnecessary drugs: the facility failed to monitor a resident who exhibited abnormal side effects to therapy.


* Physical Restraints: the facility implemented bed rails for a resident without any indication of physical or psychological condition that would require such.

* Comprehensive Assessments: the facility failed to completely and adequately assess two of 10 sampled residents to determine their care needs.

* Comprehensive Care Plans: the facility failed to meet accepted standards of care for a resident.

* Pressure Sores: the facility failed to identify risk factors and implement interventions for the development of a pressure sore on a resident.

* Naso-gastric Tubes: the facility failed to provide the necessary assessment and care for two residents who are fed via tubes.

* Hydration: the facility failed to ensure adequate hydration for a resident.

Source: Ohio Department of Health