Garrett Neese/Daily Mining Gazette Deficient practices at Mission Point in Hancock caused residents to be placed in “immediate jeopardy,” according to a state report released last week.

HANCOCK — In September, administrative staff at Mission Point in Hancock suggested closing the facility down if adequate staffing could not be obtained, according to an inspection report released last week.

Negligent practices at Mission Point in Hancock left residents in “immediate jeopardy” according to the report prepared by the state’s Licensing and Regulatory Affairs and the federal Centers for Medicare & Medicaid Services. It found deficiencies in four areas:

• Insufficient nursing staff to meet resident needs.

• Failure to follow protocols related to turning and repositioning, checking and changing of briefs, showers and basic supervision care and needs.

• Failure to timely pay facility vendors to ensure supply chain fluidity.

• Failure to maintain facility environmental safety, function and order for all facility residents.

“This deficient practice resulted in wide-spread neglect of all 43 facility residents at a level of immediate jeopardy,” the report stated.

Residents and employees interviewed in the report said chronic understaffing had left the facility unable to perform basic duties. A former resident interviewed in September said in June and July, there were sometimes only one nurse and one aide on the night shift. The former resident estimated they had gotten one shower per month; staff said they did not have time to provide more, they said. The former resident also said dietary restrictions were not being followed.

Another resident who required two-person assistance with mobility suffered pressure injuries after not being repositioned frequently. One emergency staff member would put a piece of paper under her to see if she had been repositioned. The staff member returned for their next shift to learn the resident had not been moved.

The surveyors observed another resident calling for help while lying in her bed.

“I am not able to get the help I need,” the resident said. “I don’t want to be here anymore. I want to go someplace else.”

The Hancock facility is owned by Mission Point Healthcare in Bingham Hills, which has numerous facilities throughout the state. Staff members described “begging and pleading” with the facility’s owners for additional staffing. One staff member said during a five-day week, staff would work 16-hour shifts because of mandatory overtime. The turnover had caused two certified nursing assistants to quit recently.

Staff pushed back against corporate officers trying to admit more residents during the shortage.

In a chain of emails quoted in the report, the regional director of operations asked for the facility to look at admitting more residents.

“Along with our current critical CNA staffing shortage, I do not believe it is ethical to begin taking admissions as our current residents are not receiving the care they deserve at this time,” a staff member identified as ‘Facility Staff V” said in an Aug. 26 email.

Further emails from the regional director of operations restated the desire for new admissions, asking how many unoccupied rooms were unaffected by issues with flooring or leaking windows.

“So 5 rooms out of commission due to carpet and leaks, leaving 8 available beds to move residents in?” the regional director said in an Aug. 31 email.

“Correct,” facility staff replied. “We have 4 female beds available and 4 observation beds.”

“Yahoo!” the regional director replied. “Let’s get some admissions!”

On Sept. 5, administrative staff wrote to the regional director of operations to ask for agency staff to be hired immediately to supplement the employees. If not, the staff said, Mission Point should consider closing beds and phasing out the current residents.

“I realize that the aforementioned option of closing the facility is not what anyone really wants to pursue; however realistically and from a patient/resident safety standpoint it may and perhaps should be given serious consideration,” the staff wrote.

Employees also detailed numerous instances in which the facility did not pay vendors on time. Lawn care vendors were suspended, and several other vendors refused to provide work until paid, or would only take cash after cutting off Mission Point’s line of credit. Mission Point had not paid an ambulance company for a year and a half. After the facility’s wheelchair van broke down, one resident had to postpone an appointment when the ambulance company refused to provide non-emergency wheelchair van service.

The report also mentioned the surveyor coming across water flooding a carpeted hallway from under the laundry room doors during their visit. The surveyor found hot water spraying from a fixture on the wall inside the laundry room, which had a 220-volt electric cord on the floor inside.

“This Surveyor called out for help three times before facility staff arrived,” the report said. “This Surveyor then had to assume command of the situation and instruct arriving staff to keep residents away from the area as more residents arrived to the area.”

Mission Point had accumulated $85,795 in fines over the past three years, all coming between June 2020 and December 2021, according to a CMS database. Violations had included poor hygiene, food preparation problems, and violations of COVID-19 protocols. Medicare had also suspended payments twice after previous violations.

In a statement, Mission Point acknowledged issues with staffing and paying vendors. It said it is putting plans in place to address those issues.

Regarding staffing, Mission Point said it is working with MDDHS to supplement staffing and has set up contracts with a nursing/certified nursing assistant agency. They are continuing to recruit, with five CNA candidates in the pipeline. The human resources team is also comparing staff compensation and recognition against peers to determine next steps.

The facility also added a new director of nursing, a registered nurse who also has her MSN. Mission Health is also calling on regional clinical support to ensure proper care for patients, with a presence at the facility and reviewing clinical charting each day. Mission Health is also hosting incident command calls each day between executive, regional and facility leadership.

Staff is also expected to follow the plan of care for residents to ensure they are bathed frequently. However, residents can also refuse showers and bathing.

Mission Point’s chief of operations is also meeting with the chief financial officer and others to work with vendors, and has called several local vendors to fix payment processing issues, Mission Point said.

Mission Point also commented on the water hazards reported. Residents had been relocated to other rooms when the roof began leaking after high rains. Wellness visits had been made to the residents to make sure they were OK after the move, Mission Point said. A contractor has visited the site, and repairs should begin soon.

Mission Point said the flooding observed had been the result of a broken T on a hose in the washing machine. The company that manages the washer and dietary equipment was on-site and fixed the machine immediately.