Sunnycrest Manor’s new administrator says that the county nursing facility is a “great place,” despite a mid-September state survey that fined the facility for deficiencies in safety and dining services.
“This is not us,” said administrator Cris Kirsch, who started in late September.
The facility has been uncomfortably in the spotlight since Dubuque County began attempting to lower its subsidy of the home, resulting in anxiety for staff and residents. Long-time Sunnycrest administrator Cathy Hedley left in early 2014. Since then, consultants provided an interim administrator, and the county hired Kelly McMahon this year to temporarily fill the role.
The largest of the fines levied against the nursing home, $5,000, was for not properly protecting a resident while walking, resulting in a fall. Staff had not used a gait belt, as required by care plans, and the patient suffered a hip fracture.
The state has accepted the facility’s correction plan, including having safety notices on how to move each resident in his or her room. Staff are also being instructed on using gait belts. “It’s something we work on every day,” Kirsch said.
Perhaps the state finding that reflects the greatest resident concern, however, regards food. “The facility failed to take into consideration residents’ choices and preference and maintain adequate food for residents’ meals,” according to the citation. “Interviews with residents and staff revealed the facility failed (to) provide substitutes of similar nutritional value to residents who refuse food served.” The state levied a $500 fine against Sunnycrest for deficiencies in food service.
Aramark took over consulting with dining services in mid-summer, changing Sunnycrest’s food supplier and employing two people on site. Staffing levels within dining services has been a challenge for the facility: as of last week, Sunnycrest had eight positions open in dining services.
In mid-September notes, multiple residents reported that the food had been great but had declined and that dining services refused to give them foods that weren’t on the menu. Residents complained of runny mashed potatoes, and that, if a resident took a salad, he or she had to give up another vegetable.
At the time, items not listed on the menu had to be asked for at a nursing station and came out of the nursing budget. A family reported bringing in food, and another said that, despite a physician order for eggs and being unable to eat hard-boiled eggs, they were only served boiled eggs.
Others reported being denied seconds and complained that menus were sometimes changed when dining services ran out of food.
The state also found that the facility failed to serve palatable food at the proper temperature.
A third fine, for $500, was levied against the facility for not completing background checks on Aramark employees contracted in dietary services, as required by law. Because all fines were paid within 30 days, the facility paid 35 percent less than listed amounts.
Other findings included that the facility failed to employ a certified dietician, a full-time administrator or a medical director who was a physician.
At the time, McMahon served as administrator, reporting that she working at Sunnycrest about 25 hours a week. A nurse practitioner, McMahon said she served as medical director after the resignation of the previous medical director resigned.
A state survey that started a week later found significantly fewer problems: a fire drill was missed in August, and a background check was completed a day late.
Before beginning at Sunnycrest Sept. 28, Kirsch held a similar position at Luther Manor. “This is in the past,” she said of the deficiencies. “We’re going to move past it and be the amazing place we are.”
Kirsch said that Sunnycrest staff are committed to meeting monthly with residents, regarding menus, including once-a-month “residents’ choice” menu. The facility is also trying to do simple things, such as make sure that bread is offered so residents can make a sandwich at any meal, offering a different kind of mashed potatoes and changing unpopular turkey hot dogs.
Kirsch pointed to dining services’ 88 combined years of service, as well as the dedication of staff throughout the facility. “It’s not representative of what’s going on out there at all,” Kirsch said. “I’ve been so warmly welcomed by staff and residents. It’s like we’re talking about two different places. My interactions with staff and residents have been amazing.”
At Sunnycrest, Kirsch wants to talk about things that bring joy to residents’ lives: the facility’s recent hayride, a drive-in movie and how two CNAs refurbished an unused metal cart into a brightly-painted “Sweets and Treats” cart for residents.
“This focus on the state survey, it’s not what I see,” Kirsch said of Sunnycrest. “I want everybody to know it’s the great place people thought it to be.”