LOCAL NEWS

Borman Hall

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In conjunction with the
changes, the Borman Hall
board last week approved a
voluntary, self-imposed sus-
pension of new admissions un-
til Nov. 1. "We need to get the
staff focused and energized"
on changes, Mr. Budin said.
"And we can best do that by
maintaining the same resident
population."
The key issue for Mr. Budin
— the one upon which all oth-
ers hinge, he said — is quali-
ty of life.
"I'm talking about respect-
ing the dignity of the residents,
responding to the residents,"
he said. "And that's a matter
of changing attitudes — prob-
ably the most difficult of all the
Level A violations to correct."
To achieve his goal, Mr.
Budin has instituted a num-
ber of training and teaching
seminars to sensitize staff to
residents' physical and men-
tal needs. One example is a
program, started this week, to
discuss causes and individu-
alized treatment for bladder
and bowel problems.
"What has been dealt with
until now is the symptoms, not
the causes," he explained. "A
symptom is odor — the smell
of urine. To go around and just
dean up after the accident is
not acceptable. Its also a dig-
nity issue."
For Mr. Budin, "changing
attitudes" is a program that
starts at the top. "There will
be no double standards in this
place," he said. "If it's good
enough for the housekeeper,
it's good enough for me."
Consequently, he is deter-
mined to secure top-level staff.
Among the new personnel al-
ready hired: a director of food
service, of activities and of
nursing services.
Mr. Budin also is appoint-
ing registered nurses to man
every floor of the home; each
nurse will be responsible for
guaranteeing all activities —
from patient care to food ser-
vice — in his area.
"Previously, there was no
consistency. It was simply the
job of whichever nurse was on
duty at the time," he said.
"That's unacceptable."
A new team already is at
work to improve resident as-
sessments, the records on each
person living at Borman Hall.
"What we had before was
more of a paper compliance
that really did not tell the sto-
ry of that resident," he said.
Mr. Budin wants a complete
assessment. Ha resident, gen-

erally wheelchair bound, takes
three steps one day and four
the next, Mr. Budin wants it
recorded. If another eats
pureed food but needs to move
to solids, Mr. Budin wants the
progress charted.
"It's a tall order," he said of
the required changes. "But
we're not going to just hire con-
sultants and temporary staff'
to overturn the Level A defi-
ciencies. "We want to mak
the changes permanent."
Though with this most re-
cent Public Health report
Borman Hall, for the first
time, received Level A cita-
tions, such marks are not un-.
common. Since January 1991,
44 nursing care facilities in
Michigan have been handed
Level A deficiencies.
Borman Hall has, in past.,
years, been cited for minor de-
ficiencies by a Detroit-based. ,
review group.
This year's report was is-
sued by a Lansing team and
conforms to new standards set
forth in the Nursing Home*
Reform Act of 1987. The new
law says that health officials
must conduct interviews with
residents and their families be-
fore issuing evaluations of
nursing care facilities.
Previous evaluations could be
based solely on nursing home
records.
Violations cited in the ev
uation are determined by fre-
quency. If numerous residents
complain, for example, that
their medical care is inade-
quate, the issue is likely to be-
come a Level A violation.
Should the survey team
members find an overwhelm-
ing number of Level A viola-
tions, or determine that
residents' lives are in imme-•
diate danger, they will imme-
diately bring in an interin?
staff to take over the nursing
facility.
A second option, for homes
with a significant but not over-
whelming number of Level
violations, is to give the facilii
ty in question 23 days to make
improvements, before return-
ing for a second survey.
The third option — which
the Public Health team sea
lected for Borman Hall — is to
give the nursing facility 41
days in which to show
progress.
Administrators are obligat- -
ed to address each complaint
in the report, offering a plarr
for correction and the date by
which it will be accom-
plished. ❑