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State Visit Sets off Chaos in Nursing Home

COLUMBUS, Ohio (CN) - Patients in a nursing home's "secured unit" are climbing the fence trying to escape and refusing to take medication after an inspector from the Ohio Department of Health told them they do not have to be there or take their drugs, the facility claims in court.

Regency Leasing Co., which operates the Regency Manor Rehab and Subacute Center, sued the Ohio Department of Health on July 31 in Franklin County Court of Common Pleas.

Regency says the problems stem from a July inspection by the Department of Health, checking its compliance with Medicare and Medicaid programs.

While focusing on "secured behavioral units" of patients who have been deemed incompetent by a probate court and sent to the facility by their legal guardians, the inspector "determined that the care and services that plaintiff provided to a [John Doe] resident ... were not in compliance with the conditions for participation and that this non-compliance constituted a situation of immediate jeopardy," the complaint states.

The inspector said that giving the patient a court-ordered psychotropic drug against his wishes violated his rights as a nursing home resident.

The inspector deemed the care of several other residents non-compliant, including allowing residents to be placed in the secured unit against their wishes, allowing guardians to approve medications against the residents' wishes and allowing guardians to revoke certain privileges against the residents' wishes, according to the complaint.

The inspector told the nursing home that "the finding of 'immediate jeopardy' would only be abated if plaintiff agreed to educate all staff that the right of the resident to refuse medication superseded any contradictory directive of the legal guardian."

Regency says the inspector "advised John Doe and the other residents that they were free to leave the secured unit and that they were not required to take their medications" - a directive that the nursing home says violates state law.

Since the conclusion of the Department of Health's inspection, Regency says, "numerous residents have attempted to exit the secured unit by scaling the fence in the courtyard and/or have refused to take all medications, including, but not limited to, anti-psychotics, anti-depressants, anti-hypertensives, heart medications, thyroid medications, vitamins, and diuretics.

"In short, defendant has created a situation whereby the directives of the legal guardians and the orders from courts of competent jurisdiction have been rendered meaningless. The proverbial tail is now wagging the dog."

Regency also says the inspector's report was delivered late and that it intends to dispute the report.

The nursing home seeks a temporary restraining order preventing any further communication between the Department of Health and its residents, and an injunction preventing enforcement of its proposed "plan of correction."

It also seeks reimbursement of any damages sustained to the facility and its residents and employees in the interim.

Regency is represented by G. Brenda Coey, with Bonezzi, Switzer, Polito and Hupp in Cleveland.

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