By David Grant Long

A letter expressing great dismay over deficient conditions recently uncovered at the Vista Grande Nursing Home in Cortez is being sent to Continuum, Inc., the for-profit company presently re-negotiating its lease on the home, following a Thursday meeting of the two local entities that oversee its operation.

"Both boards passed motions . . . directing legal council to notify Continuum that they were extremely disappointed in the recent indications of violations and problems at the nursing home," said Kelly McCabe, attorney for the Montezuma County Hospital District, yesterday.

"Also, the boards were concerned by the apparent lack of anything in the proposed lease that Continuum had proffered with regard to patient care other than compliance with JAHCO (an accreditation group) standards," McCabe added. "They want us to put Continuum on notice that patient care will be a priority in either a lease extension or ground lease that may be negotiated."

A variety of incidents involving insufficient patient care and hygiene as well as inadequate and tardy attention to medical conditions were documented during an inspection of the home by the Colorado Department of Health and Human Services in September.

Some deficiencies concerned incontinent, paraplegic patients being left unattended for as long as seven hours without being repositioned or having their undergarments changed, according to the report. Others involved a 93-year-old woman receiving cuts on her legs from unpadded metal protrusions of her wheelchair over a period of months, and a patient who was taking a blood-thinning medicine going without doctor-ordered tests for months as well.

The home was leased to Continuum nearly four years ago after Quorum, Inc., which still manages Southwest Memorial Hospital, informed the directors of the Montezuma County Hospital District that it was unable to manage that facility without incurring consistent financial losses for the district.

Critics of the deal expressed concerns at the time that the quality of care might deteriorate if the profit motive became paramount. They also questioned why the home couldn’t be operated more efficiently without leasing it to a private company.

In the lease, which was written by Continuum lawyers, the company agreed to make annual lease payments of about $160,000 to the district for the right to operate the home, and now wants either a revised 40-year lease under which the payments would increase in 10-year increments to only $195,000 by 2030, or a lease of ground on the property on which it would build a new nursing home.

The company is also demanding the option to sell either lease to another for-profit company if the district doesn’t want to buy it back at market value, but McCabe said there was no support among board members for this provision.

Before going into executive session to discuss their negotiating position, board members of MCHD and Southwest Health Systems, the non-profit corporation that runs Southwest Memorial Hospital for the district, agreed that the welfare of the residents must come first.

"We need to get language in that lease that protects the citizens of this community who might be or will be patients in that facility," said MCHD board member Don Jolovich. "I don’t think they have that protection right now.

"These citizens cannot protect themselves," he added. "They’re totally dependent on the facility to take care of them and they deserve as good of care as they would get at home, or better.

"That should be the bottom line, not dollars."

SHS board member Floyd Barnum responded that "you’ve still got to look at the dollars -- if you don’t have the dollars, you’ll have to close the place."

But Jolovich said the mission of the nursing home isn’t to make money for the district.

"If you could break even and give the patients the best care possible," he said, "I don’t think anyone in this community would complain."

SHS board member John Greenemeier agreed, and said his board was also concerned about the quality of care, but noted that the home would be re-inspected without leasing it to a private company.

In the lease, which was written by Continuum lawyers, the company agreed to make inspections. "It’s the first visit (by state inspectors) we need to look at," Smith said, because "the pain and suffering have already happened."

The deficiencies reported by the health department were dismissed as a one-time occurrence by Vista Grande director Jo Ann Aldrich Monday. She said all the problems had been addressed and that previous inspections have been good.

Aldrich also maintained that the home’s patients are more difficult to care for because of the severity of their illnesses and that the latest inspection had d soon to make sure the deficiencies had been corrected.

However, MCHD board president Randy Smith pointed out that follow-up inspections generally find that the original deficiencies have been taken care of, since the facility knows they’re coming.

"It’s the responsibility of the citizens have elected us to watch that."