Lakeland Village Funds Imperiled Medicaid Funds At Risk Unless Services To Residents Improved

Lakeland Village, a state institution for the developmentally disabled, will lose millions of dollars in government money unless it provides its residents with more active services.

The Medical Lake center, which has 286 residents, didn’t meet all the conditions required to receive Medicaid payments in its annual survey. Its Medicaid provider agreement will be terminated Dec. 1 unless problems are fixed.

Almost half of Lakeland’s $61.9 million, two-year budget is Medicaid money.

“I wouldn’t even know how to think about a facility that loses half of its funding,” said Laurie Zapf, the regional administrator for the Department of Developmental Disabilities, which oversees Lakeland Village. “I don’t want to think about it.”

Zapf and Lakeland administrators disagreed with inspectors’ findings. Zapf said she is confident Lakeland will meet requirements when it’s inspected again and that it wouldn’t lose any Medicaid money.

Inspectors said Lakeland didn’t meet 13 federal requirements, including protecting residents’ rights, treating residents correctly, planning and implementing programs for residents and administering drugs.

State inspectors who contract with the federal Health Care Financing Administration conducted the annual survey from May 29 to June 10.

Inspectors will examine Lakeland until all the problems are fixed, or until Medicaid money is taken away.

Many citations involve active services, or providing activities that will help residents become more independent.

“Everybody can learn,” said Darlene Aanderud, the administrator for the survey program for centers such as Lakeland for the Division of Aging and Adult Services. “You work at where they are, at their level. You help them become as independent as they possibly can.”

The active services requirements are ones that Lakeland has had trouble with before. The center faced similar threats and citations in 1987 through 1989.

In her response to inspectors, Lakeland Village Superintendent Sandra Kertes disputed 10 of the 13 citations, saying inspectors didn’t investigate thoroughly and drew erroneous conclusions.

Kertes also said state inspectors didn’t fully understand Lakeland Village’s treatment package, which blends informal and formal training. Staff members have significantly reduced residents’ outbursts, enriched the environment and trained residents to stop behaving inappropriately, Kertes said.

She said many residents were increasing their skills and independence. Others maintained skills despite degenerative or limiting conditions.

Inspectors said Lakeland failed to give 20 of 23 patients enough active treatment that was meaningful and directed toward independence.

Some patients didn’t get help correcting inappropriate behavior. Others didn’t develop basic self-care programs. Most didn’t get continuous active treatment, instead spending most of their days doing busywork, inspectors said.

One patient rocked repetitively in a reclining chair. Rather than giving the man something structured to do, a staff member said, “You look happy.”

Another patient twirled an electronic toy for 20 minutes in front of staff without being interrupted or redirected. Another flapped a paper towel roller and then flipped a sock in the air for about 45 minutes, inspectors said.

Inspectors said staff failed to ensure that patients used age-appropriate material and wore normal clothing. Residents also didn’t have easy access to their possessions.

Toiletries were locked behind a clear plastic door. One patient wore his shirt backward, another wore a shirt inside-out, and two wore heavily stained sweatshirts. Others wore pants that dropped below the waist, without any help from staff, inspectors said.

Adults were bored listening to children’s songs, like “Yankee Doodle” and “Skip to my Lou.”

One resident was seen walking through Lakeland carrying a plastic toy in his mouth and another in his hand. Five days later, he carried the same plastic toys in his mouth and intermittently replaced them with a large plastic comb.

Staff didn’t try to engage the patients with more age-appropriate activities, inspectors said.

They also said Lakeland staff administered incorrect medication - one in 41 drug handouts. A patient was given one multiple vitamin instead of the two ordered by the doctor.

Lakeland staff also failed to train many able patients to give themselves medication, inspectors said.

Kertes said the center will administer medications without errors in the future and will train appropriate residents to give themselves medicine.

, DataTimes MEMO: This sidebar appeared with the story: REQUIREMENTS NOT MET Inspectors said Lakeland didn’t meet 13 federal requirements, including protecting residents’ rights, treating residents correctly, planning and implementing programs for residents and administering drugs.