MONTICELLO — After months of District 5 Legislator Cat Scott calling for a representative from the Adult Care Center at Sunset Lake in Liberty to report to the Legislature, Deputy Administrator of the facility, Bobbi-Ann Kanoff, gave the latest report of the Care Center to the Health and Human Service Committee of the Legislature on Thursday, July 18. 

Kanoff reported that the Care Center’s health inspection rating will remain one star until their next full Department of Health (DOH) survey is completed. 

“The last citation that the facility did receive was from the DOH in October of 2023,” Kanoff stated. “Since then, any Department of Health complaints, visits or incidents that were portable, no citations were issued.”

The Deputy Administrator said that as part of normal quality assurance practices and to prepare for the next full DOH survey, a mock survey was completed on May 15. 

The mock survey noted issues with facility condition, administration and clinical. The facility condition issues are with kitchen material conditions that need improvement. It is an ongoing situation and Kanoff said they are meeting with the Department of Public Works (DPW) to make interim fixes. The Care Center report notes that long-term investments in the kitchen are dependent on the outcome of the Certificate of Need (CON) from Infinite Care.

However, County Manager Joshua Potosek said that the kitchen remodels have been an ongoing discussion with Infinite Care. He said that if the county were to do the remodel they would have to shut down the kitchen for a period of time because they wouldn’t want to operate the kitchen through it. 

“We’ve offered for [Infinite Care] to come in and have a private sector do it,” Potosek stated. “They could do it probably quicker than we could do it just because they could work longer hours. Not to say it’s the money, it’s more of an operational thing. So if we shut down, where are we getting meals from and things like that. I don’t know that it’s a wait for the CON thing, it’s more operationally how do we get this done in the most efficient way.”

Scott, the Chair of the Health and Human Services Committee, noted that it’s hard for the employees in the kitchen to do the work that they need to do because of some of the work that needs to be done on a remodel. 

“I know it impacts the type of food and quality of food,” Scott said. “And the residents, it’s one of the things that they complain about.”

Health and Human Services Commissioner John Liddle clarified and echoed Kanoff’s report that the Care Center and DPW are working on getting whatever fixes they can do in the interim done. 

The county is currently working on replacing the air conditioning units and Scott told the Democrat that she noticed a definite temperature difference between the second and first floor while visiting the facility. There were a few occasions in which Scott said the temperature had been above 80 degrees. 

Kanoff told Scott that every shift, the workers go in and monitor the temperature in each individual room where the units are not working well.

“I enjoy going and seeing residents and talking to them,” Scott said. “I’m going to stay on top of this. This is why I chose to do this, to make sure that the vulnerable people of that facility have a voice.”

Addressing issues

In the report, Kanoff spoke of the Care Center working with the Sullivan County Coalition of Hospital and Nursing Homes over the past few months in their partnership to build better communication and teamwork among the staff of each facility. 

“The Coalition meets on a monthly basis and it was established by Garnet Health to ensure we are communicating our residents’ needs, facility needs and hospital needs for mutual support,” said Kanoff. “The focus of this effort is on improving correlation between Garnet Health emergency room, the nursing home’s case workers, nurses and doctors to better serve our residents and Garnet’s patient population.”

For administration issues, the mock survey noted shortfalls with administrative procedures regarding proof of completion of mailing for required notifications to family members. Other issues were noted in the mock survey, which Kanoff said have been addressed - ensuring care plans are resolved when no longer appropriate and documentation of vaccination declination and consent. 

She also said that the education of staff has been completed and monitoring will continue. For clinical, Kanoff said that enhanced barrier precautions for infection control were noted to have improved significantly since the last survey. 

For quality measures, the Care Center is currently rated with two stars and the report notes that this measure suffers in some ways because of the relatively complex needs of the Sullivan County patient population. 

“This rating is deriving from our recent extended history of high poverty and poor health rankings,” said Kanoff. “Areas of strength on these ratings include percentages of short-stay residents who are at or above an expected ability to care for themselves and the extent of their mobility at discharge. One area we will focus on for improvement in the months ahead is vaccinations for residents and staff.”

Kanoff said that Public Health Education will support the effort of getting vaccinations for Care Center residents and staff.