Are Nevada’s Nursing Homes Safe?  Should You Be Worried About Loved Ones?

by Johnny Gunn

Following the deaths of six patients at a Carson City nursing home, questions have been raised state wide about the care and health of the elderly and infirm at the state’s nursing homes.  Evergreen at Mountain View nursing home, 201 Koontz Lane in the capital city, could lose its Medicare and Medicaid fees, and has come under intense scrutiny by the state health department and the federal Center For Disease Control and Prevention (CDC).

On December 9, 2003, six patients died at the Evergreen facility within a 21 hour period, and an investigation has revealed that on October 17, an inspection by the state Bureau of Licensure and Certification (BLC), turned up 24 deficiencies at the facility.  A reinspection on December 9 and 10 indicated that Evergreen at Mountain View was still deficient in six of those original areas.

According to Pamela Graham, the BLC Bureau Chief, the national rate for deficiencies is seven, while Nevada’s rate overall is 11.  According to state epidemiologist Randall Todd, at least four of the deaths may have been caused by influenza, and there were also indications that Strep A was prevalent.  “A Streptococcus Bacteria,” rather common in the general population has not been a common problem at the state’s nursing facilities according to Graham.

Graham said that nationwide, “health officials usually find an average of seven deficiencies and in Nevada, we have an average of 11.”  That comes, she said, from a serious staffing shortage, and an inability of the facilities to maintain a solid staff.  “There is a serious shortage of nurses in Nevada,” Graham said, and often, those who work in the facilities are recruited by out of state employers with more money to offer.

“On the average,” Graham said, “Nevada is probably about average compared to the rest of the country, maybe slightly lower.”  Graham went on to say that comparisons are difficult to make since there are so many different types of nursing homes.  She did say that Nevada exceeds the national average in citations issued.

There are three Evergreen facilities in Nevada, two in Carson City and one in Pahrump, in Nye County.  According to figures received from www.medicare.gov, the Evergreen at Carson City, 3050 North Ormsby, had 15 deficiencies listed during the complaint reporting period, August, 2002 to October, 2003.  The Evergreen at Pahrump, 4501 North Blagg Road had six deficiencies during that same reporting period, while Evergreen at Mountain View, 201 Koontz Lane in Carson City had 39 deficiencies.

From the medicare web site, it’s noted that several nursing homes are well above, not the federal average of seven deficiencies, but above the Nevada average of 11.  Among them, at random, Desert Lane Care Center, 660 Desert Lane in Las Vegas, 32 deficiencies of which at least three posed an actual harm to patients; Cheyenne Residential, 2860 East Cheyenne Avenue, North Las Vegas, 21 deficiencies;  Delmar Gardens of Green Valley, 100 Delmar Gardens Drive, Henderson, 15 deficiencies.

On the other hand, Battle Mountain General Hospital, 535 South Humboldt Street, had but one deficiency.

The CDC, after conducting its investigation indicated that Evergreen at Mountain View was improving in their handling of the discrepancies that have been noted, and their report is expected to be released sometime toward the end of January, 2004.  In the meantime, the BLC has recommended that Evergreen get no Medicare or Medicaid reimbursements, and the federal centers for Medicare and Medicaid Services will rule on that on January 17.  There will be another inspection on January 17 as well.

Among the problems that need to be addressed at Evergreen at Mountain View, according to the CDC and Nevada’s Health Division are bed sores arising from not properly moving patients.  These are referred to as ‘pressure sores,’ and apparently there was a lack of a program to assess problems from bowel and bladder ailments.

As many as four of those who died may have been influenza related according to state officials.

According to Graham, the division has a solid working relationship with nursing facilities in the state, working to continually improve how the homes are operated.  Quality improvement programs have been instituted in at least 17 facilities across the state.

Federal Marshals Close Binion’s Unpaid Union Debt Forces Closure

Home to High Rollers, Home to World Poker
Some Say it is Final End For Owner Behnen

by Johnny Gunn

After 52 years of glitz and glamour, Binion’s Horseshoe Club, under the supervision of Becky Binion Behnen for the last five and a half years, was forced to close January 9.  Federal marshals and Gaming Control agents closed the doors and seized almost $2 million from the cage.

As we go to press, The Observer has learned that Harrah’s has announced a $50 million deal to purchase the Horseshoe.  Most of that will just cover outstanding debt, according to inside sources, although terms of the buyout have not been released. 

The Nevada Gaming Control Board must OK the sale, but that is not expected to be a problem.

Federal district judge Roger Hunt signed the papers allowing for the seizure of the money, directly from the cage, to satisfy debts owed to two union funds.  Chief Deputy U.S. Marshal Fidencio Revier began the closure at about 7:00 p.m. on that Friday night.

The money is owed Southern Nevada Culinary and Bartenders Pension Trust Fund and the Hotel Employees and Restaurant Employees International Union Welfare Fund.  According to Las Vegas gaming sources, Behnen has been operating the downtown property despite very hefty debt that has been growing.

Among other creditor are the IRS with two liens on the property, seven landlords that lease the land the club sits on, and many high rollers who keep money in special vaults on the property.  Among those is developer Bill Walters whose demand for about $190,000 led to a run on cash from other’s keeping cash on hand.

The Gaming Control Board was advised of the closing late on Friday and had agents on hand.  “We wanted an orderly shut down of gaming,” at the club, Chairman Dennis Neilander said. 

Gaming officials will make sure the casino has enough cash on hand to cover the $1.9 million seizure, and still pay outstanding bets, such as, from the sports book, and to pay outstanding wages.

Myron Leavitt Dies

Nevada Supreme Court Justice Myron Leavitt passed away on Friday, January 9, leaving public life, and a large family following in his footsteps.  Justice Leavitt was what some refer to today as an old time Nevadan, one who knew the history of the state, demanded justice, yet was kind and benevolent when necessary.  He was 73 years of age, and his wife of 49 years, Shirley, was at his bedside when he died

Leavitt served on the high court since 1998, served 14 years prior to that as a district judge, and was a member of the Las Vegas city council, Clark County commission, Justice of the Peace, and was Nevada’s Lieutenant Governor during the Bob List year}

His daughter, Michelle, sitting as district judge on the bench once held by her father, said, “His legacy will be his dedication to public service.”

As a side note to his life, during the years of statewide campaigning, he would pile all eleven of his children into a large van and travel the state.  Michelle Leavitt said all the family would sing “Home Means Nevada,” the state song.  At the funeral, his 34 grandchildren gathered to sing one last time to the patriarch.

Governor Kenny Guinn is now called on to pick Leavitt's replacement.  The two coached Pop Warner football teams in the 1960s. 

“The Supreme Court will miss his wit and wisdom.  I'll miss his friendship and sense of humor,” the governor said when told of his death.

The Commission on Judicial Selection will interview applicants during the next several months, and recommend three names to the governor who then will name Leavitt’s successor.  That person will serve until the next general election, and then the seat will be on the ballot, the winner of that then will serve the final two years of Leavitt's term.

Leavitt had just had kidney replacement surgery, a kidney donated by his son James, a Las Vegas attorney, and he appeared to be on the road to recovery.  Complications set in however, and he died at 10:00 p.m. at University Medical Center.  The kidney surgery had taken place on November 17.

Entertainment Now Costs More,
Might Generate $75 Million Per Year

Nevada's new entertainment tax went into effect January 1, and joins higher taxes on cigarettes, booze, and casino entertainment.  Casinos started charging more in September.  The tax is variable, from about five percent on ticket prices at large venues, those that seat more than 7500 people, to 10 percent at smaller venues.  There will also be a 10 percent tax on food, drink, and merchandise at smaller venues with 300 to 7500 seats.

The state is expected to take in somewhere close to $75 million from the new tax which is a part of the major tax package enacted by the 2003 legislature.  Among the taxes already in effect are 45 cent increases for a pack of butts and a 75 percent increase in alcohol, which went into effect in August of 2003.  Lame Duck Governor Kenny Guinn insists he won't ask for another tax increase when the legislature meets in January, 2005.

Ticket prices for major events at the state's venues will be considerably higher.  Thomas & Mack Center in Las Vegas and Reno's Lawlor Events Center and other venues will be involved.  Probably the venue that will be most affected will be Las Vegas Speedway which hosts a NASCAR weekend in March of this year.

Non profit entertainment, such as school sports, will not be affected, nor will movies, bowling, or renting movies.  Also not being affected are restaurant piano players, or nightclubs that have DJs playing the music.  Bartenders who occasionally sing or dance won't qualify as entertainment under the new law as well.

All together, the tax bill passed in 2003 was expected to raise well over $800 million per year and is the largest tax increase in Nevada history.

Campaign Reform, Nevada Style
(An Accountant Would Cringe)

The last legislative session brought the tiniest bit of campaign finance reform, but not nearly what Secretary of State Dean Heller would like to see.  It seems, he said, that legislators “are for full disclosure, but somehow the forms never meet the basic requirements any accountant would insist upon.” He was talking about beginning and ending balances as among things missing in the forms the state requires.

There have been some reforms, however, and today, January 15 is the deadline for what's called the Annual Contributions and Expenses Report (C&E Report), now changed.  This form must be filed by all candidates, incumbents, committees, advocacy groups, and political parties.

There is a new form which was mandated by the last legislature, and it does contain a Disposition of Unspent Contributions Report, Contributions in Excess of $10,000, and the previous C&E, now all incorporated into one document.\par }

Heller said it's a move forward, but doesn't go far enough.  He points out that current law will allow politicians to hide tens of thousands of dollars from voters.  The legislature has not accepted his thinking on this.  Twice they have turned him down on his campaign finance reforms, but it appears with these changes, he may be gaining some support. 

Despite the legislative rebuke, Heller is continuing to work toward financial reforms.  “I am sending a letter to elected officials asking them to voluntarily include this information (beginning and ending balances) so the public and media will have access to complete and accurate information.”  Heller went on to say, “I hope all candidates and incumbents will comply.”

At least two of those have said they will.  Assemblywoman Chris Giunchigliani, D-Las Vegas, and Senator Randolph Townsend, R-Reno, have said they will comply with Heller\'d5s request.  According to at least one report, republican Governor Kenny Guinn has also indicated he would include the information on his forms.

Townsend said that adding the information to the forms will be one of his points of focus during the next legislative session.  “The last time I looked, we were still in public service.”

There are penalties for missing the January 15 deadline for the C&E Report, the maximum of which is a fine of $100 per day for each day the report is late.  Heller said he plans to include those missing the deadline on his web site, http://secretary of state.biz.  You can also find the forms on that site as well as previous campaign finance reports.

The Buzz Around the State

Compiled by our Correspondents

Politics First

(Carson City) --- There seems to be, if not a tidal wave, at least a disturbance in energy, to call on Las Vegas Mayor Oscar Goodman to run as a democrat in the 2006 gubernatorial race.  No comment from Goodman so far, but a recent statewide poll seems to have him as the front runner.  The names of Perkins, Titus, Gibson did not come as high in the poll.

Neither did the name Randolph Townsend bring many huzzahs, but rumors abound the Washoe County Republican senator has been talked about.  Townsend lives in Reno, a good northern base, while his wife Robyne lives in Henderson, a good southern base.

•••

In the meantime, former Nevada legislator Don Ashworth, current Clark County Probate Commissioner, has announced he will seek the seat currently held by Chief Justice Deborah Agosti.  He joins John Mason, former republican party official, and Las Vegas Justice of the Peace Douglas Smith.  The Supreme Court is a nonpartisan office.

White Pine County

(Ely) --- A grant of $15,000 from the E.L. Cord foundation will be used for advertising, community education and travel expenses for members of the Penney Replacement Team, a group of citizens planning to operate a community store in Ely.  The grant was not anticipated nor was it solicited.

The committee will travel to Powell, WY to exchange ideas with the Powell Mercantile, which serves as a model for Ely’s planned department store.  JC Penney Co. plans to close their existing franchise in the eastern Nevada community in July of this year, and the Replacement Team is looking to open a community mercantile store in its place.  They haven’t picked a name for the new store as yet.

Lincoln, Esmeralda, Nye Counties

(Tonopah) --- Pessimism abounds everywhere except at the U.S. Department of Energy (DOE).  While it seems most people can’t understand how the DOE could possibly think about building more than 300 miles of railroad through southern and central Nevada, DOE has gone to the Bureau of Land Management (BLM) to ask them to withdraw a mile swath of land more than 300 miles long.

That swath would run through Lincoln, Nye, and Esmeralda Counties and to this point in time no one has ventured a guess at the astronomical costs of such a rail line, more or less how many years or eons it might take to get all the permits it would require.

DOE has said they can build 319 miles of railroad in 46 months for $880 million.  Most in Nevada feel it will cost well over $2.6 billion and take longer than 10 years to permit and build.

We are now in a 90 day public comment period following formal notice of DOE’s land withdrawal application which was published December 29, 2003 in the Federal Register.

Within that 319 mile corridor are highways, ranches, mines, public land, private land, but not the Nevada Test Sight nor the Nellis Air Force Base bombing ranges.  They have said it would be too dangerous.

Storey County

(Virginia City) --- At the upper end of Six Mile Canyon is the Ophir Mine in Virginia City, the mine that started it all.  It’s where Old Pancake, that is Henry T.P. Comstock demanded to be the claim holder of a silver strike that has become known as The Comstock Lode.

Until just a few years ago, Six Mile Canyon road was a dirt and gravel affair that was a miserable road to try in the winter.  Now, Storey County has paved the highway and the area once known as Carson Plains, east of Dayton, is budding with thousands of homes and people, and many of them work in Reno, and use Six Mile Canyon Road as a shortcut from Dayton to Reno bypassing either Carson City and Washoe Valley, going one way, or Silver Springs and Fernley going another.

The road wasn’t built for the almost 2,000 vehicles cruising the turns and hills daily and is breaking up.  Storey County Commissioner Greg (Bum) Hess is suggesting the county make the road a toll road since most of those using the road don’t pay taxes in Storey County.

As far as we can determine, the last use of a toll road in Nevada was about 1900 somewhere in Esmeralda County.  Hess is looking for a two dollar toll per vehicle.  Nothing has been said about double occupancy.

Washoe County

(Reno) --- A continuing face lift is gathering momentum in downtown Reno, particularly along the Truckee River corridor, and in the hotel/casino district.  A 12 story condominium complex has been given the go ahead for the corner of First Street and Sierra Street at the Truckee River, while a major events center ground breaking took place at Fourth Street and Center Street. 

Called The Palladio, the condominium project will house businesses, a parking garage, and privately owned condos in the heart of downtown Reno.  Many are hailing this as the key to rebuilding what was once a thriving, now dilapidated and dirty, downtown Reno.  “This will bring other businesses to the area for the simple reason they will have a base of customers living downtown.  That’s been missing from the equation,” according to one city representative who wished not to have her name mentioned.

There are existing plans for a possible second condominium/business structure, not quite as tall, on the south side of the river from the Palladio.  Two potential developers are vying for the opportunity to build there.  It would sit adjacent to Reno’s Riverside Hotel Artist’s Lofts, a successful restoration of the historic Riverside Hotel.

The events center will be located across Fourth Street from the existing National Bowling Stadium, and will be available for concerts, smaller conventions, and trade shows, and according to Reno Mayor Bob Cashell, “Will be available for a New Year’s Eve party” at the end of 2004.

Elko County

(Elko) --- It’s mid winter and what’s a buckaroo to do?  Can’t rope them dogies.  Too cold to braid a new lariat.  And the spring round up is months away.  The Western Folklife Center in Elko came up with the answer 20 years ago, and it’s a good’un.  Break out the cowboy verse, the tall tales, and yarns of old, sing the songs your mama and daddy sang, buckaroo, and join thousands for the National Cowboy Poetry Gathering in Elko, January 24 through 31.

Contact the Western Folklife Center in Elko at 775-738-7508, or 888-880-5885.  For some fun and cowboy poetry, and who’s appearing, check out http://www.westernfolklife.org.

Carson City

(Observer Capital News Bureau) --- Another computer glitch in the capital, and this one is causing money problems for those who offer medical services to people on Medicaid.  The $17.3 million computer doesn’t work.  Medicaid vendor First Health Services Corporation of Glen Allen, VA is working with Nevada Division of Health Care, Financing, and Policy to correct the problems that may have delayed payments of claims worth about $250,000 or more.

That figure may be small, according to some.  A report from Clark County indicates that tens of thousands of Medicaid claims from pediatric dentists, surgery centers, pharmacies, hospitals and others providing care to the under served may remain unpaid.  At least 160 complaints have been filed in southern Nevada alone.

The system was brought on line September 30, 2003, and the company was given a 30 day notice to fix the problems on January 5, 2004.  Penalties can be assessed, if the problems are not corrected.