TILTON — Vermilion County has hired a private consultant to help Vermilion Manor Nursing Home staff better control infections, after the state found violations that related bacterial infections among several residents.

Because of the violations, the nursing home did not admit any Medicare or Medicaid residents for three months, and the facility also faces fines.

The most serious violation found during the April inspection by officials with the Illinois Department of Public Health concerned the facility's failure to have an effective program to prevent infection from spreading, according to the state inspection report.

"The facility failed to have, in place and functioning, an effective infection control program to prevent the spread of Clostridium difficile infection for six of 24 sampled residents ... and 10 (other) residents," according to the report by public health inspectors.

Clostridium difficile causes inflammation of the colon, known as colitis, according to the Centers for Disease Control.

The report also states that the facility failed to effectively clean and disinfect surfaces and equipment to control and prevent the spread of the infection; failed to analyze data related to the infection, identify trends and implement corrective action; failed to assess and recognize symptoms as a potential infection; failed to demonstrate knowledge of, implement and carry out isolation precautions to prevent cross contamination and the spread of the infection; and facility staff cross contaminated during direct care and failed to use protective equipment during care.

"These failures have the potential to impact all 179 residents of the facility," the report stated.

Other, less serious violations at Vermilion Manor were also noted by state inspectors.

— Staff failed to thoroughly investigate four allegations of missing money for three residents.

— Staff failed to report a fall to the charge nurse, resulting in a resident "not receiving timely necessary medical treatment for a fractured left wrist," according to the state report. The resident "experienced pain and swelling of the left wrist for 22 hours before receiving treatment."

— One resident fell twice, because electronic equipment that alerts nursing staff of the resident's attempt to get out of bed was not functioning.

— Hot food delivered to residents in remote dining locations was not served at a palatable temperature.

— Staff failed to make sure that each resident entering the nursing home without a catheter is not given a catheter, unless necessary.

As a result of the violations, the nursing home was not admitting any new Medicare or Medicaid residents since the April inspection and subsequent citations, because the federally funded health care programs will not pay for the care of any newly admitted residents until the violations have been corrected, according to Melaney Arnold, state public health spokeswoman.

Arnold said the facility could continue admitting if it wanted and, once the corrections are made, then funding from Medicare and Medicaid would be retroactive to the date the corrections were official. But there would be no federal reimbursement for care from the date of the violations to the correction date.

But Vermilion County Board Chairman Jim McMahon said the county did not want to take the risk, so the nursing home stopped admitting new Medicare and Medicaid residents but continued taking private-pay residents.

State inspectors were back at the facility this week, checking progress in rectifying the violations, and the facility has made adequate progress and was given the go-ahead to admit Medicare and Medicaid residents again, according to McMahon. He said several were admitted Wednesday.

"This is a small bump in the road," said McMahon, who added that the facility will be fined for the violations, but the amount is not yet known and depends on the length of time it has taken to correct the problems. He said the nursing home, which has in recent years overcome its financial struggles, will not be adversely affected.

Hiring a consultant from Pathway Health Service Inc. based in Westmont was the decision of county officials, McMahon said, referring to himself and nursing home Administrator Joan Darr, who was not available for comment on Thursday.

He said they both agreed that bringing in an expert with an outside point of view who could assess the situation and make recommendations would be a good idea.

McMahon said Pathways has one consultant assigned to work with Vermilion Manor staff at a price of $80 an hour with a $150-a-week travel allowance in addition to a $2,500 up-front retainer fee. He said the consultant will continue to work with staff until Darr and county administrators are satisfied that the issues have been addressed. McMahon said the consultant is mostly focusing on infection-control procedures to address the most serious violation.

Clostridium difficile

Definition: Bacteria that causes inflammation of the colon, known as colitis. People who have other illnesses or conditions requiring prolonged use of antibiotics, and the elderly are at greater risk of acquiring this disease.

Transmission: People can become infected if they touch items or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Health care workers can spread the bacteria to patients or contaminate surfaces through hand contact. Clostridium difficile spores are transferred to patients mainly via the hands of health care personnel who have touched a contaminated surface or item. Clostridium difficile can live for long periods on surfaces.

Source: Centers for Disease Control website