A single employee at Haven Health Center in Cape Elizabeth was responsible for an incident that could result in the loss of all federal Medicare and Medicaid funding for the facility, according to the nursing home’s parent company.

The incident, on May 4, involved a patient who fell and suffered a broken pelvis in the 52-bed skilled nursing section of the facility.

However, the fall wasn’t reported to the following shift at the facility and it wasn’t until two days later that the fall was reported to a physician, the family contacted and the patient hospitalized. The state received a complaint on May 18 and on May 27 the patients at the facility were ruled to be in “immediate jeopardy.”

“Immediate jeopardy” is the most severe classification of problems in a nursing home and means patients are in actual danger of harm or death, said Richard Shaw, branch chief of certification and enforcement at the regional Boston office of the Center for Medicare and Medicaid Services (CMS). He said the incident has “overtones of negligence.”

Shaw said “immediate jeopardy” is not a classification frequently used. “There weren’t more than four immediate jeopardies in the state of Maine last year,” he said.

As a result, Haven Health Care has until June 18 to submit a corrective action plan to the state for their Cape Elizabeth facility, after which time inspectors from the state will make an unannounced visit and determine whether the changes outlined in the corrective action plan had been implemented and the facility had been brought back into compliance.

If the inspectors find that the problems still exist then CMS would no longer be able to make Medicare and Medicaid payments to the facility, said Roseanne Pawelec, a spokeswoman for CMS. Payments for new patients receiving Medicare or Medicaid were stopped June 3.

Anthony Scierka, senior vice president of Haven Health Care, the nursing home’s Connecticut-based parent company, said it was “an isolated incident” and a corrective action plan had already been submitted to the state.

He said the incident was the result of an individual employee who did not follow procedure and had since been disciplined, though he would not say in what way. Scierka also said there would be a “reeducation process” with the rest of the staff at the facility.

A $3,050-a-day civil monetary penalty has also been imposed on Haven Health Care by CMS that will continue to accrue until the facility is brought back into compliance with CMS standards. Facilities that are deemed in “immediate jeopardy” can be fined anywhere from $3,050 to $10,000 per day, according to Shaw. The level of penalty against a facility is based on both severity of the infraction and the scope of the problem, he said.

Michael Norton, director of public information for the Maine Department of Health and Human Services, said the facility has been operating with a conditional license as a result of deficiencies found during an annual survey the DHHS completed last year. However, that is a state licensing issue and would not necessarily affect CMS’s enforcement actions, Shaw said.

The loss of funding from CMS would basically mean Haven Health Center could not operate their skilled nursing section, Norton said. The facility also includes a residential living section that is not affected by the sanctions.

This is not the first time the facility has been found not in compliance with federal standards. In August 2002, when the facility was under different ownership and known as Viking Nursing Home, a patient wandered from the home and drowned.

Haven Health Care took over management of the facility in April 2003, but ownership was retained by Viking. In August 2003, the patients at the Viking Nursing Home were found to be in “immediate jeopardy” after the state received a complaint that a number of patients had bedsores.

The Viking was given two weeks to fix the problem, but when inspectors returned they found four additional patients suffering from bedsores and the nursing home was given 30 days to find new facilities for the 60 patients in the skilled nursing section.

At that point, in September 2003, Haven Health Care took over ownership of the facility. Pawelec said Haven Heath Care entered the Medicare and Medicaid program in November 2003, since which time there have been three enforcement actions against the facility by CMS, though none were classified as “immediate jeopardy” and only one resulted in a monetary penalty.

That penalty was for widespread minor deficiencies found in August 2004 and a monetary penalty of $150 a day was imposed on the Haven Health Center. The facility accrued a fine of $15,600 over 104 days before they proved the problems had been fixed.

Scierka said the facility did have a long history of operational issues, but was making significant progress since Haven took over. He said the most recent incident was “an unfortunate setback,” but he was “confident that the facility will achieve compliance and be able to maintain that compliance.”

Pawelec said there is a huge financial incentive for nursing homes to fix what problems they have been cited for. In 95 percent of cases a nursing home does correct the problems, she said. “We certainly expect this nursing home to correct these problems before the date of June 18.”