The financially embattled Carbon County nursing home in Weatherly has been stopped from admitting new residents until it corrects several deficiencies found by the state Department of Health.

The deficiencies in 14 areas found at Weatherwood Nursing and Rehabilitation Center were outlined in a Medicare/Medicaid Recertification, state licensure and revisit survey completed on June 19.

The problems are not widespread or severe. Rather, they involve very few of the center's 160 residents and consist of infractions such as waking a resident to see if he needed to use the toilet or posting a sign above a resident's bed warning staff not to take her blood pressure or draw blood from her left arm because she had had a mastectomy on that side.

The state inspected Weatherwood on April 22. After a follow-up visit on June 16 found that deficiencies had not been corrected, it was suspended from receiving federal payment for new admissions as of July 22, according to Department of Health spokeswoman Holli Senior.

Government enforcement of nursing home rules has gotten much stricter in the past few years, according to Janet Gerber, president of Gerber Consulting Service, Clymer, Indiana County. Gerber is working with the county to resolve the deficiencies and prevent future infractions.

Commissioners hired Gerber on Sept. 3 at hourly rates of $110 for the time she spends at Weatherwood and $55 for work, including phone consultation, documentation and report writing, done outside the center..

"The regulations have not changed, but guidance to the surveyors has," she said. "They are a lot more in-depth. Many facilities are finding themselves in the same type of situation. There are much greater expectations."

If the nursing home is not in compliance by Oct. 22, it risks losing Medicare and Medicaid reimbursements. But that's unlikely, Gerber said. Weatherwood has set Sept. 28 as its own compliance target.

Gerber said many nursing homes have been cited for deficiencies because of the stricter enforcement. Nursing home administrators are struggling to make sure even minor infractions are corrected in several areas. She describes the struggle as "like wrestling an octopus." There are changes are in compliance enforcement for federal and state reimbursements and the regulatory environment, among other areas.

At Weatherwood, Gerber is teaching staff the rules and making absolutely sure they are understood. She is also teaching staff and supervisors how to communicate effectively in order to sustain that compliance.

"You have make sure someone understands what they are expected to do before you can hold them accountable," she said.

Efforts to reach Weatherwood Administrator Louise Bekisz on Monday were unsuccessful.

Commissioners Chairman William O'Gurek is confident Weatherwood will fix the problems.

"The commissioners are certain the quality of care issues raised by the Department of Health surveyors at Weatherwood are properly being addressed. We have every confidence the facility will clear inspection and at the time of our resurvey, we will be able to capably demonstrate compliance with the regulations," he said. "Sept. 28 is the Weatherwood-established date for compliance. That means we advised the (Department of Health) we believe we will be ready on that date for the return visit by health surveyors. We are not sure when the inspection will take place, all we know is that is the date in which we believe we will be ready. In the meantime, we have been updating policies and procedures to address care issues.

"We have been told there have been dramatic changes through the years with regard to the guidance given to surveyors when they are sent to a facility. That means the inspections have been more intense, and, from our end, we have to be prepared to meet the stringent regulations of the Department of Health, something that we obviously have not been able to do in recent visits to Weatherwood," O'Gurek said.

Last week, county commissioners said they would take a hard look at Weatherwood's operations to determine how best to handle financial problems as they develop a 2010 budget.

Problems surfaced last year when, due primarily to fewer residents and rising costs, the county had to give the center $350,000 to help meet expenses.

But the gap continues to widen, and closing it may take $2.5 million in taxpayer dollars if something isn't done.

The 200 bed center currently has 160 residents and employees about 250 people.