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During the annual survey on Monday, Nov. 19, state inspectors found the hot water in the Koronis Manor's bathtubs was at 135º, well above the legal limit of 115º.

The system quickly lowered the temperature, established new procedures to check the temperature regularly, and monitored the temperature for two weeks.

A new sensor has been installed in the hot water line as it leaves the boiler room. This sensor sends an alarm to the nurse's station in the hospital if the temperature rises above 115º or drops below 105º, the legal limits.

"I think the biggest problem is we didn't catch it," LaCroix told the board. "We should have been monitoring it."

While all baths at the Koronis Manor are supervised, hot water, explained LaCroix, can easily scald the skin of residents, leading to the temperature requirements.

As of Monday, PAHCS still had not received notice from the health department about the penalty for the violation. Immediate jeopardy can be the grounds for temporarily closing a facility or putting it under temporary outside management.

The facility could also be fined up to $10,000 per day. The water at the Koronis Manor was out of compliance for only one day, said Bev Mueller, patient care administrator.

Part of the problem is that the Manor currently uses one tub to give baths to all its residents, which means it needs to keep filling and refilling the tub. The water supply in the Koronis Manor is at the end of the hot water loop at PAHCS and the insulation on the water lines was removed during the remodeling project because the insulation contained asbestos.

Needing lots of hot water to fill the tub and losing heat through the bare pipes, nurses continually asked maintenance to raise the temperature, LaCroix explained.

Part of the remodeling project at PAHCS will remedy this situation. When the project is completed, the Koronis Manor will have its own computerized water supply system.

The new boilers for this system should be ready in the next month to a month and a half, and LaCroix said he had already talked with the plumbing contractor about putting in a temporary line to the Koronis Manor to give them better regulation and supply of hot water.

"We've known we had mechanical deficiencies in the Manor," he told the hospital board last week. "We've talked to this board and before that the city board, but frankly we haven't had the funds to do it."

The violation also triggered a more intensive survey - with more inspectors spending more days at the Koronis Manor. This extended survey revealed three minor deficiencies: a patient who needed more frequent psychological evaluation, physicians signing resident charts within five days, and an omission in a resident care plan. All these have been remedied, too.

The Koronis Manor will most likely be reinspected by the health department within the next 30 days, said Mueller.