A Minnesota Department of Health report released at the end of May concluded Thorne Crest Retirement Community in Albert Lea is responsible for neglect of one of its residents last November.

The report stated a woman had severe respiratory and anxiety symptoms for 12 hours in November before she was taken by ambulance to a hospital, where she died shortly after.

“In addition, the facility failed to ensure that they were provided physician assistance in managing (the resident’s) crisis medical situation,” the report continued.

The conclusion came following a state Department of Health investigation in December into the events, which took place Nov. 5 and 6, 2008. The woman died Nov. 6.

The investigation included a review of the resident’s medical record, a review of several of the policies and procedures at the facility, along with observational rounds of residents who receive oxygen therapy.

It also included interviews of staff, the involved physician and other unspecified people; a focused review of two additional resident medical records; and a review of nursing staff schedules.

While reviewing the medical records, investigators found that the woman had a diagnosis of a restrictive lung disease with chronic hypercapnic respiratory failure. This condition is when there is an increased amount of carbon dioxide in the blood.

Thorne Crest Administrator Shanna Eckberg said following the incident, the nursing home developed a correction plan that was approved by the state. Thorne Crest was found to be in full regulatory compliance when it was surveyed during a follow-up visit.

Eckberg said she hired an experienced director of nursing and former nurse consultant in January. The director of nursing audited the entire facility for residents with similar diagnosis.

The nursing also home reviewed and revised policy and procedures regarding oxygen administration and monitoring, educated staff on that new policy and has been closely supervising the staff.

In addition, the administrator said the pre-employment and post-employment practices were revised and implemented to demonstrate strong judgment and skills. The facility also revised and implemented policies related to physician contact during an emergency event.