Federal officials reconsidered a decision to cut off Medicare and Medicaid funds to a troubled nursing home after receiving an inquiry on its behalf from U.S. Sen. Rick Santorum, an official with the U.S. Centers for Medicare & Medicaid Services testified yesterday.

Santorum, R-Pa., contacted CMS officials early in 2001 and asked them to conduct a rare fourth inspection of the Ronald Reagan Atrium I Nursing and Rehabilitation Center in Robinson, according to Dale Van Wieren, a CMS certification and enforcement representative.

That request came shortly before CMS officials were about to cut off all Medicare and Medicaid funding to Atrium because state Department of Health inspectors had discovered numerous violations in 2000, Van Wieren testified. Those inspectors also assess facilities for compliance with Medicare and Medicaid.

Van Wieren's testimony came during the third week of trial for the defunct nursing home and its former administrator, Martha F. Bell, 59, of West Mifflin. Bell and Atrium have pleaded not guilty to charges of defrauding Medicare and Medicaid and making false statements to hide fraud and poor care of patients, many of whom had Alzheimer's disease.

Violations, or "deficiencies,'' cited at Atrium after an inspection and two follow-up visits included 19 incidents involving actual harm to patients and many other less serious problems, Van Wieren said.

That prompted CMS to notify Atrium and to publish a newspaper announcement of its plan to remove the nursing home from the rolls of certified Medicare and Medicaid providers as of Jan. 26, 2001, Van Wieren said.

Many nursing home patients receive some funding from the federal programs, so the cutoff would have drastically affected Atrium's finances. CMS also assessed a $58,000 penalty against Atrium, which was reduced to $37,000 after the nursing home waived its right to appeal, he said.

But before the cut-off deadline, a fourth inspection of the facility was made after federal officials were contacted by Santorum, Van Wieren testified. A third visit must be approved by the CMS regional office in Philadelphia and a fourth must be approved by its central office in Baltimore, he said.

Under questioning by defense attorney Thomas Ceraso, Van Wieren acknowledged that Santorum asked CMS officials to consider the fourth visit. He said it is not unusual for a political figure to make inquiries to the agency on behalf of constituents and agreed when Ceraso characterized it as "nothing more than that.''

During an interview after his testimony, however, Van Wieren characterized a fourth inspection visit as "very unusual." He said he was not sure why CMS officials authorized it, saying "That [decision] was made above me.''

"Most facilities never reach that point of termination. It's rather rare" that facilities do not correct problems before reaching that point, he said.

Robert Traynham, a spokesman for Santorum, said the senator's office handled the inquiry on behalf of the nursing home as it would from any constituent.

"The senator's office was simply passing along a request to the Centers for Medicare & Medicaid Services. This was a routine constituent issue that the senator's staff passed along to the appropriate agency,'' he said.

After the fourth visit, inspectors found the nursing home was in compliance with regulations, so the funding cutoff was called off, he said. CMS also started proceedings to cut off all Medicare and Medicaid funding to Atrium in 2002 and 2003, but Atrium came back into compliance both times, Van Wieren testified.

CMS did on several occasions cut off reimbursements for admissions of new patients, Van Wieren said, including the admissions ban and $10,000 penalty levied after the death of Atrium resident Mabel Taylor, 88, who died Oct. 26, 2001 after she was trapped in a locked courtyard on a 40-degree night. Taylor's death triggered state and federal investigations of patient care and finances at Atrium that led to the charges against Bell and the nursing home.