Category Archives: Nursing.Homes

Even discussing selling a nursing home leads to staff turnover, lower quality of care

Source: Rick Lee, York Daily Record, February 28, 2018
From Sweden to Taiwan to the United States, decades of international research has established that privatizing nursing homes results in increased staff turnover and decreased quality of care. Even discussing taking a nursing home out of government hands and putting it into the private sector causes staff turnover to begin, according to sociologist Steven Lopez, now an associate professor at Ohio State University. Twenty years ago, Lopez examined three Pennsylvania nursing homes – one that considered privatization; one that was taken over by a for-profit management company; and a privately owned nursing home documented as having low wages, high employee turnover and poor quality of care. Currently, the York County commissioners are exploring the possibility of selling the county-owned nursing home – Pleasant Acres Nursing and Rehabilitation Center. …

… Russ McDaid, the president and CEO of the Pennsylvania Health Care Association, an advocacy organization for many of the commonwealth’s nursing homes, said that is a problem facing many county-owned homes. … There are some people, McDaid said, who believe they can make a nursing home profitable through enhancing revenues and/or decreasing costs. The obvious places to cut costs is with staff numbers and wages, he said. … Both Adams and Lancaster counties sold their county nursing homes for similar financial reasons that are facing York County. …


Results mixed for other counties that sold nursing homes
Source: David Weissman, York Dispatch, February 28, 2018

As York County Commissioners consider selling the Pleasant Acres Nursing and Rehabilitation Center, they can look for guidance from plenty of other Pennsylvania counties that have recently sold their nursing homes. A York Dispatch review of state Department of Health records and local news reports from across the state found that at least 18 counties have sold their nursing homes, primarily to for-profit companies, since 2005. York County is one of 18 counties that still owns their own nursing homes, according to the review. … Selling Pleasant Acres, which taxpayers have subsidized to the tune of about $75 million during the past 10 years, has been discussed for many years because of its rising costs. The county has contracted the assistance of Susquehanna Group Advisors to solicit bids for Pleasant Acres, though commissioners insist they haven’t made a final determination to sell the 375-bed facility. Andrisano said she has seen counties reverse course after expressing an interest in selling their nursing homes because of constituent feedback, though it’s rare and she couldn’t recall any specific example. York County administrator Mark Derr said he’s been told 15 companies have expressed some form of interest in the nursing home, and final bid submissions are due March 15. …

Handpicked Cedar Haven owner lost control within months, to county’s surprise

Source: Daniel Walmer, Lebanon Daily News, January 26, 2018

The Lebanon County commissioners took great efforts in 2014 to ensure they sold the county-owned nursing home into good hands – but within months, those hands had been forced out of any involvement with Cedar Haven. Now, the union representing Cedar Haven nurses is involved in a bitter, three-month-old strike with current owner Stone Barn Holdings and its managing partner Chas Blalack. Union leadership says the county commissioners deserve some of the blame for not sufficiently scrutinizing the financial situation of the purchaser when it sold the home. …


Lebanon County Commissioners letter to Stone Barn Holdings, the group that owns Cedar Haven
Source: Lebanon Daily News, January 26, 2018

The following is a letter from the Lebanon County Commissioners sent Jan. 18 to the owner of Cedar Haven nursing home, Chas B. Blalack with Stone Barn Holdings. …

Two months in: When will the Cedar Haven strike end?
Source: Daniel Walmer, WITF, December 21, 2017

The Cedar Haven Healthcare Center nurses’ strike reached its two-month point this week with little fanfare from the union – but behind the scenes, there have been nurses crossing the picket line, an aborted attempt at a negotiation and business dealings by Cedar Haven’s owner. … Here are the basics: There is still no contract agreement on the horizon. The parties met for a mediated negotiation session on Dec. 4, but Cedar Haven owner Stone Barn Holdings rejected it despite “movement” on the part of the union, said AFSCME Council Director Steve Mullen.

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Editorial: Self-dealing by nursing home owners threatens patient care

Source: Editorial Board, St. Louis Post-Dispatch, January 14, 2018

The outsourcing of logistical support services, which became commonplace in the U.S. military in the 1990s and later was adopted by state prison systems, has now come to dominate the nursing home industry. And while nursing homes, unlike the military or prisons, are not part of federal or state governments, Medicaid pays for the care of 62 percent of all nursing home patients, amounting to $55 billion in 2015. … In a remarkable story published Dec. 31, Kaiser Health News reported that the owners of nearly three-quarters of the 15,600 nursing homes in the United States buy a wide variety of goods and services from companies in which they have a financial interest or control. Nursing home owners can rent the land to themselves at above-market rates, or own the staffing company that provides nursing care and management. These business dealings, known as related-party transactions, offer efficiencies that can hold down costs and help minimize taxes. … In the nursing home industry, however, with its reliance on taxpayer dollars, related-party transactions can also encourage insider dealing, maximizing profits for the outside vendors while siphoning off funds needed for patient care and staffing. If a nursing home gives a no-bid contract for, say, linen services, to a firm controlled by the nursing home’s owners, it often pays inflated prices. … For nursing home owners, a complex web of related-party transactions can offer a shield against lawsuits or governments seeking restitution for Medicaid overpayments. This is outrageous. …

Champaign County Board votes to put nursing home up for sale

Source: Tom Kacich, News-Gazette, January 9, 2018
Champaign County Board members voted Tuesday night to put the county nursing home up for sale.  By a margin of 13-8, with Democrats Pattsi Petrie, C. Pius Weibel and Shana Jo Crews joining all 10 Republicans, the board voted to issue a request for proposals from private operators to purchase the county-owned facility in east Urbana. … Among the terms to any sale of the nursing home: … — The purchaser would assume the existing collective-bargaining agreement between the nursing home and the AFSCME union.  — The purchaser must agree to rehire all existing employees who pass a background check, not terminate 10 percent or more of the employees within the first 60 days following the closing date and not 20 percent or more of the current employees during the first six months after the closing date, all at their current salary levels with benefits similar to those currently received. …


County board to get first look at proposal for sale of nursing home
Source: Tom Kacich, News-Gazette, October 10, 2017
Champaign County Board members will get their first review tonight of the proposal for the sale of the county-owned nursing home.  The agenda for the board’s committee-of-the-whole meeting includes an item calling for the release of a request for proposals for a privately owned firm to buy the 12-year-old facility in east Urbana. If the board approves the RFP this month, the sale of the home could be completed this winter. … The proposed request for proposals for the sale of the facility carries a number of stipulations: … That the purchaser assume the existing collective bargaining agreements at the home with the AFSCME employee union. …

Patient advocates back county ownership of nursing home
Source: Debra Pressey, The News-Gazette, March 29, 2017

Selling the Champaign County Nursing Home could lead to staff reductions, poorer care and service cuts, a group of advocates for medical patients and retirees contended. Gathering less than a week before voters will be asked to weigh in on two public policy questions — whether they support selling or disposing of the financially ailing nursing home or a tax increase to help keep it going — the Illinois Alliance for Retired Americans, Champaign County CARE, Champaign County Health Care Consumers and others Wednesday urged voters to get behind the option that will keep the nursing home in the county’s hands. Research from Center for Medicare Advocacy, Kaiser Family Foundation and others have demonstrated that nursing home ownership matters when it comes to patient care and staffing levels, said Champaign County Health Care Consumers executive director Claudia Lennhoff. … “For-profit facilities, particularly those owned by multistate chains, are more likely to reduce spending on care for residents and to divert spending to profits and corporate overhead,” the Medicare center said in a report. … A 2011 analysis of the 10 largest for-profit nursing home chains found they had the lowest staffing levels and highest levels of deficiencies between 2003 and 2008, Lennhoff said. She also said a new owner — especially a larger and/or for-profit one — who would fill more beds at the nursing home, even increasing the Medicaid census in the process, could be a “recipe for disaster.”

… Lennhoff said Champaign County doesn’t have to look any farther than neighboring Vermilion County to see what can happen when a county disposes of its nursing home. After the county sold its Vermilion Manor Nursing Home to FNR Healthcare Group in 2013, the county was caught by surprise when 39 employees were cut by the new owner, she said. Now called Gardenview Manor, the Danville nursing home was hit by the Illinois Department of Public Health in January for two “type A” violations, which mean “a substantial probability that death or serious mental or physical harm will result or has resulted” in the past three months.

Exclusive: Nursing Home Sought Help From Lobbyist Friend Of Governor

Source: Jim Defede, CBS Miami, November 3, 2017

State officials intended to permanently shut down the now infamous The Rehabilitation Center at Hollywood Hills in 2014, when a lobbyist with deep ties to Governor Rick Scott interceded on behalf of the man who wanted to take it over, CBS4 News has learned. The role of one of the Governor’s friends lobbying state officials on behalf of Dr. Jack Michel so Michel could obtain the license for the Hollywood Hills nursing home has not been previously reported. The nursing home is now drawing intense scrutiny following the deaths of more than a dozen residents after its air conditioning system lost power during Hurricane Irma. … In 2014, Michel wanted to buy the nursing home, whose owner at the time, Karen Kallen-Zury, had just been convicted of Medicare fraud and was sentenced to 25 years in prison. … Political leaders have questioned whether Michel should have been granted a license given the fact that Michel and two former business partners paid $15.4 million to the federal government to settle fraud claims. …


Hollywood nursing home should never have been licensed, state senator says
Source: Bob Norman, Local 10 News, October 26, 2017

The U.S. Justice Department hit Michel with civil Medicare fraud charges in 2004, alleging he received $70,000 each month in kickbacks to funnel nursing home patients into Larkin Community Hospital in South Miami for medically unnecessary procedures. … Michel eventually purchased the Larkin hospital (beginning with what the feds alleged appeared to be sham transactions) and, according to the complaint, began paying to other doctors for more bogus Medicare referrals. … Farmer says the fraud described in the Michel complaint has become all too common. … Michel and his business partners — including Chicago Rabbi Morris Esformes and his son, Philip — paid $15.4 million to settle the fraud case while admitting no wrongdoing. Published reports show that the Esformeses have a long history of nursing home violations going back decades in Chicago and other cities, including one case in 2001 involving the deaths of four women during a heat wave in St. Louis. Criminal investigations netted no charges in that case, but the nursing home was hit with a $275,000 civil judgment in one suit while three others ended with undisclosed settlements. But after paying the $15.4 million settlement to the federal government, both Michel and the Esformeses simply continued in the business of running nursing homes and hospitals. …

Hurricane Irma: Hospital linked to nursing-home deaths was paid $48M to care for Florida prisoners
Source: Arek L Sarkissian, Naples Daily News, September 26, 2017

The owner of a Florida nursing home whose 11 residents died after Hurricane Irma has benefited for years from millions of dollars in government contracts despite repeatedly running afoul of state and federal regulators. Dr. Jack Michel, owner of Rehabilitation Center at Hollywood Hills, owns a Miami hospital that has received $48 million in taxpayer money since 2006 to treat state prisoners. The payments to Larkin Community Hospital started the same year Michel settled a federal fraud lawsuit that accused him of bilking taxpayers. They continued after the state barred one of his assisted-living homes from taking new patients. And state officials are giving no indication that the payments will stop now despite Florida Gov. Rick Scott’s comments that the owner is unfit to care for patients after deaths at his nursing home.

Larkin provides the prison hospital care under no-bid agreements that the Florida Department of Corrections approved, according to agency contract and finance records. The hospital has served as a subcontractor to the state’s prison health care vendors with approval from corrections officials. Eight elderly patients died Sept. 13 after Irma knocked out power at Michel’s nursing home and residents remained for several days without air conditioning. Three other patients died days later after being hospitalized with complications. …

Stephenson County Board postpones decision on nursing home referendum

Source: Jane Lethlean, The Journal Standard, October 12, 2017

The Stephenson County Board postponed a vote today to place an advisory referendum on the November 2018 ballot to gauge public opinion about selling the county nursing home. Dan Neal, chairman of the County Board Nursing Home Committee, said there has been strong sentiment by some board members to sell the Stephenson County Nursing Center to a private company. … Ed Sadlowski of Janesville, Wisconsin, spoke on behalf of American Federation of State County and Municipal Employees Council 31. “This sends the wrong message to the community, and you need to lead,” Sadlowski told the board. “Once you hand the nursing center over to the private sector, it will end up costing residents more.” …

Possible sale of Berks County’s nursing home raises questions of quality

Source: Nicole C. Brambila and Karen Shuey, Reading Eagle, September 24, 2017
While the financial future of county-owned nursing homes might be uncertain, decades of research is fairly clear: a public sale likely means the number of health violations will go up as the quality of resident care goes down. Observed by researchers for roughly two decades, the phenomenon is often the result of the new for-profit owners cutting costs by reducing staff and slashing employee benefits. … These questions loom large as Berks County commissioners are mulling over whether to sell Berks Heim Nursing and Rehabilitation in Bern Township. No decision has been made but the county-owned nursing home faces a projected $3 million deficit. Citing questions of quality and safety, Berks Heim staff and some residents are speaking out against a sale.

… Berks County’s commissioners considered selling Berks Heim two decades ago but opted against it. But then, a public sale in the late 1990s would have been a first in the region. … research also shows that a sale becomes more likely when surrounding counties have divested. Among Berks County’s six contiguous counties, four counties – Lancaster, Lebanon, Montgomery and Schuylkill – have all sold county-owned nursing homes since 2005. Only officials in two – Chester and Lehigh counties – have held onto their county-owned facilities. … Talk of a potential sale has been met with sharp opposition from residents and staff. … Divesting a county-owned home then will likely disproportionately impact the poor. … And Harrington, a nationally respected expert on nursing home care, has repeatedly found that for-profit facilities receive more deficiencies than nonprofit or government-owned nursing homes. Comparing the 10 largest chains in the U.S. to government-owned facilities, Harrington found in a 2012 study that serious deficiencies in chains were 41 percent higher. A significant reason for the care discrepancy is staffing levels, typically reduced under new ownership to control costs. …

Daily understaffing persists at Grand Rapids Home for Veterans

Source: Amy Biolchini, MLive, August 10, 2017

Understaffing at the Grand Rapids Home for Veterans continues to be a problem, according to an follow-up audit released by the state. That’s after the home entered into a new staffing contract in fall 2016. … However, most other major problems at the Grand Rapids Home for Veterans identified in a blistering state audit in February 2016 have largely been resolved, the report found. …


Blame for poor care at Grand Rapids veterans home sits at the top, Dems say
Source: Amy Biolchini, MLive, July 27, 2017
Democratic State Representatives Winnie Brinks and Tim Greimel say Republican Attorney General Bill Schuette hasn’t gone far enough to hold officials with the Grand Rapids Home for Veterans and the state accountable for the poor conditions at the facility.  “Why did it take so long to get some action? For years, our veterans were literally calling for help, pressing the help button beside their bed, and hearing silence,” Brinks, D-Grand Rapids, said at a Thursday, July 27, press conference in front of the home.  This week Schuette announced felony charges for falsifying medical records against 11 former nursing assistants who worked for the former contractor, J2S Group Healthforce. His investigation found there wasn’t enough evidence to bring criminal charges over the five worst complaints about member treatment, in some of which veterans died. …

Did a 2011 lawsuit against Grand Rapids Home for Veterans predict the future?
Source: David Bailey, WZZM, July 25, 2017
The lawsuit was filed by veteran Anthony Spallone intending to stop the on-going privatization at the time.  Gov. Rick Snyder recommended taking state-employed care aides out the home and replace them with nurse aides hired by local contractor J2s.  It was a contentious environment at the time as state aides lost their jobs and were replaced by people they considered to be less-skilled, less-experienced and cheaper.  Union leaders did everything they could to stop the job losses including filing Spallone’s lawsuit.  It alleged the privatization would lead to substandard care and contended J2S had a quote “dangerous track record of care”.   Spallone’s attorney at the time was adamant veterans could be put in terrible situations with the privatization. …

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Atlantic County considers privatizing assets to mitigate PILOT costs

Source: John DeRosier, Press of Atlantic City, April 27, 2017

Atlantic County is considering privatizing some of its assets to mitigate the costs associated with casino tax refunds and because it’s not getting a 13.5 percent share of the PILOT money. Such moves could save taxpayers money but cost some county employees their jobs. The county has been responsible for refunding more than $65 million to Atlantic City since 2010 because of costly tax appeals by the casinos. … On Tuesday, however, Freeholder Chairman Frank Formica said the county is considering privatizing assets that don’t make money, such as Meadowview Nursing & Rehabilitation Center in Northfield, in an effort to spare residents from large tax increases and keep social services, such as Meals on Wheels, intact. …

Pinecrest staffers face almost daily patient assaults in wake of cutbacks, officials say

Source: Mark Ballard, The Advocate, March 25, 2017
The state’s efforts to privatize and economize health care at the state’s remaining facility for the intellectually impaired have resulted in regular assaults on staff by patients, state officials have discovered.  Almost every day, sometimes several times a day, a mentally impaired resident at Pinecrest punches, bites or otherwise violently lashes out at the mostly middle-aged women who help the individuals dress, eat and function in the world. The sudden and dramatic increase in violent attacks is an unintended consequence of “real quick privatization,” says Louisiana Department of Health Deputy Secretary Michelle Alletto, whose responsibilities include the 95-year-old facility near Pineville. Looking to save money, the state slashed budgets, laid off personnel and in 2013 closed other public facilities, intending to send the bulk of the patients to small, privately-owned group homes in communities around the state where their needs could be addressed on a more individualized basis. Pinecrest Supports and Services Center got the rest. … Budget cuts in other state agencies limited programs that treated these individuals in the past.

… For the 12 months prior to Feb. 28, the staff filed 524 reports, required by workers compensation regulations, for incidents at the facility where three years ago virtually no violence took place. … Perry, an officer in the employees union, says worker’s comp forms are only the tip of the violence iceberg because no publicly available forms are filled out unless the “slap leaves a mark.”  Local 712 of the American Federation of State, County and Municipal Employees began collecting statements from its members that provide a little more detail. … Many of the statements collected by the union complained about how they are unprotected by police and, often, are removed from direct patient care. … But the staff has lost its patience, says James Ray, AFSCME field representative and a Methodist minister. “They always say be patient, it’s going to get better. But the state, as an employer, has a legal obligation to provide a safe workplace, which they are not doing,” he said.


Health firms make privatization pitches
Source: Michelle Millhollon, Advocate, February 14, 2014

In an overheated Holiday Inn banquet room Thursday morning, business leaders made pitches for privatizing a $2 billion slice of the state’s health care business. United Healthcare, Amerigroup Louisiana, Louisiana Healthcare Connections and LifeShare Management Group are interested in managing the long-term care needs of 73,000 Medicaid-eligible people. The companies want to oversee the personal care, doctor’s visits, transportation, hospitalizations and other daily needs of people with disabilities, as well as those with age-related or adult-onset challenges.

DHH Wants More Medicaid Privatization, Stakeholders Hesitant
Source: Ashley Westerman, WRKF, November 5, 2013

The state Department of Health and Hospitals is taking preliminary steps to further privatize Medicaid in Louisiana. In August, DHH released a concept paper about reforms to long-term care for the developmentally disabled and low-income elderly.

In a nutshell, the department wants to bring in a private managed care organization – or MCO – to create a network of healthcare providers to serve those populations. Proponents of private MCOs claim they save money, cut down on fraud and improve the quality of care. The state Dept. of Health and Hospitals is looking to privatize the managed care for Medicaid patients with developmental disabilities and low-income elderly. Other stakeholders and advocates for the disabled and elderly throughout the state, for the most part, welcome reform but skepticism remains….

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