Facilities News Spotlight

2023-02-26 Spotlight on Nursing Home Closures in Western MA

‘It’s flooding an already completely congested market.’ Nursing home closures in Western Mass. leave families and hospitals scrambling.

Boston Globe, February 26, 2023, by Kay Lazar

The abrupt announcement that four nursing homes in Western Massachusetts will be closing this spring has forced hundreds of people to scramble to find alternative facilities for their fragile family members.

At the same time, overwhelmed hospitals in the region that frequently discharge patients to the four nursing homes are bracing for potential gridlock — elders with nowhere to go languishing in beds needed for new-arriving patients — underscoring the precarious condition of the state’s overwhelmed health care system.

“I was calling so many other nursing homes and either not getting a call back or being told they are full,” said Edward Czepiel, a retired Chicopee deputy fire chief who scrounged to find his 98-year-old mother another nursing home after learning Feb. 7 that Willimansett Center East in Chicopee is among those closing.

His struggle — and his mother’s predicament — could soon be replicated across the state, as nursing homes and their frail residents head into a time of heightened uncertainty and risk.

And Czepiel is among the lucky ones. He has secured a nursing home in Amherst, about a half hour’s drive away, that has a bed for his mother, who has dementia.

“She is fearful,” Czepiel said. “It’s like anything else, if you move anyplace else, you are apprehensive about what will happen.”

Northeast Hospital Group, the Pennsylvania company that owns the nursing homes — Willimansett Center East and West in Chicopee, Chapin Center in Springfield, and Governor’s Center in Westfield — declined to speak to the Globe.

But two weeks earlier, on Feb. 6, in letters to residents and families, the company said it could not financially keep the four facilities afloat after meeting state requirements to reduce occupancy from three and four residents in a room to no more than two per room.

After COVID-19 deaths tore through nursing homes, the state in March 2021 updated regulations requiring the facilities to have no more than two residents in a room by April 30, 2022. Nursing homes were able to apply for a waiver if they could demonstrate that other mitigation measures acceptable to the state were in place and that each resident has a minimum of 108 square feet of space and at least 6 feet between the beds.

“We are in regular communication with Northeast Health Group about possible alternatives to closure which prioritize patient safety, quality, and infection control,” the Executive Office of Health and Human Services said in a statement.

State records show that two of the four facilities, Chapin and Governor’s, score below the state average on recent inspections and were cited for deficiencies in care last year that, inspectors found, resulted in harm to patients.

The state’s HHS agency recently told families searching for alternate nursing homes that there are 25 other facilities with approximately 450 open licensed beds within a 10-mile radius of the four facilities closing. Still, the agency acknowledged that finding available beds might be challenging because the average occupancy in the region where the four facilities are located is 85 percent, slightly above the statewide nursing facility occupancy of 82 percent.

The agency also said in a statement that it is “mindful of the impact” a nursing home bed shortage could have on the region’s hospitals, which already struggle to find appropriate discharge destinations for patients who require a nursing home level of care.

Hospital administrators put it more bluntly.

“It’s flooding an already completely congested market,” said Christine Scibelli, senior director of patient care services at Baystate Health, a system of hospitals and medical providers in Western Massachusetts.

“Having four skilled nursing facilities close and essentially removing 300 people from their homes will just further narrow that window of available beds,” she said.

Baystate Health includes Baystate Medical Center in Springfield and three community hospitals in Greenfield, Palmer, and Westfield. The roughly 1,000-bed health system has up to 100 patients awaiting discharge daily, often to a nursing home for rehabilitation or long-term care.

The latest survey by the Massachusetts Health and Hospital Association shows Western Massachusetts has the second-highest number of people in the state languishing in hospitals waiting for a nursing home bed to become available, outside of the metro Boston area. In January, that was 103 people.

Across the state, hospitals have been filled to capacity, often forcing new patients to wait for hours in emergency rooms for available beds. Those hospital beds are filled with people not able to be discharged because nursing homes are overwhelmed.

The full impact on the state’s health care system from the new rule on nursing homes is still an open question.

Several nursing homes, including ones in Lexington, Wrentham, Falmouth, and Norwell, have taken steps to comply with the new occupancy rule, filing plans with the state to expand their facilities so they can stop housing more than two residents per room.

Yet 31 other nursing homes have sued the state, claiming the rule is “expected to push many of them to the brink of closure.” If their multi-bed rooms were eliminated, they said, they collectively stand to lose more than $54 million per year and would be forced to lay off more than 436 staff members. The regulations would also effectively force them to eliminate close to 800 of their beds, they said.

A judge has temporarily suspended the two-bed rule for those nursing homes.

Meanwhile, state Senator John Velis, a Hampden and Hampshire counties Democrat, is leading a group of state lawmakers trying to find a middle ground that would help keep the four Western Massachusetts nursing homes open, but only if they are deemed safe for residents. The four did not join the lawsuit,so the judge’s ruling does not apply.

“I have heard from multiple constituents, many family members crying saying they have no place for their loved ones to go,” Velis said.

“It makes all the sense in the world that three and four bed rooms could present a very serious problem, particularly in light of what we learned during COVID,” Velis said. “No one is asking for anything that would compromise the physical and mental health for the residents there.”

State Representative Bud Williams, a Hampden County Democrat, said he worries that low-income families and those who are Black and Hispanic may be disproportionately affected by the closures.

“Some folks may be in position to go to assisted living and other nursing homes if they meet the specifications, but I know the burden of proof will always be on Black and brown folks, who are less likely to afford it, and less likely to have the insurance, so that is a real concern,” Williams said.

“This is very devastating to Western Massachusetts,” he said.

Czepiel, in Chicopee, said he is relieved to have tentatively secured a place for his mom in Amherst but is bewildered why the situation became so dire so abruptly for hundreds of families.

“I don’t know who to blame more; the administration at the nursing home, or the legislators, or the [state health department],” he said. “I don’t know who the real culprit is.”

Right now, his family is just concentrating on finalizing plans to move his mother to her new facility. In addition to suffering from dementia, she is in a wheelchair, and her health is failing.

“I am hoping,” he said, “Mom survives the move.”