In addition to concerns on staffing and finances at nursing homes, which has led directly to neglect of residents, DignityMA is also perplexed at the seeming lack of oversight and enforcement from the state.
Download, or scroll to read, a letter to the Commissioner of the MA Dept of Public Health, Robert Goldstein.
The Provincetown Independent has had several in-depth reports on nursing homes, and the Seashore Point nursing home for rehabilitation in particular.
- August 7, 2024 Nursing Home Reform Languishes on Beacon Hill
- July 31, 2024 Private Equity Doesn’t Care
- July 31, 2024 Reviewers Suspect Fraud in Nursing Home Filings
- July 24, 2024 Patients Suffer at Outer Cape’s Only Nursing Home
A July 21 article in the CT Mirror “Athena nursing home workers say medical bills still going unpaid” details the problems at a specific Athena nursing home in Connecticut. MA has several Athena homes. Or download Athena nursing home workers say medical bills still going unpaid (pdf).
Other areas of concern are N.H. Staffing and Private Equity.
August 12, 2024 – Response from Commissioner Goldstein (pdf) to letter below
Letter to Commissioner Goldstein
Dear Commissioner Goldstein:
Dignity Alliance Massachusetts is concerned about the oversight of a number of nursing homes in the Commonwealth and the well-being of their residents and staff.
Facilities of particular concern include Highview of Northampton in Leeds owned by Athena Health Care Systems and all four facilities owned by Blupoint Healthcare: Blackstone Valley in Whitinsville (Northbridge), Pioneer Valley in South Hadley, Mill Town in Amesbury, and Quabbin in Athol, three of which have now been placed under receivership. All, except Blackstone Valley are one-star rated. At least two are deemed special focus facilities (SFF) or candidates by the Centers of Medicare and Medicaid Services (CMS). Issues involving these facilities have been reported in local media reports. In many instances, the unacceptable conditions in these homes have continued for months. Why are these situations allowed to go unabated? Why have admission freezes not been imposed? Has any type of operational oversight been imposed?
Our concerns have been amplified by a July 21, 2021 report in The Connecticut Mirror about Athena Health Care Systems (see attached) which details major financial problems including failure to pay employees’ health care bills for more than six months as well as various vendors and suppliers. If this is occurring in Athena’s Connecticut facilities, it is surely also in its seventeen nursing homes and three hospice programs operating in Massachusetts. Moreover, we are hearing that similar problems may also be occurring with other Massachusetts nursing home owners. Is the Commonwealth prepared to respond to failures of this magnitude?
Data reported by CMS relative to nursing home deficiencies and fines are, indeed, sobering. Many Massachusetts licensed facilities appear on the list with multiple serious violations. We view, as disturbing, that in the period from July 2021 through May 2024, hundreds of thousands, possibly millions, of dollars, in penalties were levied against Massachusetts nursing homes but not processed until June 1, 2024. Why is it that fines levied a few years ago are just now being processed? We believe that timely enforcement, especially if brought to public attention, can help to expedite corrective action and identify other areas of concern.
At a Senate Ways and Means Committee hearing earlier this year, Dignity Alliance testified:
We call for the increase of nursing home inspections and the decrease in the use of antipsychotics with nursing home residents. Massachusetts nursing home surveyors (inspectors) have the highest number of homes to inspect in New England, and more frequent inspections could improve quality of care and resident safety. The misuse of antipsychotics is a special concern, since Massachusetts also has one of the highest usage rates in the country, despite the requirement of informed written consent (IWC) before the administration of psychotropics and ongoing required dementia care trainings for specified staff. Over-drugging can be used to keep residents quiet, especially when nursing homes are understaffed in violation of state regulations. Dignity Alliance applauds legislators for establishing a system for tracking opioid drugs and supports a similar process for tracking antipsychotics and other psychotropic drugs, along with more effective regulation of the legislatively mandated requirement for IWC.
We have several questions about the survey process and DPH’s capacity to monitor all nursing homes in a timely fashion and ensure regulatory compliance:
- Are there enough fully trained and experienced surveyors?
- Are there too many homes for each surveyor to cover?
- Does DPH prioritize inspections, such as focusing on one-star and two-star facilities?
- How does DPH handle complaints, especially repetitive ones?
- How are Massachusetts’ minimum staffing requirements being enforced?
- How are facilities operating “specialty” programs and services being monitored to ensure regulatory compliance and quality of care?
- In light of the BluPoint facilities, for which ownership has recently changed, is the current vetting process during suitability review sufficient?
Dignity Alliance is very concerned with the lack of effective oversight by DPH regarding the nursing homes for which the agency is statutorily responsible and for which the federal government provides financial support.
DPH is the licensure agency for nursing homes, hospices, and other healthcare providers in the Commonwealth. As such, it has the authority- and responsibility- not only to monitor and evaluate, but to act and protect when the safety and well-being of persons, especially those who are vulnerable and dependent upon others, are at risk. When it is apparent that the issuance of deficiency reports and imposition of fines and penalties are not sufficient, state agencies must be willing to exercise authority to impose operational controls up to and including receivership and licensure revocation.
We also believe that MassHealth has a responsibility to the taxpayers of the Commonwealth to make sure that public funds are being effectively spent. Each year, funds for nursing homes have increased to cover a declining number of residents and, in many instances, a reduction in quality care. We raise these issues and ask the questions on behalf of residents in Massachusetts nursing homes, family members, caregivers, and taxpayers. We welcome the opportunity to meet and discuss the state of affairs involving the operation of the 350 nursing homes in Massachusetts and the more than 30,000 residents. We look forward to hearing from you.
Paul Lanzikos, Coordinator, Dignity Alliance MA