Summary: The Need to Improve Quality of Care and Quality of Life

Summary: The Need to Improve Quality of Care and Quality of Life

While there are nursing homes in WNY that do provide quality and safe care, too many do not. As stand-alone facilities sell to for-profit, multi-facility ownership entities, there must be greater oversight and enforcement to ensure they provide safe and quality care to all residents.

In operating a nursing home, owners make a promise to the residents, the community (taxpayer) and the government that they will provide safe and quality care in return for Medicare and Medicaid payments. It is a legal and moral obligation to provide such. However too often staff are cut, and other measures are taken that impede resident safety to the benefit of the ownership group. In Comprehensive at Williamsville’s case, it is clear the ownership sought, and has acted, to save money through cuts in staffing (both numbers and benefits). Whether the ownership is siphoning funds away from the facility, as has been alleged in AG James’ lawsuit against the Villages of Orleans, and in Sam Halper’s federal case, is definitely a question worth investigating. In addition, the publicly available information detailed above shows similarities to that detailed in AG James’ lawsuit against the Villages of Orleans.

Red flags should have been raised at the NYS level pretty immediately upon Comprehensive Healthcare Management Services, LLC’s takeover of St. Francis and this operator group’s ability to own/operate other nursing homes in NYS. For example:

• Health deficiency weighted score after revisits for the August 20, 2015 survey cycle period totaled 270 points. This is approximately 4x the points when officially owned by Catholic

Health System for the December 18, 2014 survey cycle, and 13.5x higher than the December 10, 2013 survey cycle.

o 2013 while owned by Catholic Health System: 8 federal deficiencies, one cited at “E” scope/severity (no actual harm with the potential for more than minimal harm that is not immediate jeopardy but is a pattern).

o 2014: while owned by Catholic Health System: 15 federal deficiencies, 2 cited at “E” scope/severity.

o 2015: 30 federal deficiencies, 16 cited at “E scope/severity; >53% of the deficiencies.

• Health deficiency weighted score after revisits for the June 8, 2016 survey cycle period totaled 428 points. This is approximately 1.6x the points from the August 20, 2015 period.

o 2016: 33 federal deficiencies, 1 cited at “G” scope/severity (Actual Harm that is not immediate Jeopardy), 5 cited at “F” scope/severity (No actual harm with potential for more than minimal harm that is not immediate jeopardy that is widespread)), 7 cited at

“E” scope/severity. 18.2% of the deficiencies were for substandard quality of care.

• The CMS star rating for staffing drastically fell from 4 stars in 2014 and 2015 to 1 star in 2016.

• After taking over the two adult homes: Symphony Living at Dunkirk closed on January 7, 2018, and Symphony Living at Lancaster’s care drastically declined, and operations were turned over

November 15, 2017.

While Comprehensive at Williamsville during the current 3 cycle survey period has not been cited at Actual Harm and does not have the distinction of having the worse survey points in Erie County, 111 issues with resident care and safety remain. Comprehensive at Williamsville continually fails to rectify violations of federal and state nursing home resident rights and care regulations, is one of the highest utilizers of contract staff in Erie County, relies heavily on LPNs instead of RN, and has the highest nurse turnover rates in Erie County. In addition, the physical environment of Comprehensive at Williamsville has declined since current ownership’s takeover of operations and the facility.

During the course of the COVID-19 pandemic, there were many legislative changes and additions to the NYS Public Health law to address issues of substandard care in nursing homes. These included: minimum nurse staffing standards, nursing home disclosure requirements, and updates to the ownership change certificate of needs requirements. While these new laws are not perfect, they must be fully enforced and not eroded by the nursing home industry and its lobby. In addition, the DOH and others must scrutinize operator cost reports and related party transactions.

When a for profit operator purchases and/or takes over operations of a nursing home, the operator makes a legal promise to abide by the federal and state standards. There must be accountability.

111 That distinction goes to Buffalo Center for Rehabilitation and Nursing, with 184.33 total points for the current Cycle 1 period.