Home Nurse course NC nursing home set to lose Medicare and Medicaid funds

NC nursing home set to lose Medicare and Medicaid funds


The vast majority of patients living in a struggling Salisbury nursing home may have to move as the facility is set to lose almost all of its government funding, The Charlotte Observer has learned.

The Citadel of Salisbury, a for-profit home that has repeatedly breached federal health and safety requirements, has been told it will lose its Medicaid funding in addition to its Medicare funding, according to the Department of Health and North Carolina Social Services.

In 2020, about 80% of inpatient days at the facility were funded by Medicaid and Medicare, according to figures compiled by snfdata.com, which compiles nursing home information from Medicare cost reports. and other sources.

The understaffed nursing home now has around 85 residents.

The Citadel of Salisbury will lose Medicare eligibility on May 19, the federal Centers for Medicare and Medicaid Services (CMS) announced earlier this week. Medicaid termination will occur simultaneously, DHHS said.

“The facility has been advised that Medicare will stop paying for services provided to Medicare and Medicaid beneficiaries admitted after May 19, 2022, although payment may continue for up to 30 calendar days for patients admitted on or before May 19, 2022. May 2022,” the federal agency Medicare said in a press release.

CMS urged patients and family members to visit the ‘Nursing Home Compare’ site for information on other nursing homes where they might want to seek treatment.

A spokesperson for Portopiccolo, the New Jersey investment firm that owns the Citadel of Salisbury, said Friday the retirement home would ask the federal government to reverse its decision.

“We are shocked and disappointed with this decision,” Angela Hooper, administrator of the retirement home, said in a statement. “The progress this nursing home has made in improving the quality of care during a global pandemic is respectable. The staff are heroic.

“The Citadel improved its quality metrics to a 4 star rating from a 2 star rating in just 18 months. We love our residents dearly and our mission was only to share their lives and make them happy .

In the past 10 years, no North Carolina nursing home has lost Medicare funding, a DHHS spokesperson said.

Accordius Health in Brevard, another retirement home owned by Portopiccolo, received a similar termination notice from Medicare in March. But state inspectors later found the facility met Medicare and Medicaid requirements, so the federal government ultimately did not withdraw its funding.

“Involuntary termination of a supplier agreement is generally a last resort after all other attempts to remedy a facility’s deficiencies have been exhausted,” the federal press release reads. “In this case, CMS has found that Salisbury Citadel does not comply with CMS baseline health and safety requirements.”

A recently released state inspection report includes more than two dozen violations at the facility.

A resident was injured by a caregiver trying to move him. When he screamed, she put her hand over her mouth to muffle the sound. Another resident said no one helped her after she complained to staff about a resident who kept offering her money for sexual favors.

A third had to be hospitalized with surgical wound infections after nurses did not change his bandages for a full week.

A Citadel nurse’s aide said staff were so ‘awful’ she couldn’t help residents out of bed or give them showers on some days. A director of nursing reported that staffing was so thin she sometimes worked 22 hour shifts – and yet ‘things fell through the cracks and she couldn’t keep up’.

“Left Alone,” a recent investigation by The Charlotte Observer, documented how a shortage of caregivers in North Carolina nursing homes is putting thousands of vulnerable residents at risk.

Unlike most states, North Carolina has set no minimum staffing ratios for nursing homes.

An analysis of the data by Observer reporters also revealed that for-profit owners tend to operate with significantly smaller staff and more gaps than nonprofits.

Portopiccolo has about three dozen nursing homes in North Carolina, and the vast majority of them only scored one or two stars for staffing and overall performance on the government’s five-star rating system. federal.

Salisbury Citadel has been hit with more than $370,000 in fines since 2020. For the past two years, the federal government has put the home on its “Special Focus” list, reserved for the worst-performing nursing homes in the world. country.

In an ongoing federal class action lawsuit against the Citadel of Salisbury, the families of two residents allege that “systematic understaffing” has led to residents not receiving frequent medication, showers and medical attention. On some days at the home, just three orderlies were on duty to care for the more than 70 residents, according to the lawsuit, filed by law firm Wallace and Graham last year.

In a court filing, Portopiccolo called the understaffing allegation “baseless,” saying the nursing home mistakenly underreported hours worked by agency nurses.

In 2020, the Salisbury Citadel had more than $13 million in revenue – and a profit margin of around 8%, according to the cost report it submitted to the federal government.

Patients pay for understaffing in nursing homes

A nationwide struggle to hire and retain caregivers is driving North Carolina nursing homes to a crisis point — a trend that is putting thousands of residents at risk, our survey finds. An influx of for-profit nursing homes and fewer regulations during the pandemic are deepening the crisis. So what should families do to protect their loved ones?

This story was originally published May 6, 2022 2:49 p.m.

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Ames Alexander, an investigative reporter for the Observer, examined corruption in state prisons, the mistreatment of injured poultry workers and many other topics. Her stories have won dozens of state and national awards. He was a key member of two reporting teams that were named Pulitzer Finalists.