As trend shifts to in-home care, Connecticut cuts funding to nine nursing homes with high vacancy rates
Aug. 22-- Aug. 22--The state has targeted nine under-performing nursing homes with large numbers of empty beds for millions of dollars in Medicaid cuts, but the operators, the union, and some lawmakers in the affected areas are pushing back hard, saying the homes should be given a chance to raise occupancy rates.
State officials counter by saying the industry knows there are at least 3,000 empty nursing-home beds in Connecticut and the trend is toward in-home care. Nearly 70 nursing homes have closed on their own here since 1995, with 15 shutting their doors since 2016 alone, records show.
The empty beds carry a cost and the public is paying the bill, the officials said.
The state is heavily involved in the funding and regulation of nursing homes. It allocates the federal Medicaid dollars, and it inspects and licenses the homes.
The legislature this past spring passed a law that removed "stop loss" protections against rate decreases for nursing homes with high vacancy rates. The nine targeted homes all had vacancy rates of 30 percent or higher. Some were in the 40 or 50 percent range.
The operators of the nine homes learned last week just how much they'd be losing -- a total of nearly $6 million this year -- and several sounded the alarm, saying they may be forced to close. Union leaders said the process of transferring to other nursing homes could be traumatic for some residents.
Pennsylvania-based Genesis Healthcare owns five of the nine homes. They are Arden House in Hamden, the state's largest nursing home, Quinnipiac Valley Center in Wallingford, Kimberly Hall South in Windsor, Village Green in Bristol, and Governor's House in Simsbury.
Apple Rehab, based in Connecticut, owns two -- Hewitt Health in Shelton and Wolcott Hall in Torrington. The final two are individually owned, Carolton Chronic Convalescent Home in Fairfield, owned by Carmen Tortora Jr., and Meridian Manor, owned by James Cleary.
The 350-bed Arden House was 32 percent vacant as Sept. 30, 2018, according to state records. Quinnipiac Valley had a vacancy rate of 50 percent.
The nursing-home industry and the Service Employees International Union says the cuts are short sighted, and demand might return as the baby boomers age over the next 10 years.
The state's population of people age 65 and older will grow by nearly 60 percent by 2040. The Census Bureau reported in 2016 that Connecticut had about 575,000 people age 65 or older, about 16 percent of the state population.
Closing any of the homes would hurt the local economy and have a disproportionate affect on minority staff members and nursing center residents, said Rob Baril, president of Local 1199 of the SEIU.
He said some of the homes offer special services, such as dialysis, that he said cost less in nursing homes than in hospitals.
The state should give nursing home operators the opportunity to downsize, rather than forcing them to shut down completely," Baril said.
State officials said there would be no immediate closings. The operators have to make a case for closing and a certificate of need would have to be approved. The state's long-term care ombudsman would be involved in the consideration of any transfers of residents.
Even if a building was placed in receivership and an operator handed the keys over to the state, the home would not close immediately, said officials with the Department of Social Services and the Office of Policy and Management.
The cuts are retroactive to July 1.
In the spring, a top Genesis executive wrote to then-Social Services Commissioner Roderick Bremby, saying the company would be willing to eliminate 356 beds across the five nursing homes -- if it could have until October to do it.
"I believe this gives the state the desired reduction of licensed beds but is done in a strategic manner ... versus a haphazard process where entire buildings will have to close," wrote Sean P. Stevenson, senior vice president for operations at Genesis.
To date, his proposal hasn't been accepted.
In a statement to The Courant on Wednesday, Stevenson said the state's empty-bed count could be misleading.
He said many centers have removed beds "to create private rooms and add specialties such as hospice care. As a result, occupancy levels are not accurately reflected due to beds out of service."
In response to the cuts at the nine homes, Gov. Ned Lamont noted that the other 204 nursing homes in the state got Medicaid increases -- for wage and benefit enhancements. He said the state "must adapt and respond to the information at hand."
He said the rate reductions "will allow us to meet consumer demand ... and improve the long-term care experience for our residents and their families."
But Rep. Mike D'Agostino wonders at what cost.
In a letter to Lamont earlier this month, D'Agostino said steep rate cuts could cause a facility to close over night -- which the state disputes.
"This would be the case at the Arden House in Hamden, which has operated for decades ... Of its 400 employees, over 200 live locally in Hamden and New Haven, which would make the impact of its closure economically devastating to the area," D'Agostino wrote.
Matt Barrett, CEO of the Connecticut Association of Health Care Facilities, said nursing homes are diversifying, and most of the nine could have "right-sized" themselves with adequate notice.
Five of the nine homes had quality-of-care issues and were rated below average in at least one healthcare category, according to the U.S. Centers for Medicare and Medicaid Services, or CMS.
Based on health inspection reports as of September 30, 2018, Arden House was given one star, or a grade of "much below average," for its overall rating and how it fared in health inspections, and two stars, or "below average," for staffing. Hewitt Health was assessed one star for overall rating and performance in health inspections and Village Green received one star for staffing.