This morning, the federal government officially retracted its decision to terminate funding to the Vermont Veterans’ Home, allowing the facility to keep its primary source of funding.
This decision comes one week after the Centers for Medicare and Medicaid Services (CMS) issued the country’s second oldest home a “Notice of Termination,” which said the federal agency “will” decertify and cut funding to the home on Sept. 28. The $10 million to $12 million in federal funds would have accounted for more than half of the Bennington facility’s roughly $19 million operating budget.
Those cuts would have threatened the home of 137 veterans and spouses, as well as the jobs of about 250 employees.
Although Vermont congressional delegates pressured federal regulators to continue funding the home, CMS officials maintain they are continuing to fund the home because its staff has corrected a range of federal violations. The home’s administration indicated this week that it plans to implement sweeping reforms, and the federal government has restored the home’s power to administer funds to new Medicare and Medicaid beneficiaries. CMS cut that funding on June 28.
Now, less than two weeks after the home failed its sixth federal survey this year, regulators have indicated that they will continue funding the home because they say the numerous violations dating back to March have been corrected.
Such violations include, but are not limited to: a licensed practical nurse punching and breaking the nose of an 82-year-old veteran on Sept. 11; a caretaker performing tasks she was unlicensed to perform; an incontinent patient sent to an appointment without a caretaker; a caretaker allegedly writing derogatory comments about two residents on their care forms; and numerous instances of insufficient staff levels.
Earlier this week, Gov. Peter Shumlin told reporters at a press conference that this decision takes a huge weight off state officials and taxpayers.
“Had we been denied our CMS funding, it would’ve been a $10 million disaster for Vermont taxpayers on an annual basis and a real challenge to get the dollars needed to give the care to the veterans who deserve it,” he said.
As a result of some violations, veterans’ home officials confirmed that assistant administrator Karen Woodcock was let go last week. They would not divulge why, but Joe Krawczyk Jr., president of the home’s board, said that to his knowledge she was the only employee who has yet been fired.
Krawczyk, who previously served as a state representative, did say that the nurse who punched a veteran and the nurse who allegedly wrote derogatory comments are on leave pending the results of investigations.
On Wednesday, the facility’s board of trustees, administrators and people concerned about the condition of the home met to discuss a path forward.
“We’re going to look at every policy and every procedure and make sure we’re up to date,” said home administrator Melissa Jackson. “And we’re going to do a total revamp of our education program.”
Jackson said that the board is going to ask the U.S. Military Academy in West Point, N.Y., to conduct leadership training for the facility’s administrators. She also said that the facility would continue to employ the services of a nurse consultant, hire a scheduler and look to revamp the former assistant administrator’s position so that it better jibes with the needs of the facility.
Krawczyk said the board would review the facility’s auditing system and look at how the board is broken into specialized committees.
He also expects Shumlin to appoint retired, but still licensed, physician Richard Dundus of Bennington to the board in an effort to help the board better understand medical practices. Krawzcyk recommended Dundus for the position, and he said Dundus would become the board’s 18th member. There should be 20 board members, according to statute, and the governor appoints all of them.
Krawzcyk also said that he’d meet with staff members who are part of the Vermont State Employees Association once a month, and he and board member Gen. Robert Carter of Shaftsbury would regularly attend the residence council’s meeting.
Reflecting back on the six months of violations, Krawzcyk said that they were intolerable, but that the board, administration, staff and the veterans are all ready to move forward.
“The incidents that occurred were not acceptable; they were wrong; and they were identified by us, in most cases, and reported to CMS,” he said. “It was bad, but it was not indicative of the quality of care that is given day in and day out at the veterans’ home.”
Pressure from Sanders and Welch
In response to the termination notices, Sen. Bernie Sanders’ and Rep. Peter Welch’s offices indicated that Vermont’s congressional delegates contacted federal regulators in an effort to ensure that Vermont veterans received the funding to remain at the home.
Sanders, who sits on the Senate Veterans’ Affairs Committee, said he contacted Patrick Conway about the issue. Conway is in charge of inspections and certifications for CMS.
In a statement issued to VTDigger on Wednesday, Sanders said he believes that the U.S. owes it to its veterans to provide them with high quality health care, housing and benefits.
“I believe that goal can be best achieved if the federal government continues to work constructively with the state of Vermont to improve the care at the Vermont Veterans’ Home, rather than by pulling federal funding,” he wrote. “That is why I urged officials in Washington to give the state time to address the shortcomings at the Vermont Veterans’ Home.”
But despite Sanders’ and Welch’s efforts, CMS spokeswoman Courtney Jenkins maintained that politics did not have anything to do with this decision.
“The scheduled termination was rescinded as a result of a final onsite review by surveyors earlier this week in which the nursing home was able to demonstrate that it is in substantial compliance with federal requirements for quality of care and safety.”
Correction: The staff member who broke the nose of a veteran was a licensed practical nurse, or lpn, not a licensed nurse practitioner — as the article previously stated.