A publicly traded holding company from Pennsylvania is seeking approval from state regulators to buy up five nursing homes in Bennington, Berlin, Burlington, Springfield, and St. Johnsbury.
Genesis Healthcare, Inc., which runs 500 nursing homes across the country, including 100 in New England, wants regulators at the Green Mountain Care Board to approve a permit, called a certificate of need, to buy the properties.
Genesis applied for a certificate of need on Oct. 16. The company would buy the properties from Revera, Inc., another for-profit company, as part of a $240 million deal to buy nursing homes in nine states, including Massachusetts, Rhode Island, and Connecticut.
The company is traded as $GEN on the New York Stock Exchange. The value of its buildings were $4.3 billion in 2015, and cash flow in 2015 was $552 million.
Dick Blinn, the president of the Northeast division of Genesis, told regulators at a hearing Thursday that the company has senior leadership located right in Vermont, where it already owns four nursing homes, and doesn’t simply send people from Pennsylvania every now and then.
“It’s a good geographic and cultural fit for us,” Blinn said. “Having a regional team located in New England and in the state of Vermont makes it kind of a natural fit to grow in the state of Vermont for us.”
Genesis owns four facilities in three cities in Vermont: Bel Aire Center in Newport, Mountain View in Rutland, Rutland Center in Rutland, and a nursing home in St. Albans. All are owned and operated through a string of limited liability companies, and the company is proposing to use the same model at the new properties.
Con Hogan, a board member and former human services administrator, asked the company to provide data on nurse turnover. He asked whether in a state with low unemployment “and in a business that’s tough on people, nurses in particular, how do you stay staffed in this environment?”
Michelle Costa, the vice president of clinical operations for Genesis, called staffing “a challenge not just in Vermont but everywhere.” Costa said the company does “recognize that our turnover rate is high, and we’re not satisfied.” She said she would submit the turnover rate to the board at a later date.
Vermont Department of Disabilities, Aging, and Independent Living endorsed Genesis in the certificate of need case, calling the company “a capable owner and operator” as well as “an active partner with the state, with the current Vermont accountable care organizations, and with the nursing home trade organization.”
The five new nursing homes have 579 beds among them, according to the application, and almost all of them are in semi-private rooms with more than one bed. The company is planning to eliminate 52 beds among the five new nursing homes and convert some rooms to private care.
If approved, Genesis would own approximately one-third of the nursing home beds in Vermont.
Jessica Holmes, an economist who sits on the board, asked Genesis why it would seek to eliminate almost 10 percent of the beds it is buying at the nursing homes. “This is a little surprising given what we’re hearing about with our growth rate of people over age 65,” Holmes said.
“In Massachusetts, where they’re really sort of leading the way … length of stays are getting much shorter,” Blinn responded. “You’re going to see a reduction of length of stay (at nursing homes). That’s really the whole aim of the government.”
The hearing became heated when Hogan questioned quality measures at certain Genesis nursing homes, where he said patients were less healthy than the state average. He pressed the company to provide information to justify the patients’ health problems.
Linda Cohen, the lawyer representing Genesis, told Hogan that the company “is working diligently at improving quality” at the regional level. She asked the board not to impose quality measures as part of the certificate of need because the company is already regulated through other entities.
“I gotta tell you. I don’t want to hear this,” Hogan said. “At Bel Aire, your ‘falls and major injuries’ were three times the state average—three times. Your ‘need for help with daily activities,’ a third higher than the state average. ‘Lost too much weight,’ three times the state average.”
Blinn told Hogan that Bel Aire is a small facility, so statistics may be skewed. The facility has 58 beds, according to the application.
“I could go on, and I could find these for each of these facilities,” Hogan responded. He said Mountain View in Rutland has a high rate of depressive symptoms among patients, and that the Rutland Center has a high level of ulcers and depressive symptoms.
“This is serious stuff,” Hogan said. The hearing ended shortly after the exchange.
Public comments can be submitted here for 10 days.
A decision is expected two weeks after the public comment period is over, according to board chairman Al Gobeille.
