Following four reports of neglect at nursing homes across the state, one of which resulted in death, Attorney General TJ Donovan announced a $740,000 settlement Wednesday with a national nursing home provider.
The settlement with Genesis HealthCare, which Donovan called one of the largest, if not the largest nursing home settlement in state history, will be split between the state and federal governments.
The lawsuit was spurred by four cases, including one death and three others in which patients required hospitalization.
At Burlington Health & Rehab, a nurse delivered an incorrect food tray to a resident who, as a result, had a respiratory emergency and ultimately died. Another patient there discharged himself, despite not being allowed to do so, and then had sepsis the next day and had to be hospitalized.
At St. Johnsbury Health & Rehab, another incorrect food delivery led to a choking incident, and at Berlin Health & Rehab, workers identified two ulcers on the lower leg of a resident, but did not properly treat the ulcers, which caused the resident to need emergency hospitalization.
All four incidents occurred between December 2018 and April 2019.
Donovan said that kind of neglect, stemming from a lack of trained professionals, represents the kind of problems that Vermont’s workforce challenges present.
He said caring for older Vermonters is “big business” for the state, and one that will continue to grow in coming years — but he said it’s important that the state’s workforce can match that demand.
“We know the demographics in our state,” Donovan said at a press conference Wednesday. “We’re getting older. And more and more folks are going to need care and treatment, and are going to pay to go into some of these facilities. And it is our commitment to continue to protect Vermonters, wherever they may be.”
Donovan said the federal government will receive part of the settlement since some of the services deemed “essentially worthless” were billed to Medicaid. The funding that goes to the state will be split between the state’s Medicaid office, the Attorney General’s Office and the state’s Program Integrity Unit.
The settlement also includes the creation of a new patient care coordinator position that will be split between the three state offices. The coordinator will be responsible for ensuring that all residents are being monitored properly and that the people who deliver care services to those residents are properly trained. The settlement also guaranteed that an independent monitor will come to the facilities annually for at least two years and report to the state on the quality of care at the facilities.
Ross Farnsworth, the executive director of Burlington Health & Rehab, where some of the most serious allegations took place, said there has been a “major improvement” in the care they provide residents. He said the facility’s most recent survey found them to be “deficiency-free.”
Farnsworth said because of changes that have already been made, he doesn’t think the new positions will make a major difference at their site.
“I think we were very focused on quality assurance and improving our process whether this person is in place or not — this is just one more layer of oversight,” Farnsworth said in an interview Thursday. “I don’t think it’s a bad thing. I don’t think it’s going to overhaul what we do.”
He said the facility currently has a 4-star rating and is aiming for a 5-star rating by the end of the year.
Genesis has nine facilities across Vermont, representing about a third of the state’s total nursing homes, Donovan said. However, he said, the new positions will just focus on the three facilities where problems were reported.
“I think Vermonters and family members who have Vermonters in skilled nursing facilities can rest a little bit easier knowing that, not only does this affect Genesis facilities, but it’s a deterrent for other facilities to wake up and understand that if there is a lack of quality of care, there’s oversight that will make sure that Vermonters get the care they need,” said Linda Purdy, who directed the state’s Medicaid Fraud Unit at the time of the incidents.
Donovan said in cases like these, no amount of money is ever truly enough, but he thinks at the end of the day, the settlement was a good deal for Vermonters.
Genesis nationally has annual revenue of $5.7 billion — but Donovan said he still thinks the $740,000 it had to pay out for the settlement is a significant figure for it.
“I think it’s an appropriate amount,” Donovan said. “And I can’t speculate what their bottom line is and the impact that this is going to have. But I think it’s a good result.”
