Gov. Cuomo's administration has quietly signed off on giving $850 million to be split among more than 600 nursing homes around New York state -- even though federal regulators have found quality of care at more than two-thirds of the facilities to be below average or much below average.
The money is part of what’s being called the “universal settlement,” a payout intended to boost the bottom lines of nearly all New York nursing homes in exchange for those facilities dropping thousands of challenges to New York's Medicaid reimbursements.
“While it sounds like a lot of money, I think the state made a calculation that this was in their best interest,” said James Clyne, president of LeadingAge, an industry group representing nonprofit nursing homes.
According to an I-Team analysis, more than 230 of the 601 nursing homes in line to get a cut of the settlement have inspections resulting in one-star or two-star ratings. The federal government measures a nursing home’s quality of care on a scale of five stars.
"If you're a one-star facility, you're one of the worst facilities in the country," said Richard Mollot, an advocate for nursing home residents. "Why would we be giving them more money? We should be taking away money, but we never do that."
Mollot, who runs the Long Term Care Community Coalition, isn't the only one calling the $850 million nursing home settlement a sweetheart deal.
Andrew Cempa, whose wife Carolyn Evans recently suffered severe dehydration after staying at The Riverside Premier Rehabilitation & Healing Center on the Upper West Side, said the state should withhold settlement money from the facility until it makes improvements to quality of care.
"You have money going out from tax dollars," Cempa said. “Where is their ability to penalize? Where is their ability to hold these people accountable?”
Citing patient privacy, administrators at The Riverside declined to answer questions about the treatment of Carolyn Evans. Medical notes from The Riverside staff show employees were aware dementia and seizures were interfering with the patient’s ability to swallow food and drink water. The notes say medical staff even talked to Cempa about the possibility his wife might need a feeding tube.
But Cempa said no one explained how grave her condition was, until he demanded an ambulance take his wife to the hospital, where emergency room doctors said she was malnourished and nearing kidney failure.
“They were incredulous. They couldn’t understand how someone in a facility could come in in that condition,” Cempa said.
“That’s why we went to the nursing home, to take care of our loved ones,” said Kip Evans, the patient’s son. “Where is the humanity?”
The Centers for Medicare and Medicaid Services (CMS) has given The Riverside two stars, the second lowest federal rating for overall patient care. Inspection records show The Riverside has the lowest possible rating for staffing levels. On average, registered nurses at the Riverside spend just 25 minutes a day with each resident. That is less than half the national average for RN hours per resident per day.
Representatives of The Riverside also declined to discuss their federal inspection records. However, the nursing home industry has long criticized federal surveys as being backward-looking.
“I might have been a two-star facility because I had a bad survey, but I’ve changed my practice and retrained my staff,” said Clyne. “I still get listed as a two-star until my next survey comes along but the quality of care I have is really good.”
Cuomo did not respond to the I-Team’s request for comment about the $850 million nursing home settlement. Instead, Cuomo’s office referred questions to James Plastiras, a spokesman for the New York State Health Department. Plastiras defended the settlement as a win for nursing home residents and taxpayers alike.
“Nothing in the settlement would limit the state’s ability to enforce rigorous state and federal standards to ensure that residents are protected,” Plastiras said.
He added that the additional cash will “provide nursing homes with greater financial stability, thus allowing them to make strategic investments that maintain and enhance resident care.”
Cempa and his stepson have now filed a complaint with the state health department against The Riverside nursing home. They’ve also hired a private company called Medicaid Advisory Group to manage medical and financial decisions for their wife and mother.
Ginalisa Monterroso, president of Medicaid Advisory Group, questioned whether New York should be handing a cash payout to a nursing home that failed to make sure her client was well nourished and hydrated.
“I don’t think there would be any taxpayer that would agree that they paid for someone to go into a facility and not even get the bare minimum of water,” Monterosso said. “Definitely the taxpayers did not get their money’s worth.”