One woman suffered a cardiac emergency and died waiting for staff to summon properly trained help. Another died after nursing home staff failed to prevent her from developing pressure sores. And a third perished from bowel complications.
Massachusetts Attorney General Maura Healey cited the grim details Tuesday, along with repeated instances of neglect, in settlements with five nursing homes that required them to pay fines and upgrade their staff training.
“Residents of long-term care facilities across Massachusetts and their families deserve to feel confident that every resident will be cared for and protected,” Healey, who is running for governor, said in a statement. “We took action against these facilities to ensure that nursing home residents are provided the best possible care, and to secure the safety and training protocols needed to avoid preventable harm.”
The action comes three years after Healey banned one company from operating any taxpayer-funded nursing homes in Massachusetts for seven years following multiple deaths and injuries and slapped fines on several other operators.
The latest settlements impose fines on the nursing homes ranging from $30,000 to $81,500 for a total of just over $250,000. Four of the facilities are required to upgrade staff training and policies, conduct regular audits of their progress, and report the progress to the attorney general’s office for up to three years.
The nursing homes did not admit or deny wrongdoing in the deaths and injuries that occurred from 2015 through 2019. But in agreeing to the financial penalties and other conditions, they will not face prosecution by the state, according to the settlements. Some face private lawsuits by families.
Slightly more than half of the total civil penalties collected from the nursing homes — roughly $137,000 — will go to the state’s Long-Term Care Facility Quality Improvement Fund, according to the agreements. The fund is used to improve the safety and quality of care in nursing homes, including staff training and education.
The Massachusetts Senior Care Association, the state’s largest nursing home trade association, declined to comment.
But a leading elder care advocate said the attorney general’s action paled in comparison with the tragic outcomes.
“I think it was a missed opportunity to take some stronger action against facilities ... where residents suffered real harm,” said Toby Edelman, senior policy attorney at the Center for Medicare Advocacy. “When nursing homes are owned by some of the largest chains in the country, a $30,000 fine is a slap on the wrist.”
The five nursing homes include Heritage Hall North and Heritage Hall West, both in Agawam and both owned by one of the largest post-acute care providers in the nation, Genesis Healthcare, Inc.
“It’s not a whole lot of money, and it doesn’t cover all the nursing homes in the Heritage chain,” Edelman said. “That’s troubling. I would like the state to say, ‘We have a problem with non-implementation in policy in this facility we should look at all of them.’” (The Heritage Hall chain includes four long-term care facilities in Agawam.)
Heritage Hall West was fined $33,725 for failing to conduct mock automated external defibrillator drills for its nursing staff from September 16, 2016, through July 10, 2019. Heritage Hall North was fined $55,175 for failing to train staff on how to prevent pressure sores.
Wingate at Silver Lake in Kingston was fined $30,000 for failing to ensure its staff was properly trained and certified in CPR. Healey said the staff failed to “appropriately and adequately” respond to a patient needing such resuscitation, and that person died.
Brandon Woods in New Bedford received a $52,000 fine for failing to appropriately care for a resident at high risk for pressure wounds for five weeks. The woman suffered severe complications related to the wounds and died.
Sarah Brayton Nursing Center in Fall River will pay $81,500 for failing to properly implement its continence care protocol for more than 10 residents or ensure staff competencies in bowel management protocols. Healey said the facility failed to provide adequate and appropriate care to one patient resulting in her hospitalization and death due to severe fecal impaction.
The fines and requirements for additional training in the nursing homes come four years after John Olier’s mother, Beverly, developed severe, “avoidable” pressure sores from “reckless neglect” during her post-surgery rehabilitation in early 2018 at Heritage Hall North, according to the documents.
“We were unhappy how they were treating her there, and we took her to a doctor who said, ‘Oh my God, we’ve got problems here with these bed sores,’” Olier said.
“They really put my mother through hell,” he said.
After that, Beverly Olier required nearly seven months of care at a hospital and at home for the deep wounds to fragile skin on her tailbone and heels, her son said. She survived but died two years later, in 2020.
In addition to the fines and training requirements, Healey also filed legislation that increases the time in which her office can bring a civil suit for abuse or neglect of nursing home residents from two to four years. It also increases the civil penalties the office can seek for mistreatment, abuse, or neglect, up to $250,000 in cases resulting in death.
The cases cited by Healey occurred before COVID-19 hit in early 2020. But since then, advocates say, instances of neglect have likely climbed. The nursing home industry, which typically pays low wages to many nursing assistants who do the bulk of the hands-on care, has struggled to attract and retain workers.
Now, federal regulators are concerned that some of the waivers they granted to the industry to remove minimum quality standards during the pandemic, which provided them more flexibility in staffing, may have come at a high cost.
An April notice from the Centers for Medicare & Medicaid Services said that recent inspections at nursing homes have revealed “significant concerns.”
Edelman, the Center for Medicare Advocacy attorney who monitors nursing homes nationwide, said as the pandemic eases she expects to see more cases of nursing home abuse and neglect come to light.
“There is a lot of weight loss and pressure sores. This is what advocates have heard from families when they finally were allowed to see people,” she said. “Nursing homes are more under-staffed than usual and things have gotten worse.”