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More nursing home scrutiny proposed for sales, closures

Synergy Health Centers, which some advocates harbor concerns about, owns The Breaemoor Health Center in Brockton.
Synergy Health Centers, which some advocates harbor concerns about, owns The Breaemoor Health Center in Brockton.Gretchen Ertl for The Boston Globe

Companies aiming to sell or close Massachusetts nursing homes would be required to first notify residents, families, and a wide array of officials, under proposed new rules detailed by regulators Wednesday, a year after state lawmakers directed them to create a more public process.

The rules come amid mounting concerns by patient advocates that elder care is suffering as the state’s nursing home industry experiences an upheaval, with many facilities being sold and some closed.

There is “considerable consternation” among state lawmakers about the rapid changes, Representative Denise Garlick, chair of the Legislature’s Joint Committee on Elder Affairs, told the Public Health Council, an appointed body of academics, consumer advocates, and physicians that writes health regulations.

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In an interview after she spoke at the council’s monthly meeting, Garlick, who is also a registered nurse, said she is concerned that the state health department may not have enough inspectors to adequately monitor nursing homes amid the changes.

State records indicate at least 13 inspectors recently applied for early retirement under the Baker administration’s plan to bridge a state budget shortfall.

“We will be vigilant to ensure [the department] has the inspectors it needs,” Garlick said.

Under the proposed new rules, nursing home owners intending to sell a facility would be required to provide written notice to residents, their families, resident and family councils, nursing home staff, unions representing staffers, elected state and local officials, and the state Ombudsman’s office.

A public hearing would be required before the sale if at least 10 people petitioned the state health department. Such hearings would be mandatory — without a petition — for proposed closings of any nursing homes, and public notices, similar to those for proposed nursing home sales, would also be required.

The proposed new rules will undergo a public comment period before the council votes whether to adopt them.

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“Health care workers are pleased to see the Public Health Council moving forward with these public hearings that will help give families, seniors, and caregivers a stronger voice in the process,” Veronica Turner, executive vice president of the union that represents nursing home workers, 1199 SEIU United Healthcare Workers East, said in a statement.

Roughly 40,000 residents live in the state’s 400 nursing homes.

Senate majority leader Harriette Chandler, who championed the law that required the creation of a public hearing process, said the proposed rules “will force transparency and force the light of day,” and will “stop companies from coming in and doing harm to long-term care communities.”

In particular, Chandler and other advocates said they are concerned about Synergy Health Centers, a New Jersey company with no track record of owning nursing homes before it bought 11 Massachusetts facilities in the past 2½ years.

Since then, Synergy has racked up citations for dozens of violations involving patient safety and care.

Ray Cryan, a former state health department manager who oversaw nursing home sales and closures before he retired three years ago, said the Synergy sales highlight the department’s anemic monitoring of nursing home sales since then.

“I am embarrassed and ashamed for the department,” Cryan said.

“With Synergy, you let them buy one home, and see how they do. But not 11, and let them screw it up,” Cryan said. “Given the present [state review] process, whatever the heck it is, maybe a public hearing would be good.”

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But Cryan said the proposed new rules requiring a public hearing before a nursing home is allowed to close may jeopardize patients’ health and safety — especially if the hearing process is drawn out.

“The bills won’t get paid, staff will leave, and it will end up in receivership,” Cryan said. “You want it done as quickly as possible, so you can get residents to another facility.”

Paul Lanzikos, a member of the Public Health Council, urged his colleagues Wednesday to consider a more expansive goal with their rewriting of nursing home rules, saying a comprehensive overhaul was years overdue.

“I don’t want to give the impression that this is a process that rubberstamps, but that there is serious consideration,” particularly on nursing home sales, said Lanzikos, who is a former state Elder Affairs secretary.

After the meeting, Lanzikos said he worries the current health department review process for proposed nursing home sales is not nearly as robust as it should be.

“Suitability [of a proposed new nursing home owner] should take into account the level of quality of a provider, and not just whether the people are able to meet minimum criteria,” Lanzikos said. “We should be requiring the best care for our vulnerable citizens.”


Kay Lazar can be reached at Kay.Lazar@globe.com Follow her on Twitter @GlobeKayLazar.