Federal regulators moved this week to impose an unusually steep fine against a troubled Wilmington nursing home where two residents have died since December amid concerns about substandard care.
Woodbriar Health Center is facing a $278,900 penalty that will climb $7,100 a day until the most significant problems are fixed, according to a letter made public Wednesday.
In calculating the fines, regulators said they considered Woodbriar’s “history of noncompliance, including repeated deficiencies.”
Regulators said they also took into account Woodbriar’s “degree of culpability, including but not limited to, neglect, indifference, or disregard for resident care, comfort, or safety.”
The nursing home faces an even more dire penalty if it does not resolve remaining serious problems by next Wednesday: removal from the government programs that cover most residents’ bills.
Woodbriar’s owners said they are working with the Massachusetts Department of Public Health to address concerns.
The latest sanctions, which represent rarely issued penalties, were imposed in a letter sent to the nursing home Tuesday by the US Centers for Medicare & Medicaid Services.
It is unusual for the federal agency to issue penalties topping $100,000 in New England, according to the agency. Terminating a nursing home from government health insurance programs is rarer still. Typically, no more than one or two are cut off in a year, and many years, none face that extreme sanction, the agency said.
State health inspectors uncovered safety and health problems at Woodbriar after a resident was accidentally dropped from a mechanical lift on Christmas Day and died two days later.
State and federal regulators have not released the reports that detail what inspectors found when they visited Woodbriar on March 21. Federal regulators said they are prohibited from making the documents public until 14 days after they are sent to Woodbriar, meaning they should be released in mid-April.
But in the letter federal regulators sent Woodbriar this week, they noted that only two of the problems discovered during the inspection following the December death of the resident had been corrected by March 21. They noted that at least one of the problem areas had gotten worse, and three new areas of concern were discovered.
Right after the March 21 visit, regulators declared Woodbriar residents were in “immediate jeopardy” because of so many serious health and safety issues, and ordered the nursing home to stop accepting new patients.
The letter sent to Woodbriar this week also notes that inspectors visited Woodbriar on Feb. 29 following a complaint and found two more areas of concern, “with the potential for more than minimal harm.” The letter did not detail the nature of those problems.
Woodbriar is part of a problem-plagued chain of 11 nursing homes owned by Synergy Health Centers, a New Jersey company that has endured mounting citations for faulty care since buying its first Massachusetts facility in 2012.
Synergy said in a statement Wednesday it is “confident” problems will be fixed.
“We are eager to resolve this matter for the sake of our residents and their families who have endured disruption and uncertainty as a result of this process,” the statement said.
David Hoey, a North Reading attorney who has successfully sued nursing homes for residents’ deaths and injuries, said the fines imposed on Woodbriar are unique in his 20 years of filing lawsuits against Massachusetts facilities. Hoey represents the family of Mary Meuse, the 83-year-old Woodbriar resident who was dropped Christmas Day and died two days later.
Hoey also represents the family of a woman who died Feb. 9 after falling out of bed the evening before at Woodbriar.
“This is a strong message of deterrence to other providers of nursing home care in New England and this company in particular,” Hoey said.
“A company like this can afford to pay this kind of fine,” Hoey added, “but I’d rather see the money go into improving the quality of care and quality of life in the 11 nursing homes they have in Massachusetts.”
State health inspectors in January found significant problems with communication and staff training at Woodbriar following the Meuse accident.
The inspectors concluded three shifts of nurses knew Meuse broke both legs in the fall but failed for 24 hours to let her, or her family, know the results of an X-ray. Meuse, who was taking blood-thinning medication for heart problems, was bleeding internally. She died two days later.
Inspectors discovered additional troubling signs during the March 21 visit. They had returned to Woodbriar to determine whether the nursing home had corrected the problems uncovered after Meuse’s death. It was during the March visit that they found issues surrounding the resident who died Feb. 9.
They discovered that nurses put the resident back to bed Feb. 8 after she fell out of bed. They were supposed to be regularly checking overnight for complications, but the next morning, the woman was discovered dead in bed.
A month earlier, Woodbriar staffers had received special training to spot problems in this exact type of case, according to state documents.