A court-appointed receiver is working against a May 24 deadline to find new living quarters for residents of five South Coast nursing homes that are shutting down this month. The closures are the latest blow to a state network of skilled nursing facilities that has shrunk by a third since 2000.
As of Tuesday, receiver Paul Valentine and his team had relocated all but 21 of the 245 residents of the Skyline Healthcare sites in New Bedford, Fall River, and Dighton. Their shutdown, and the transfer of all residents and their medical records, is expected to be completed by the end of next week.
New Jersey-based Skyline, which surrendered its licenses to run the properties on April 23, is being investigated by state authorities for allegedly not paying employees during the past month. The company, which appears to have collapsed financially, has also bounced checks and been sued in other states for unpaid health care claims.
“Our first priority is to find a proper facility to house each of the residents,” said Valentine, senior managing director at KCP Advisory Group in Billerica, who was named receiver by a Suffolk Superior Court judge on April 27. “The good news is that other facilities in the area are going to get more residents, and that’s going to improve their financial stability.”
The closing of Skyline’s properties will bring to 29 the number of Massachusetts nursing homes shuttered since last year, leaving the state with fewer than 400 homes. The consolidation has uprooted hundreds of older and infirm residents from Brewster to Brighton to the Berkshires in the long-struggling industry. While the circumstances of each closure are different, many for-profit and nonprofit operators face increasingly precarious finances and find it difficult to attract skilled nurses and other employees.
“We are a system that’s underfunded,” said Tara Gregorio, president of the Massachusetts Senior Care Association, a Waltham-based trade group for the state’s nursing homes. “We’re in a historic financial and workforce crisis that affects all our facilities.”
Some nursing homes lose money because of inadequate reimbursement from MassHealth, the state Medicaid program, which pays for the care of most long-term residents. Many wealthier residents, who paid higher rates out of pocket historically, have been lured away by newer assisted living facilities.
Medicare — the government insurance program for older Americans — doesn’t pay for long-term care. But it has helped to offset the Medicaid shortfall in the past by reimbursing at higher rates for short-term rehab patients in nursing homes. More recently, though, that funding source has diminished as a new class of “accountable care organizations,” created under the federal Affordable Care Act to administer Medicare plans, has tightened requirements on how long they’ll pay for residents discharged from hospitals into nursing homes for rehabilitation.
At the same time, more older residents are choosing to “age in place,” bringing skilled nursing care into their own residences rather than moving into nursing homes.
Financial conditions have deteriorated since 2000, when the state had about 600 nursing homes, forcing many independently operated homes to close or sell to larger chains, often based out of state. Skyline, which had its headquarters in Wood-Ridge, N.J., had purchased the five South Coast properties in the past several years as part of a roll-up of more than 100 nursing homes in far-flung states such as Florida, Arkansas, and North Dakota.
The Massachusetts Department of Public Health began monitoring Skyline last year after learning of its financial difficulties in other states. After talks with a potential new buyer of the South Coast nursing homes fell through, Skyline failed to pay its staffers and vendors in two payroll periods, officials said. It ultimately surrendered its licenses at the five homes.
A spokeswoman for state Attorney General Maura Healey said her office’s investigators “received complaints relating to nonpayment of wages [by Skyline] . . . and are actively looking into those complaints.” The company is also being investigated for bounced checks and faces lawsuits alleging insurance fraud in other states. It wasn’t clear this week if Skyline remains in business; calls to its headquarters in New Jersey weren’t answered.
Valentine said two of the former Skyline nursing homes in New Bedford — Bedford Gardens Care and Rehabilitation Center and Rockdale Care and Rehabilitation Center — have already closed. The other three — Bedford Village Care and Rehabilitation Center of New Bedford, Dighton Care and Rehabilitation, and Highland Manor Care and Rehabilitation Center — remain open as his team continues working to place some of the residents.
While some employees left after their checks bounced, Valentine said most have remained to help wind down operations at the nursing homes. He said his team is working to figure out how much employees are owed in wages and paid time off and to reimburse them.
Tim Foley, executive vice president of Local 1199 of the Service Employees International Union, United Health Care Workers East, said his union — which represents about 2,500 nurses and service workers at more than 35 nursing homes in Massachusetts, though not the Skyline homes — has joined with the industry to support more MassHealth funding for the homes. It also backs a budget measure calling for an emergency state task force to look into the sector.
“Nursing homes play a significant role in the long-term care of residents,” Foley said. “We’ve experienced rapid closure of nursing homes and frequent changes of ownership. We need to understand what’s going on.”