Concerns increase over fate of nine high-vacancy nursing homes targeted for Medicaid cuts

Aug. 28--In the weeks since the operators of nine nursing homes with high vacancy rates learned they stand to lose a total of about $6 million in Medicaid funding, concerns about closures, major job losses and trauma to elderly residents have intensified.

All nine homes slated for cuts have filed appeals with the Department of Social Services, officials confirmed Wednesday.

Meanwhile, the cuts to the nine homes are on the radar of legislative leaders as they decide which topics to address in a potential special session this fall.

Union leaders and nursing home industry executives said they would push for a reversal of the law behind the rate cuts if it made it onto a special session agenda.

The legislature this past spring removed "stop loss" protections against rate decreases for nursing homes with high vacancy rates. The nine targeted homes all had vacancy rates of 30 percent or higher. Some were in the 40 or 50 percent range. The bill saves money and reflects the shift to in-home care for the elderly, state social service and budget officials say.

While the measure, part of a broader budget bill, had enough support to pass the General Assembly, legislators in districts with the affected nursing homes have written to, called or met with the governor's office to try to delay or reverse the Medicaid cuts.

But it wasn't clear Wednesday whether a compromise is in the air.

A member of Gov. Ned Lamont's staff recently met with executives of Genesis Health Care, which owns five of the nine targeted homes.

"We're trying to help Genesis work through the rate changes," Max Reiss, Lamont's communications director, said Wednesday. "In some ways, this is about what care is going to look like in the future, and how Genesis can fit in with that."

The nursing home industry in Connecticut has offered to eliminate several hundred excess beds if the cuts were postponed, but the state hasn't accepted the offer.

The industry is saying certain beds removed from the daily mix and devoted to dialysis and other specialty care are being wrongly counted as empty, but the state has showed no signs of changing its vacancy counts or methods.

The nine targeted homes are the Arden House in Hamden, the state's largest nursing home, Quinnipiac Valley Center in Wallingford, Kimberly Hall South in Windsor, Village Green in Bristol and Governor's House in Simsbury. Those five are owned by Pennsylvania-based Genesis.

Apple Rehab, based in Connecticut, owns two -- Hewitt Health in Shelton and Wolcott Hall in Torrington. The final two are individually owned -- Carolton Chronic Convalescent Home in Fairfield, owned by Carmen Tortora Jr., and Meridian Manor in Waterbury, owned by James Cleary.

"We are respectfully asking the administration to delay implementation of this measure so that we can fully evaluate the negative implications of the new policy," Sen. Cathy Osten, D-Sprague, and Rep. Toni Walker, D-New Haven, wrote recently to Gov. Ned Lamont. The two are co-chairs of the budget-writing appropriations committee.

Osten and Walker said they support the ideas behind the measure, but feared "overnight closure of facilities, leaving both the residents and the workers who serve them literally out on the street."

Their letter follows one by Rep. Mike D'Agostino, D-Hamden, who said closures would seriously damage the local economy. There have also been community meetings at some of the targeted homes.

State officials note the nursing homes would have to make a case to close and couldn't shut their doors without state approval -- and that wouldn't happen overnight.

The Service Employees International Union and the Connecticut Association of Health Care Facilities are also challenging the empty-bed counts that the state is using to determine occupancy rates.

Matthew Barrett, the health care association's CEO, said the targeted nursing homes could remove, or "de-license," at least 400 beds over the next several months -- tantamount, he said, to closing several smaller nursing homes but without the job loss and disruption to the lives of the residents.

State officials say they wonder, then, why the industry didn't remove hundreds of beds months ago. Several of the nine targeted homes also had quality-of-care issues.

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The state maintains there are at least 3,000 excess nursing home beds in Connecticut. About 70 nursing homes, with more than 6,600 beds, have closed on their own since 1995 as seniors opt to stay home and insurance companies push for shorter stays in nursing centers and hospitals.

Barrett, a former official with the state Department of Social Services, disputes the excess-bed figure. In any case, he said, some nursing homes are adapting by offering special dialysis, memory and respiratory care, and by branching into assisted living and even in-home care.

He said he'd rather see smaller nursing homes than fewer nursing homes.

Josh Kovner can be reached at jkovner@courant.com.

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