Feds permit Casa Real to resume Medicare, Medicaid billing

Oct. 07--The Casa Real nursing home in Santa Fe has at least temporarily corrected persistent quality-of-care problems and can resume billing Medicare and Medicaid for newly admitted residents covered by the insurance programs for the elderly and poor, a federal agency has found.

The Centers for Medicare and Medicaid Services, in a letter Thursday to Casa Real, said the nursing home can bill for admissions that occurred after Sept. 10.

For more than two months, Casa Real had been barred from charging Medicare or Medicaid for new residents after the Centers for Medicare and Medicaid Services found the nursing home wasn't in substantial compliance with federal care standards.

The federal agency also threatened to cut off all Medicare and Medicaid payments to Casa Real if it didn't come into substantial compliance with care rules by Thursday. The action would have been a significant blow to area residents seeking nursing home care because Casa Real is one of only two homes in Santa Fe that accept Medicare and Medicaid patients.

In its letter to Casa Real, the Centers for Medicare and Medicaid Services said an inspection of the nursing home in August -- the fourth this year -- found continuing care problems but that the deficiencies had been corrected as of Sept. 11.

The August inspection found residents weren't receiving medications as directed by their physicians and that the nursing home wasn't doing enough to ensure that residents didn't receive unnecessary drugs, including psychotropic medications.

The earlier inspections this year turned up a long list of problems, including medication errors, expired food and drugs on shelves, unreported resident injuries and assault, poor care of bed sores, nursing understaffing and inadequate safeguards against the spread of dangerous infections.

Casa Real's operator, Preferred Care Partners Management Group of Plano, Texas, has declined repeatedly to comment on inspection findings or the actions against the nursing home by the Centers for Medicare and Medicaid Services.

The federal agency in May designated Casa Real as a "special focus facility" because of its poor record of complying with care standards, and it said the nursing home would be subject to more frequent inspections. The designation is given to the nation's poorest-performing nursing homes and is meant to address the "yo-yo" problem of facilities routinely falling in and out of compliance with care standards.

The New Mexican reported in July that Casa Real and its sister facility, the Santa Fe Care Center, have received the federal government's lowest rating for nursing homes -- one out of five stars -- and have been cited repeatedly by inspectors for serious deficiencies in resident care over the past 15 years.

The nursing homes also have faced hundreds of complaints from patients and several wrongful-death lawsuits in recent years.

The state Attorney General's Office is suing Preferred Care, alleging it has defrauded Medicaid by having insufficient staff to meet the needs of residents at its Santa Fe nursing homes, as well as its facilities in five other New Mexico communities. Preferred Care has denied the allegations.

A woman who said she was director of nursing at Casa Real from May to August has alleged that she was fired in part because she complained to superiors that a manager at the nursing home had forged patient records in an attempt to show the facility was in compliance with care standards dealing with monitoring of medication effects on residents.

Preferred Care also has declined to comment on that allegation.

Contact Thom Cole at 505-986-3022 or [email protected].

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