After failing to rectify a situation of immediate jeopardy to residents in the skilled nursing unit of the Pacifica Healdsburg Senior Living facility, the unit is losing its Medicare/Medicaid funding on Jan. 15 and will be closing. As a result, the skilled nursing unit is asking its 16 residents to leave by Jan. 15, according to some family members of residents.
According to a notice to the public from the Centers for Medicare & Medicaid Services (CMS) Center for Clinical Standards and Quality/Quality, Safety & Oversight Group, notice of the funding termination for the Pacifica Healdsburg Senior Living skilled nursing unit was given on Dec. 16, 2021.
Requests for comments from SoCoNews to the Pacifica Senior Living Regional Director of Operations Leslie Quintanar were unanswered as of Tuesday morning, Jan. 4.
The notice states that the CMS “will terminate the agreement between the Secretary of Health and Human Services and Healdsburg Senior Living Community, Healdsburg, California as a skilled nursing facility in the Medicare program. In addition, authorized by the California State Medicaid Agency, notice is given that the provider’s agreement as a nursing facility in the Medicaid Program will also be terminated effective Dec. 16, 2021.”
Medicaid is a federal-state program that helps pay for health care for the aged, blind, disabled and for low-income families with children. Typically each state will determine specific eligibility and which health services are covered and the federal government reimburses a percentage of the state’s expenditures.
Medicare is a federal health care insurance program for people 65 and older and for the disabled. Eligibility is mainly based on eligibility for social security. Medicare can help pay for charges from hospitalizations, for stays in skilled nursing facilities, for physician’s charges and for some related health costs.
The CMS notice is one of the biggest blows that the troubled facility has received since Pacifica Senior Living Inc. took over the facility in 2018. It was previously run by Avalon Healthcare Management LLC.
Since Pacifica, a San Diego-based company, took over operations, the facility has had numerous deficiencies in service and care, several substantiated complaints, 39 Type A citations and 36 Type B citations from the California Department of Social Services Community Care Licensing Division, the entity that provides oversight for the memory care and assisted living portions of the facility.
Type A citations are given when there are deficiencies that pose an immediate health and safety or personal rights impact and Type B citations are given when there are deficiencies that pose a potential health and safety or impact personal rights.
Many of the deficiencies in care centered around a lack of adequate staffing and ability to meet resident needs according to California Department of Social Services Community Care Licensing investigative reports into complaints about the facility.
CMS and the California Department of Public Health (CDPH) are the entities that oversee the skilled nursing portion of the facility.
The CMS notice states that, “CMS has determined that Healdsburg Senior Living Community has failed to remove a situation of immediate jeopardy to residents’ health and safety and attain substantial compliance with the following Medicare and Medicaid participation requirements, 42 CFR §483.70 – Administration.”
This requirement mandates, among several other stipulations, that a facility must be administered in “a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental and psychological well-being of each resident.”
The termination of federal funding for the skilled nursing unit comes after a recent CDPH/CMS survey that found two “immediate jeopardies,” according to Healdsburg Senior Living Family Council member Marie Butler and Crista Barnett Nelson, the executive director of Senior Advocacy Services.
“Basically it is what it sounds like — imminent danger to the health and safety of the residents. I do know what those are but I don’t know if I’m allowed to say,” Barnett Nelson said of the two jeopardies.
Butler said after the CDPH did their annual survey, they allegedly found over 20 to 29 violations/issues and that two were considered “health and safety” issues putting residents “in jeopardy.”
SoCoNews tried to confirm this with CDPH but did not hear back in time for publication. SoCoNews is waiting to hear back from CDPH regarding questions about the survey, the alleged violations and the notice regarding skilled nursing.
Patrick Collins, whose aunt is a resident of the skilled nursing unit, said he was notified of the skilled nursing funding termination around Dec. 30.
Independent management firm Sycamore Healthcare Inc., a Bakersfield-based company, took over management of the skilled nursing unit from Pacifica shortly before the CMS notice was released.
Collins’ aunt was placed in memory care in June. She later had an incident where she got pressure blisters on her foot so in November she was moved temporarily to skilled nursing. According to Collins, it was then decided that she would be kept in skilled nursing.
“From what I’m hearing, their memory care has improved quite a bit,” Collins said, adding that it’s unfortunate that she had to go into the skilled nursing unit.
Collins said they weren’t given a specific reason as to why skilled nursing was losing their funding, but he heard from another source that the unit had received a couple of violations and were losing their Medicare/Medicaid payment due to violations that they didn’t address quickly enough.
He said he’s now looking for a new place for his aunt.
“There’s a list of facilities that the ombudsman gave us and I’m just going down the list, asking specific questions that relate to my aunt to try to find a place that would be a good fit for her,” Collins said.
He said he is extremely angry regarding the situation and is considering taking legal action.
“We’re very surprised. There was a meeting scheduled last week and they didn’t give us any heads up. They said it was just about our loved ones and their situation, so it was kind of a drop of a bombshell on all of us. Supposedly they want everybody out by the middle of the month … I’m pretty damn ticked off about all this. They really screwed up, badly,” Collins said. “Since she’s only been in there six months I don’t feel like I got my money’s worth. It was nothing but problems the whole time she was there. They lost clothes, communication was horrible, they had phone problems the first three to four months, they lost her wheelchair — I’m not even sure if they found it again. It’s an ongoing list of issues with these guys.”
Butler alleged that Healdsburg Senior Living said skilled nursing residents must leave by Jan. 15, “That is not correct — we have 30 days notice upon receipt of their letter to vacate,” Butler said.
Barnett Nelson confirmed the residents have 30 days and said Healdsburg Senior Living has to continue to care for the skilled nursing residents at their own cost until everyone is placed in a new facility.
“We (the ombudsman) can’t do anything with actual placement. The burden of that is on the facility,” Barnett Nelson said.
Butler, who said that Medi-Cal-covered skilled nursing beds are hard to come by, said her other concern is surrounding resident and family notification of the closure of skilled nursing.
“I got a letter in the mail on Monday saying there was a meeting on Wednesday (Dec. 29) and there was an invitation to meet with Don Doyle and learn about loved one’s health care. Don wasn’t at the meeting so the person who conducted the meeting was BrieAnna Henderson,” Butler said.
Doyle was appointed as the temporary manager/health care consultant from the independent firm for Healdsburg skilled nursing unit management. Henderson is the skilled nursing administrator with Pacifica Healdsburg Senior Living.
Requests by SoCoNews for comments from both Doyle and Henderson were not answered as of Monday evening Jan. 3.
Butler said during the Dec. 29 meeting Henderson told the small meeting group the news about the CMS notice.
“We were stunned, and there weren’t a lot of family members there but it wasn’t clear that the meeting was to tell us to evacuate. It is a real travesty. We are all paying the price,” Butler said.
Barnett Nelson said the only other time she recalls a similar scenario happening to a facility was when the Fircrest Convalescent Hospital had to close its Sebastopol skilled nursing facility after losing its Medicare and Medicaid services agreement in 2018.
This is a developing story.
