GRAND RAPIDS, Mich. (WOOD) — Fifteen of the 21 COVID-19 nursing home hubs set up by the state to care for elderly patients have faced a total of more than $1 million in fines for bad inspections over the last three years, a Target 8 investigation found.
Nearly half the nursing homes scored below or much below average in their overall Medicare ratings before they became hubs, records show.
Among the homes chosen as a hub is SKLD Muskegon, which was fined $350,000 three years ago, before new owners took over. The home still has a below-average overall rating by Medicare and a much below rating for its record of inspections, though the new owners said they have made improvements.
The state paid it $260,000 for 52 COVID-19 beds, nearly half of its capacity.
Also among the homes the state designated as a hub is Medilodge of Grand Blanc, where conditions were so bad that Medicare labeled it a “special focus” home. It has faced $148,000 in fines over the last three years.
The state paid Medilodge of Grand Blanc $135,000 upfront for 27 beds, though the state recently decommissioned it and some others as hubs.
“If the evaluations coming back from the federal government are less than sufficient, why would we want to put COVID patients in these places?” said Sen. Peter J. Lucido, R-Shelby Township, who is pushing to end the hubs. “Why would we allow this?”
The state, based on an executive order by Gov. Gretchen Whitmer, paid a total of $3.6 million upfront to 21 COVID-19 hubs across the state for 715 beds — $5,000 per bed.
The state also agreed to pay the homes $200 a day extra for their care, which works out to about $6,000 a month.
MORE THAN 1,000 DEFICIENCIES
Target 8 used the ProPublica Nursing Home Inspect website to review inspection reports for all 21 hubs. It showed that state investigators working on behalf of the Centers for Medicare and Medicaid Services had written the hubs up for a total of more than 1,000 deficiencies over the last three years.
Medicare rates nursing homes on a scale of 1 to 5, with 1 being worst. Ten of the 21 hubs scored either a 1 or 2, below average or much below average.
“If they scored so terribly in terms of caring for patients prior to COVID, then why are still operating? Why were they still caring for other people’s loved ones?” wondered AARP Michigan Director Paula Cunningham.
Three of the homes, Medilodge of Frankenmuth, Advantage Living Center Wayne and Advantage Living Center Redford, got a total of $490,000 up front for COVID-19 beds despite the lowest possible Medicare ratings, much below average, and a total of $189,000 in fines.
Lucido, the state senator from Shelby Township, said some nursing homes were available as COVID-19 hubs only because they had empty beds — empty for a reason.
“If it’s a rated nursing facility of a 2 of out 5 (below average), why do you think the beds were open to begin with?” he said. “Because they’re not delivering the services.”
Critics said the hubs put existing residents at those homes at higher risk.
The state House and Senate have passed Lucido’s legislation to eliminate hubs and move toward COVID-only centers across the state. It awaits the governor’s signature or veto.
‘LIKE SENDING IN DEATH’
Denise Erickson’s 90-year-old stepfather, Harold VanEtten, died with COVID-19 at SKLD Muskegon on May 21 before it became a hub. While COVID is listed under “other significant conditions,” his death certificate shows he died of cardiac arrest.
She questions the decision to open hubs at all.
“Why would you send a COVID patient into a place where people are already having serious medical conditions?” Erickson said.
“It’s just like sending death in,” she said.
Michigan Department of Health and Human Services spokesperson Lynn Sutfin said the agency chose hubs based on their willingness to take COVID-19 patients, how close they were to hospitals with high COVID-19 counts, their ability to isolate patients and their performance history.
Sutfin said the state gave “extra scrutiny” to the “special focus” home in Grand Blanc.
“This facility (is) a vent facility that is highly familiar with respiratory issues,” she wrote.
MDHHS worked with the Department of Licensing and Regulatory Affairs to approve it as a hub “given the improvement the facility had shown since they were first identified as a (special focus facility),” Sutfin wrote. She said the home also gets checked twice a year by LARA.
As for the new owners of SKLD Muskegon, a company called Illuminate, they said they’re living in the shadow of the former owner, which filed bankruptcy. Since buying the company in July 2018, they said they have improved care and conditions and are well-equipped to care for COVID-19 patients.
“We cannot address any surveys and fines that occurred prior to our ownership,” company vice president Henry Boutros said in an emailed statement. “Survey scores stay with a facility for three years and contribute to their overall survey star rating.”
He points to the home’s 5-star Medicare rating for quality of resident care.
“Our staff are fully equipped and trained. We plan on continuing to serve those infected with COVID-19,” Boutros wrote.
‘A WORLD WITHOUT PERFECT SOLUTIONS’
The state said there’s no evidence imported COVID-19 patients have infected others in hubs. They say hubs are required to take extra precautions — separate wings, separate staff, separate meal service.
In a Senate committee hearing in May, MDHHS Director Robert Gordon defended the hubs.
“This is a world without perfect solutions,” Gordon said. “The solutions we’ve come up with aim to provide strong protections for providing the care the COVID-positive folks need and also strong protections for those who are not positive.”
The hubs have reported taking in more than 1,200 COVID-19 patients from hospitals and from other nursing homes, according to the state.
Records show 219 residents have died of COVID-19 at the hubs. That’s out of the more than 2,000 deaths of 440 skilled nursing home residents that the state has record of.
Among the 219 was Lynn Schierbeek, who caught the virus at Samaritas Lodge in Grand Rapids before moving to the SKLD Muskegon hub. She died July 2, about 30 days after the move. She was 80.
Her sister, who didn’t want to be identified, didn’t want her moved.
“It was a COVID hub,” she said. “They told us that they had to be transferred to a COVID hub.”
Her sister said she didn’t know about SKLD Muskegon’s low Medicare ratings. She questions why the state would use it as a hub.
“I would have refused it (the move), but you couldn’t refuse it because that’s what they said they had to do,” she said. “Do you have a choice then when the state does that?”
She couldn’t visit at SKLD Muskegon because of the pandemic and was frustrated the home didn’t help her communicate more with her sister.
“While my sister was there, she was there for only 30 days, I only talked to her twice in that 30 days,” she said.
The state has decommissioned 10 of the hubs, based on “patient volume,” leaving 11. But even some that remain as hubs have questionable records, including two of the lowest-rated homes and SKLD Muskegon.
“That doesn’t make any sense for them to send other people there when they aren’t taking care of what’s there,” said Beverly Carpenter, whose son, Scott Carpenter, died of COVID at SKLD Muskegon.
Her son was 60 when he developed COVID-19 and died May 27 at SKLD Muskegon before it became a hub.
“He was just a delightful young man, never bothered anybody,” she said.
He had been there nearly two years since suffering a head injury, suffered with COPD and asthma. She had no idea how he caught COVID-19.
“Just in the nursing home,” she said. “We didn’t take him out, so he had to get it in the nursing home.”
Carpenter said she was not happy with the care at SKLD Muskegon and questions why the state later allowed it to become a hub.
“I had to ask two or three times for them to change him because he had bladder problems,” she said.
She said she has called the home five times, hoping to learn more about her son’s death, but nobody has called back.
“I thought they at least would tell me how it was at the end,” she said. “I just have a blank that I do not know who was with him when he died.”