C.M.S. defended the program, saying that nursing homes on the watch list showed more improvement than did comparably struggling facilities not selected for enhanced supervision. “C.M.S. continues to work to improve oversight to prevent any facility from regressing in performance,” the statement said.
Special scrutiny was lifted for about one-fourth of the nursing homes in less than a year. Facilities need to pass only two consecutive inspections without major violations or substantiated complaints.
“The period of time is just not long enough for them to show that they can sustain improvement,” said Robyn Grant, director for public policy at the National Consumer Voice for Quality Long-Term Care in Washington.
In 2010, NMS Healthcare of Hagerstown, Md., left the watch list after 10 months.
Last year, Maryland’s attorney general sued the facility and its owner, Neiswanger Management Services, alleging that they evicted frail, infirm and mentally disabled residents “with brutal indifference” when their health coverage ran out or the facility had the opportunity to get someone with better insurance.
Among those was Andrew Edwards, who was told by NMS that he was being discharged to an assisted-living center, according to the lawsuit. Instead, in January 2016 the staff sent him to a crowded, unlicensed Baltimore rowhouse where the owner confiscated his bank card and withdrew $966 over his objections, the lawsuit said. Though NMS said it had arranged for his outpatient kidney dialysis, “that was false,” Mr. Edwards said in an interview. He ended up in an emergency room after he missed his treatment.
NMS maintains it stopped referring patients to that owner when told of the conditions. This month, C.M.S. expelled the Hagerstown nursing home from Medicare and Medicaid after citing it for more violations. The company is closing the facility. NMS, which still runs other homes in Maryland, has sued state regulators, claiming they are vindictively trying to drive the chain out of business.
Lack of Nurses
Too few nurses, particularly registered nurses, provide care at some of the most troubled homes, the analysis shows. In 2009, Pennsylvania health regulators released Golden LivingCenter-West Shore in Camp Hill after 17 months of supervision. The company said in a recent statement that when a home is put on that list, “we mobilize the resources necessary to help get that LivingCenter back into compliance.”
But data from Medicare’s Nursing Home Compare website shows the facility has among the worst nurse-to-patient staffing ratios in the nation. Golden LivingCenter-West Shore was fined $59,150 in 2015 after being cited for, among other violations, allowing a resident’s feeding tube to become infested with maggots, records show.
Last year, Golden Living sold its Pennsylvania homes to Priority Healthcare Group.
Priority is following a common strategy for shedding an unwanted reputation: changing the facility’s name. In California, Parkview — where Ms. Fisher slipped from her wheelchair — is being rebranded too, as Kingston Healthcare Center.