25 Investigates: Nursing home staffing emergencies cost MA taxpayers $82 million

Massachusetts spent more than $82.4 million providing emergency staffing to nursing homes, rehab centers, and assisted living facilities around the state.  For-profit healthcare companies have received the most publicly funded staffing help, according to data 25 Investigates obtained through a public records request with the Massachusetts Department of Public Health (DPH).

The Rapid Response program was launched at the beginning of the COVID-19 pandemic when the virus was sweeping through residential facilities.  In April 2020,  the Baker Administration signed contracts with three healthcare staffing agencies to deploy administrators, Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Certified Nursing Assistants (CNAs) to facilities facing staffing emergencies.  All the contracts have been extended multiple times.

Staffing agencies bill the state $65.00 an hour for a CNA, $155.00 an hour for a RN, and $187.00 an hour for a charge nurse.  The rates are three to four times more than median wages and include agency operating costs.  Deployments can range from one day to several months and include round-the-clock coverage.

According to Massachusetts Senior Care Association, the nursing home worker shortage remains at historic highs with 22% of positions unfilled statewide.  Adriana Kosiba, who grew up in Natick, told investigative reporter Ted Daniel, she witnessed it firsthand in August when her father, Nicholas A. Pierro was admitted to Life Care Center of the South Shore in Scituate to recover from a fall.

“He literally fell on day one, fell out of his bed because they had actually given him a temporary bed with an air mattress.  They also happened to forget to bring him meals,” she said. “They blamed it on the shortage of staff. They blamed it on people not wanting to work.”

DPH data shows Rapid Response Teams have been sent to Life Care Center of the South Shore three times in the last thirteen months and taxpayers have been billed for 536 hours of emergency staffing.  A Rapid Response Team was not present during the six days Nicholas A. Pierro spent at Life Care South Shore.

Life Care Centers of America is a Cleveland, TN-based healthcare provider operating in 28 States.

There have been 19 deployments to Life Care facilities in Massachusetts totaling 150 days of taxpayer-funded medical care.  According to Forbes, “The private firm raked in $2.7 billion in sales in 2020 from nursing homes, assisted living facilities and retirement living communities…”

Lifecare did not respond to multiple requests for comment.

As 25 Investigates reported in September, DPH ordered a Rapid Response team to Advinia Eastpointe in Chelsea after firefighters reported finding residents roaming a hall with no nurse in sight.  When questioned, a staffer said a nurse assigned to the wing had left after working a double shift and there was no one to replace her, according to a Chelsea Fire Department report.  It was the fourth Rapid Response Team deployment to Eastpointe since April 2020, according to DPH records.

The State has been billed for 95 days of emergency staffing at nursing homes owned by Eastpointe’s parent company AdviniaCare.  Chris Hannon, Chief Operating Officer, AdviniaCare released a statement to 25 Investigates.  Part of it reads:

“Several AdviniaCare centers have, like many others in the nursing home industry, faced dramatic staffing challenges throughout the global COVID-19 pandemic.  The state had the foresight to create clinical rapid response…  we are maintaining safe staffing levels at all of our centers and continue to provide high-quality care to our residents.”

DPH data shows the State has been billed for 101 days of staffing at locations operated by Royal Health, and 207 days at facilities owned by Connecticut-based Bear Mountain Health Care.

Roberta Henderson is the sole owner and administrator of Sudbury Pines, an independent nursing home that opened in 1965 in Sudbury.  she said the 95-bed facility primarily serves low-income patients who rely on Medicaid.

She said rapid response has been a “godsend” when her staff and patients have become ill.

When asked about repeated deployments to large for-profit chains, Henderson said, “They can command huge amounts of finances and support and such to manage most of these events. Whereas independents, we’re on our own.  I was worried about calling them the couple of times and I called them myself.”

Dignity Alliance Massachusetts is a group that advocates for vulnerable populations in residential settings.  Cofounder Arlene Germain expressed surprise when we shared DPH data with her that shows Rapid Response Teams have been dispatched 376 times and often to the same facilities.

Germain said if nursing homes paid and managed their workforce better, there would be less turnover and fewer staffing emergencies

“These people are taking care of lives, so they need to be paid for the type of work that they’re doing.  If the state does impose one of these teams on a nursing home, it should go hand in hand that there would also be an admission freeze because the residents are obviously in jeopardy,” she said.

A DPH spokesperson told 25 Investigates, “DPH does not take action against a nursing home or its parent company for accepting assistance from a Rapid Response Team.”

The most recent contract extends rapid response until at least March 2023.

Adriana Kosiba said her father developed an infection within days of his arrival at Life Care of the South Shore and had to be admitted to a hospital.  Already battling cancer, Nicholas Pierro died on October 6.

“My father was there for six days and I think it truly changed his life irrevocably. He was never the same after that,” she said.

Rapid Response contracts are generated by the Massachusetts Executive Office of Health and Human Services (HHS).  A request to speak with HHS Secretary Marylou Sudders went unanswered.

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