An onsite investigation at Andbe Home, Inc. in Norton, Kansas, revealed noncompliance with federal requirements for long-term care facilities, according to Centers for Medicare and Medicaid Services (CMS) documents obtained by Fox News.
The survey investigation by the Kansas Department for Aging and Disability Services cited “widespread immediate jeopardy” to resident health and safety, according to the documents. The facility was also slammed with a $14,860 federal civil money penalty while it worked to correct noncompliance back in May.
Stephen Crystal, director of the Center for Health Services Research at the Rutgers Institute for Health, told Fox News that the move marks CMS’ “ultimate penalty; decertifying a facility.”
“Most of the time, they try very hard do other things before they go to that step [like civil monetary penalties],” he said, adding “CMS actually doesn’t do this very often, and one could argue that they haven’t moved quickly enough on other facilities that had out of control spread,” referencing New Jersey and New York as examples.
In the case of the Kansas facility, staff identified two symptomatic patients on Oct. 5 and confirmed positive test results two days later but failed to separate them from the rest of the residents.
“During this time, COVID-19 positive residents cohorted with COVID-19 negative residents, with only a curtain between them, against [Centers for Disease and Prevention Control] guidelines and best practice to prevent the spread of highly contagious COVID-19,” said the documents obtained by Fox News. The facility also allowed communal dining for two days after they discovered the symptomatic patients.
These failures, among others described in the report, ultimately exposed all 61 residents to the virus, every single one testing positive, which led to one hospitalization and 10 deaths. By Oct. 19, 37 staff members tested positive.
Crystal wasn’t privy to all the details but upon a brief account said, “It sounds pretty egregious.”
The facility’s administrator, Megan Mapes, received a notice of a 23-day involuntary termination of the Medicare provider agreement: “We have determined that Andbe Home, Inc. no longer meets the requirements for participation as a skilled nursing facility in the Medicare program under Title XVIII of the Social Security Act.”
The termination will go into effect Nov. 18, 2020.
CMS informed Mapes that the Medicare program won’t pay for covered services to patients admitted to the facility on or after Oct. 27, 2020. Medicare will cover patients admitted before that date for up to 30 days “to ensure residents are successfully relocated.”
The facility was also notified that the Kansas Department for Aging and Disability Services would assign management to Mission Health Communities to temporarily manage staff, funds and facility procedures, among other tasks, which went into effect Oct. 28.
If the facility decides to re-enter the Medicare program, it has to assure its capabilities to comply with certification, due to the “serious nature and circumstances of the involuntary termination.”
Further review of the documents revealed the facility actually had a detailed plan for potential coronavirus infection, but failed to follow it.
“My sense is that too much has been left up to the operators. The states need to go in, CMS needs to go in,” Crystal said.
Peter Pitts, former Food and Drug Administration associate commissioner and president and co-founder of Center for Medicine in the Public Interest, said to Fox News: “At best, it’s an oversight in recognizing where sources need to be directed. At worst, it’s negligence.”
While nursing homes operate on different sources of revenue, federal funding is clearly a large one, Pitts explained.
“Any facility that loses federal funding is going to be seriously impacted on the care that it can provide,” Pitts said.
“The issue is that federal funding hasn’t trickled down to support staff in nursing facilities and senior centers more broadly,” Pitts said. “When you don’t properly compensate aides, versus physicians and nurses and pharmacists, it’s not surprising that that’s where the problems begin to arise.
“Hopefully these types of things can be corrected before they result in massive wildfire of COVID-19 infection in senior centers, as we had in New York early in the pandemic…Shame on us if we wait for people to die before we address the problem.”