Bacon's Rebellion

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Virginia Ranks 40th of 53 in Nursing Home Ratings

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by

James A. Bacon
in

by Carol J. Bova

One of three nursing homes receiving Medicare payments in Virginia (35.3%) scored below average or much below average in the latest Medicare ratings found in the new Care Compare website.

On February 1, 2021, the Centers for Medicare and Medicaid (CMS) updated its ratings report for nursing homes in the United States, District of Columbia, Puerto Rico and Guam. Compared to the ratings before the COVID-19 pandemic, Virginia has reduced the number of facilities with the low 1- and 2-star ratings. Still, Virginia nursing homes ranked 40th of 53 for below and much below average overall quality.

Nursing Home Ratings by State

Who owns these nursing homes?

A CMS nursing home ownership dataset, processed on October 1, 2020 and downloaded on February 25, provides incomplete data. In many cases, names are listed as having 5% or greater direct ownership interest, but the file says, “No percentage provided.” Some nursing homes show the managing employees, officers or directors, all coded as “Not Applicable” to ownership, but list no owners.

Of those owners who are identifiable, some own multiple facilities including both those rated average and above average for quality standards and those with below-average.

Trusts naming W. Heywood Fralin, sometimes with other trusts, have owned eight below average facilities since December, 2012.

Simcha Hyman and Naftali Zanziper, co-founders of the Portopiccolo Group with Accordius Health as a subsidiary, have owned eight below-average nursing homes since 2019.

ALG LAVIE, LLC, BENCON HOLDCO, LLC, MCP LAVIE, LLC, SALCON HOLDCO, LLC, SAY LA VIE, LLC, SENIOR CARE, LLC, AND TRECON HOLDCO, LLC own thirteen 1 or two 2-star and one unrated nursing home in a special focus facility program for a history of serious quality issues.

Two different smaller combinations of the above LLCs own two more nursing homes. All sixteen below-average nursing homes were acquired on the same day: January 21, 2020.

TRIO HEALTHCARE, LLC owns seven below average nursing homes, all acquired in December, 2019.

WWBV HOLDINGS LLC, CLEARVIEW III HOLDINGS LLC, WILLIAM I WEISBERG FAMILY DYNASTY TRUST, BENJAMIN N VOLPE REVOCABLE TRUST, WIW DYNASTY, LLC, individually or in combination have ownership interests in eleven below-average nursing homes dating to 2019. Whether those interests are direct or indirect is unclear from the report and website, and no percentages are provided.

So, five owners or groups of owners, most of whom are for profit, are responsible for 50 of the 101 nursing homes with below and much below average ratings.

When is the Department of Health going to enforce basic standards, and when are our legislators going to appropriate enough for inspectors to do the job? Until that happens, the residents of those 101 nursing homes are paying the real price of substandard care and conditions.

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19 responses to “Virginia Ranks 40th of 53 in Nursing Home Ratings”

  1. James A. Bacon Avatar
    James A. Bacon

    Some nursing homes may deserve criticism. But we have to be careful about judging new owners. They have have facilities in their portfolio that suck. But did the facilities suck before they were acquired? Have the facilities gotten better or worse under new management?

    Another factor to consider: I’ll bet the worst facilities are mainly Medicaid funded. Does Medicaid underfund nursing homes as much as it underfunds physicians and hospitals? If so, that may be the real explanation.

    Again, to be be clear, I’m not defending anyone here. I just want to make sure we don’t rush to any conclusions based on a one-time snapshot.

  2. LarrytheG Avatar
    LarrytheG

    re: “medicaid funded nursing homes”. the devil and the deep blue sea.

    wanna threaten to shut them down and transfer their patients to other nursing homes for the same low medicaid reimbursement?

    If the government would down a facility – who is responsible for finding new facilities for those in that home on medicaid?

    In other posts on BR pages, we lament the cost of Medicaid to taxpayers. Nursing homes are a significant component to those costs.

    What do we want government to do?

    1. Nancy Naive Avatar
      Nancy Naive

      Government doesn’t work but it’s amazing how much they can do with far less than is needed.
      I mean, can you imagine what things were like 100 years ago? 50?
      Oh, that’s right. Our elders died at home. Not their home, our home, under the care of the little woman, while we paid their bills and destroyed our wealth.
      Or, in charity wards.
      Or, on the street.

      1. LarrytheG Avatar
        LarrytheG

        Medicare and Medicaid in 1965 and Social Security in 1935.

        Life expectancy in 1935 for men was about 60.
        Retirement age was 65.

        Social Security did not originally cover farmers and domestic workers.

        One could argue that the US screwed everything up when medical knowledge and care led to people living longer – and we started these welfare programs for older folks …. and then it spread to poor folks and the whole system went to hell in a handbasket… 😉

        1. Nancy Naive Avatar
          Nancy Naive

          “medical knowledge and care led to people living longer”

          Where else can McDonald’s get a $7.35/hr employee?

          1. Lenhihy Avatar
            Lenhihy

            What? Union propaganda! McDonalds was intended to be a first job for high schoolers or those in college. McDonalds have career advancement programs and tuition reimbursement if you want to take college courses not intended to be a lifetime career. Now if you choose for it to be one, the go for it but stop griping.

          2. LarrytheG Avatar
            LarrytheG

            ” McDonald’s made a splash recently when it announced a partnership with AARP and AARP Foundation to hire people 50 and older to help fill the chain’s 250,000 summer openings. Turns out, this is part of a bigger effort by McDonald’s to bring on older workers, particularly unemployed ones over 55 with low incomes. “

        2. Lenhihy Avatar
          Lenhihy

          Nor did we have to cover illegals.

          1. LarrytheG Avatar
            LarrytheG

            And last I heard, they still could not receive Medicaid and the irony is that undocumented make up a good percentage of the care-givers in nursing homes.

            ” Immigrants Are The Backbone Of The Long-Term Care Workforce
            LTC facilities have served as the epicenters of fatal COVID-19 outbreaks; by the end of May, over 40 percent of all COVID-related deaths were linked to nursing homes. Staff of LTC facilities are especially at high risk of contracting and spreading COVID-19 due to their direct care roles, in addition to the poor infection protocols and labor and PPE shortages in the facilities. Some workers even reported being asked to care for over thirty residents while reusing a single face mask for 1-2 weeks. Although data on LTC staff infections nationwide is sparse, as of mid-July, over 11,000 staff in LTC facilities in California tested positive for COVID-19 and over 100 have died from complications with the virus.

            “Immigrants, both legal and undocumented workers, fill integral staffing voids within the LTC workforce. Approximately one in four direct-care workers in LTC facilities were born in a foreign country. Immigrant workers are more likely to work nontraditional shifts and fill key shortages in under-resourced nursing homes.”

            https://www.healthaffairs.org/do/10.1377/hblog20200914.520181/full/

      2. Lenhihy Avatar
        Lenhihy

        Take those funds from those able bodies who can work and put them in these necessary funding. Just a thought. Sometimes our government is the most inefficient firm of wasted tax dollars at work.!

  3. Nancy Naive Avatar
    Nancy Naive

    Netflix — “I Care a Lot.” Definitely not Medicaid facilities. Kind of a disturbing business model… but plausible.

    1. Lenhihy Avatar
      Lenhihy

      Glorifies the evil! Netflix has a lot of disturbed writers, producers/ actors. Twisted. Glorifies the worst kind of people. Just canceled my subscription.

  4. LarrytheG Avatar
    LarrytheG

    I believe about 1/2 of nursing home residents are Medicaid. One might argue that a good number live longer than we make money during our lifetimes to pay for. Certainly, a good number of folks who never got much more than a high school education probably were never able to set aside enough money for their needed care when they got older even though their life expectancy is often less than more affluent folks.

    https://uploads.disquscdn.com/images/a3d1e673c11a3e352e6821dfe9fc50305eba31c5909e5ad7430d9706d680f35f.png

    1. Lenhihy Avatar
      Lenhihy

      Our government seems to be giving a lot of money away to a lot of countries, I say they take those money and take care of ours first.

  5. CJBova Avatar
    CJBova

    Disqus and I had a difference of opinion. Reposting my reply to Jim Bacon’s comment:

    The real issue is insufficient inspections and enforcement of regulations. If the reimbursement rates were the issue, how would these groups expect to make money on their acquisitions? One way is cutting back on staffing and services which in turn lowers quality ratings, keeps them low, and leads to citations that result in penalties.

    Medicare says on the compare website, “When a nursing home gets a serious health or fire safety citation, or fails to correct a citation for a long period of time, this can result in a penalty.”

    Of the 50 nursing homes. 20 had federal penalties before the ownership interest changes; 7 had penalties before and after; and 7 more had penalties after. (That doesn’t count citations not yet resulting in penalties.)

    1. CJBova Avatar
      CJBova

      In support of this:

      MarketWatch.com on March 14, 2020 wrote: “About 70% of U.S. nursing homes are run for profit, and private equity activity in the industry has jumped in recent years.” They further said, “In particular, private-equity ownership of nursing homes across the U.S. has coincided with cost cutting, declining quality of care and increasing violations discovered in government inspections.”
      https://www.marketwatch.com/story/coronavirus-pandemic-puts-private-equity-ownership-of-nursing-homes-under-microscope-2020-03-14

      Barron’s on August 6, 2020 discussed the Portopiccolo Group’s approach: “The story of Portopiccolo’s growth underscores longstanding industry issues such as understaffing and infection-control problems that have made some nursing homes particularly vulnerable to Covid and reveals a tension between patient care and profit motives. It also highlights weaknesses in regulatory oversight of facility owners, resident advocates say, even as private investors’ appetite for nursing homes has drawn scrutiny from lawmakers and researchers. Private-equity buyouts of nursing homes are tied to lower nurse staffing and declining care quality, according to a recent study by researchers at the University of Pennsylvania, New York University, and the University of Chicago.”

  6. Nancy Naive Avatar
    Nancy Naive

    Google “predatory professional guardians”

    Spend 1 hour reading.

    Then, call a lawyer, set up a Trust, name one of your kids trustee and fill out whatever is needed to appoint them your guardian.

    Corporate America is out to get you, and the courts are compliant.

  7. LarrytheG Avatar
    LarrytheG

    Another issue – As our population ages, more and more will go to long-term care facilities and costs to Medicaid, increase.

    When we hear complaints about the costs of Medicaid , a substantial portion is for the elderly.

    https://uploads.disquscdn.com/images/54530a48332c265a4bed04ed4d4e7c4cba4f372701adb820aa66c3736008385e.png

  8. Private-Equity Ownership and Nursing Home Quality | Bacon's Rebellion

    […] days ago, Carol J. Bova published data showing that 50 of the 101 Virginia nursing-home facilities rated as below average in the latest […]

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