Genesis HealthCare, a large publicly traded firm that owns and operates nursing homes, agreed to pay Vermont $740,143 to resolve allegations of neglect resulting in three serious injuries and a death. The agreement settles claims relating to the state’s vulnerable adult statutes and the False Claims Act. The settlement stems from preventable incidents at three facilities in 2018 and 2019.
The three facilities — St. Johnsbury Health & Rehab, Berlin Health & Rehab Center and Burlington Health & Rehab Center —have a history of problems. The St. Johnsbury and Berlin homes both have one out of five stars, based on metrics that include three years’ worth of health inspections, staffing levels and clinical outcomes for residents. The Burlington facility has two stars. The statewide average for nursing homes is 3.2 stars, while Genesis-owned homes average 2.6. Genesis is a Pennsylvania-based corporation that owned or managed 425 facilities in 29 states as of December 2018, according to its reports filed with the Securities and Exchange Commission.
In addition to paying damages and penalties, Genesis said it would create a position for a patient care coordinator, who would be in charge of training staff at the three facilities and report progress to the state. The company also agreed to hire an independent monitor to perform an annual review of the three facilities. However, Genesis denied the clear violations of standards but agreed to the settlement “to avoid the delay, expense, inconvenience and uncertainty of litigation,” according to settlement documents. In 2017, Genesis agreed to pay $53.7 million to the U.S. Department of Justice to settle claims of false billing practices. Over the past three years, the company has also paid $131,687 in regulatory fines for deficiencies at its nine Vermont facilities. The company reported $4.98 billion in revenue in 2018.
Staffing problems factored into multiple incidents the state flagged as part of the Genesis settlement. In two instances, short-term staffers at the Burlington and St. Johnsbury facilities gave residents who were on specialized diets the wrong food, and the residents choked. The St. Johnsbury resident required hospitalization; the Burlington resident later died.
The state also cited an incident at the Berlin Health & Rehab Center in which staffers identified two ulcers on a resident’s leg but failed to perform required wound assessments. The resident required hospitalization to treat the ulcers.
In an April incident, the Burlington Health & Rehab Center improperly discharged a resident with lower-body paralysis after failing for months to treat his emotional issues and alcohol addiction. A staffer dropped the resident off at a nearby hotel, booked a one-night stay for him and left, despite knowing that he could not get into bed, use the toilet or access food, drink or medications without help. The facility did not notify his family or the Visiting Nurse Association about the discharge until the next day.
After the man spent a single night in the hotel, staff asked police to check on his welfare. He wound up at a hospital, where staff noted he was covered in feces, had a burst catheter bag, and was suffering from fever and an acute kidney infection.
The settlement noted that the facility billed Medicaid for the man’s care the day after he was dropped off.