It first came as warnings, then threats if actions weren’t taken. Now, federal and state officials have taken giant steps forward in their efforts to ensure the safety and welfare of residents inside a besieged Andover nursing home.
The New Jersey Department of Health has revoked the license of Woodland Behavioral and Nursing Center, citing in a court filing Thursday that the facility has failed to correct violations despite multiple enforcement actions by the state to bring the facility into compliance. As a result, the Mulford Road facility poses an “immediate and serious risk of harm to the health, safety and welfare of long-term care residents,” said Robin Ford, the state Department of Health’s deputy commissioner of health systems.
Woodland will have to transfer their 366 residents to another facility by Aug. 15.
The major step comes on the heels of the Centers for Medicare and Medicaid Service’s decision, also dated Thursday, to seize the facility’s funding beginning June 25. The division provides 92% of Woodland’s funding, according to Ford’s 153-page report.
CMS warned they would cut off Woodland in March after finding a litany of abusive and neglectful actions by staff members that placed residents at risk of serious injury, harm or even death. They stopped short at the time, but warned they’d reconsider in August.
That reconsideration was pushed forward when surveyors twice in April and in early May found conditions at Woodland had only gotten worse, sparking CMS’ decision.
In April, for example, one resident with a feeding tube was transferred to the hospital with a bowel impaction. The resident suffered serious medical issues and aspiration pneumonia, surveyors determined, because the tube feeding had nowhere else to go if the colon was blocked, except back up through the oral cavity and down to the lung. The facility had blank logs to track bowel movements and there was no documentation that staff had provided a care plan or medication for the resident prior to the hospitalization.
Another resident earlier this month was hospitalized with a similar impaction but was never properly assessed. The oversight could have led to colon perforation, sepsis or death, the surveyors said.
Surveyors also found issues with Woodland’s COVID-19 protocols, with staff not wearing or not properly wearing proper protective equipment. Some residents who tested positive were found roaming hallways without a mask, the report shows.
The facility has also had significant deficiencies for certified nursing assistants and social workers, which is against state law.
Ford, in her court filing, said the combination of a license revocation and the halting of CMS funds “must dramatically and immediately ramp up the transition of patients from Woodland to other facility to avoid a situation where federal funding runs out while the transition, which has started, is in process.”
“This is an actual life-and-death situation,” she added.
Earlier this week, Gov. Phil Murphy and the Department of Health called on a state Superior Court judge to employ a receiver to assume control of Woodland. If granted, the move would appoint an individual or business to take over the facilities’ finances, to retain staff and maintain proper services for residents, according to the state’s top leaders.
Ford said in her court filing that the state already has approved Alan Wilen of Eisner Amper as their chosen receiver, who they believe should work in concert with Atlantic Health System. Atlantic Health has been serving as monitor for the facility since they were appointed in March. Wilen had more than 20 years experience, specifically with health care facilities, including managing the closure of Hahnemann University Hospital and the sale of St. Christopher’s Hospital for Children, both in Philadelphia.
Attorneys representing the owners of Woodland said in their own court filings on Thursday that the state’s actions are an “obscene overreach” and called the heaps of criticism of against the facility unjust.
“In reality, Woodland’s dedicated leadership and staff moved mountains to attempt to care for their residents, pleading with every available state and federal resource to provide them critical aid during the height of the pandemic only to be turned down because no one was in a position to assist,” said Peter Slocum, whose firm represents Alliance Healthcare Holdings, which operates Woodland.
Woodland’s cries for help, he wrote, were ignored at the height of the pandemic and their attempts to make the best out of an impossible situation left them with a target on their back, he wrote.
Woodland had tried earlier this year to negotiate a transfer of the facility to a “well-respected multi-state operator” and the state was aware the contract was nearing completion when they filed their court application, Slocum said.
He also pointed to Woodland’s “unique” population that “presents its own challenges above and beyond those that present themselves in more tradition long-term care facilities.”
Woodland, formerly Andover Subacute and Rehabilitation II, houses residents with advanced dementia, schizophrenia, bipolar disorders or other severe mental illnesses, Slocum said.
“Many have no relatives, some are convicted criminals or registered sex offenders, and many are wards of the State under the guardianship of the Office of the Public Guardian in the New Jersey Department of Human Services,” Slocum wrote.
A long history, bankruptcy
Woodland appears to be nearing acute financial distress and is at risk for filing for bankruptcy protection, state officials said in their court filings.
The facility, they noted, has a negative cash flow, limited borrowing capacity and projected required capital expenditures.
Woodland’s balance sheet, as of Jan. 21, showed total assets of about $15.8 million and total liabilities of about $19.8 million, further indicating Woodland’s inability to pay off debts when they become due, the state wrote.
Violations at the state’s largest long-term care facilities have been thrust into the spotlight since the facility made national headlines when 17 bodies were found stacked in a makeshift morgue in April 2020. A scathing federal report detailed the conditions inside the facility at the time, with staff, among other concerns, incorrectly using protective equipment and broken thermometers. Surveyors also found that two patients died after staff made no effort to perform life-saving measures, the report showed.
The facility appeared to come into compliance in 2020 and paid off a civil penalty of over $220,000, according to CMS documents, but in January, the facility again reported a severe COVID outbreak — the largest across all state long-term care facilities.
Members of the National Guard were deployed in January to assist and have remained at the facility since.
Lori Comstock can be reached on Twitter: @LoriComstockNJH, on Facebook: www.Facebook.com/LoriComstockNJH or by phone: 973-383-1194.