Federal agency ranks Sweet Brook among nation's worst nursing homes


WILLIAMSTOWN — A Williamstown nursing home with a long history of deficiencies in care has been designated by the Centers for Medicaid & Medicare Services as one of the poorest quality facilities in the country.

On Feb. 21, the federal agency included Sweet Brook Rehabilitation and Nursing Center on its list of "special focus" facilities. There are less than 90 on the list in the United States and only two in Massachusetts.

These nursing homes have been identified by the U.S. Department of Health and Human Services to have a history of serious quality issues and have been placed in a special program in an attempt to "stimulate improvements in their quality of care," according to the Centers for Medicaid & Medicare.

About 50 percent of the nursing homes in the special focus facility program significantly improve their quality of care within 24 to 30 months after being included on the list, while about 16 percent tend to be terminated from Medicare and Medicaid.

"Frankly, they're really the worst of the worst," Richard Mollot, executive director of the Long Term Care Community Coalition in New York, said of facilities on the list. "These are facilities that are at the bottom performing facilities in the country."

In a statement Monday, Sweet Brook administration said that over the past 18 months, the facility has been focused on assuring that all issues raised in prior regulatory reviews have been fully addressed. A spokeswoman for the nursing home said it has done this by providing additional staff training and oversight, improved processes for maintaining and updating the facility, and improving the capacity to address patient or family concerns.

"While assuring quality care is an ongoing and long-term effort, we have made important progress and believe the care at Sweet Brook is safe and meets quality standards," spokeswoman Diana Pisciotta said in a statement. "The recent designation as a 'Special Focus Facility' is based on past regulatory reviews; the issues noted in those reviews have largely been addressed by the organization. We nonetheless welcome the opportunity to highlight for regulators the progress that we have made during this time and use any feedback they may offer to further improve care."

Long-standing issues

In the past year and a half, Sweet Brook racked up hundreds of thousands of dollars in fines for failing to abide by state and federal regulations in resident care.

Inspections of the nursing home have found dozens of instances in which patients were mistreated, abused or neglected by staff.

In January — prompted by a series of Eagle reports on the poorly rated facility — state Rep. John Barrett, D-North Adams, reached out to Gov. Charlie Baker's office to see what is being done to correct the long-standing issues.

"I do know that they are very much involved in the situation," Barrett said, referring to the governor's office. "There are major-league problems there."

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Most nursing homes have some deficiencies, with the average being six or seven per annual inspection. But most correct the issues in a reasonable period of time, according to a statement from the Centers for Medicare & Medicaid.

Nursing homes designated as a special focus facility, however, have more problems, usually twice the average. The issues are also more serious and can involve harm or injury to residents. In addition, these facilities have demonstrated a pattern of problems that have persisted over a long period of time, the statement said.

The goal of the special focus programming is to provide increased inspections, through the form of an additional yearly survey, to these facilities. Within 24 months, the facilities are expected to improve and be removed from the program or have their Medicare and Medicaid funding terminated.

In response to The Eagle investigation, Sharon LeBlanc, administrator for the nursing home, invited Sweet Brook residents and staff to a Jan. 17 meeting to address concerns from the community.

"We are not making excuses for the situation that [led] to those citations," she said in a letter sent to residents. "Rather, we are focusing on correcting the problems, and to that end we have made significant progress."

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Despite claims of progress, Barrett, who has been contacted several times about the facility since January, has learned through several residents and others familiar with the facility that problems in care continue to be an issue.

Barrett said he was also informed that administration told staff and residents at a facilitywide meeting that they are prohibited from talking to him or members of the media.

Many of those who called Barrett were "fearful of retribution," he said.

"There's real issues there," he said. "They figured if they can cut off information from the inside getting to the outside world, this can just go away."

'Yo-yo complacence'

While the special focus designation is intended to ensure that the worst performing nursing homes in the state are permanently corrected with in a year, long-term care advocates find that isn't always the case.

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Every nursing home is inspected at least once a year by the Centers for Medicare & Medicaid and when significant deficiencies are found, they are at risk of losing their government funding.

When a nursing home "falls out of compliance" with federal regulations, they are required to provide a plan to correct the issues in order to ensure their funding continues, but oftentimes the plans they create are not put into action, according to Mollot. This practice can result in "yo-yo complacence," where the same facilities repeat the same deficiencies again and again, he said.

The Long Term Care Community Coalition has found that 42 percent of all facilities in the country have chronic deficiencies— the same citations for the same regulatory standards at least three times in a three-year period, he said.

The Special Focus programming is supposed to address this issue or recurring deficiencies, but it often doesn't, he said.

"They're supposed to be improved within 24 months or they're kicked off the program," Mollot said. "They're rarely kicked out in 24 months, they're rarely kicked out at all. In even worse cases, you have facilities that go off the list and then go on the list again."

A spokesman for the Centers for Medicare & Medicaid didn't return multiple requests for comment on Monday.

Toby Edelman, senior policy attorney for The Center for Medicare Advocacy, believes that facilities on the Special Focus facility list aren't getting the special treatment and monitoring that the federal agency promises.

When nursing homes fail to comply with regulations, the Centers for Medicare & Medicaid can issue monetary fines or deny them payment for new admissions.

Edelman, however, has found that even the facilities that have been cited with causing actual harm and placed in immediate jeopardy of losing their funding are not always find or denied payment for new admissions.

"These are the worst facilities," said Edelman. "They're supposed to be really going after them, having stronger enforcement, more penalties but what's happening? Nothing much."

Haven Orecchio-Egresitz can be reached at horecchio@berkshireeagle.com, @HavenEagle on Twitter and 413-770-6977.


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