Nursing Home in limbo

Wyoming Department of Health (WDH) Director Tom Forslund, held a last-minute press conference on Friday where he announced that at the direction of Gov. Matt Mead, his department was taking over temporary management of the Rock Springs and Saratoga nursing homes. The nursing homes are owned by Deseret Health Group (DHG), which has seen similar closures of its facilities across several states in the last few weeks.

While the state and federal rules require an entity such as DHG to give 30 and 60 day notices respectively for voluntary closure of a nursing home, it appears the company doesn't have the financial solvency to meet the obligations it has to the staff and residents of these facilities.

The situation has caused a great deal of confusion at the state level about how to handle the burden thrust upon it by DHG's inability to properly close the facilities under its care.

"This situation has been difficult, stressful and confusing for everyone involved," Forslund said of his departments efforts to mitigate the effects this closure will have, not just on residents whose lives have been upturned, but the staff and communities that are now without a much needed service and jobs.

In the notice the WDH sent to the Saratoga Deseret facility on Friday the state outlined the violations the state found regarding the "complaints from the administrator and the community related to inability of the facility to obtain appropriate food and medications."

According to the notice the following violations were listed:

A. The facility is unable to care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.

B. The facility is unable to provide appropriate provision of services, including nursing and related services, medically-related social service, pharmaceutical services, dietary services that assure that meals meet the daily nutritional and special dietary needs of each resident.

C. The Deseret Health Group is not providing the Saratoga facility with funds or cash flow necessary to purchase medical, personal care, or food supplies.

D. As of the time of this letter, state surveyors report that there is only a one-week supply of food at the Saratoga facility.

E. The facility administrator reports that representatives from Deseret Health Group have instructed her to "drop residents off at the hospital."

F. The petty cash fund for the facility has been depleted.

G. An order of supplies to Medline for items such as briefs and gloves was denied because Medline has closed the facility's account due to non-payment of bills.

H. The facility only has sufficient medical supplies to last approximately two weeks.

I. The Saratoga facility has been forced to turn to its local community for donations of medical supplies and food to continue its operations.

J. The power, gas, phone, and water bills for the facility are currently in overdue.

K. Representatives from Deseret Health Group contacted the Department of Health, Office of Healthcare Financing this week and requested release of funds that are owed to the State's Medicaid program in order to meet Deseret health Group's payroll obligations.

L. The facility's inability to guarantee payroll creates significant concerns regarding the ability to monitor, assess, care for, and otherwise treat residents at the Saratoga facility.

When asked if the WDH was examining its policies and procedures concerning licensing of nursing homes after these illegal closures, Forslund responded that he didn't think that it was a priority at this point. Forslund was also asked if he was disturbed to find out the founder of the company, Jon H. Robertson had plead guilty last year for filing false tax returns in connection with a health care facility he operated under a different company in Utah. Forslund's only response was, "I'm not sure what you want me to say about that."

Forslund was able to say that if the DHG is found to be non-compliant, criminal charges would be filed although at the time of this article the Attorney General's Office had still not returnedemail and phone requests for comment on the situation by Attorney General Michaels.

For now, it seems the staff will at least receive remuneration for their tireless work in the face of their own uncertain financial futures. The state has agreed to pay the employees salaries until the last resident is discharged according to temporary administrator Bill Sexton of the WDH, who was on-site Saturday to oversee the state’s takeover of management.

After speaking with Sexton, the Saratoga Sun tried to reach Administrator Anita Mills for comment. Sexton advised the Saratoga Sun that he and the WDH would, “Strongly prefer you only communicate with myself or Kim Deti, our Public Information Officer.”

While the WDH may not be saying much, Mills was still available for comment when she met with the Sun after hours. “This is getting more and more emotionally draining every day for me and my staff,” Mills said Monday morning as she prepared herself mentally to discharge more residents. “I took (a couple residents) to Laramie yesterday, on Mother’s Day. “We had to sedate them. One of them was yelling at us, ‘you lied! This isn’t my home!’. It’s really the pits,” Mills said.

On the matter of the staff receiving compensation, Mills was still skeptical on whether they would be paid or not. “I’m hearing so many different stories, about how this person’s check bounced, this one is on hold, whether or not the state will pick up these checks for this pay period or if everyone will have to wait ... I just don’t know.”

On top of worrying about her 11 residents she planned on discharging Monday, Mills also planned on contacting the labor board to get a straight answer regarding their pay. Mills also plans on attempting to contact DHG CEO Skylar Robertson to ask him about the payroll.” He called me last week and asked me to get the residents to send in enough money to cover the staff’s payroll I want to ask him, ‘where did that money go? Why are our checks bouncing?’”

According to Mills, S. Robertson texted the staff at noon to say the payroll would arrive and could be released at 3:30 p.m. but less than 20 minutes later sent a text saying that, “Payroll cannot be released today” and that, “if any checks are released they will bounce.”

Medical Director, Dr. Dean Bartholomew also seemed less than thrilled about the WDH’s handling of the situation.

“I can tell you we had very frank discussions with officials at the WDH (Monday, May 4) where (Anita and I) related that we were very, very concerned about payroll.” Bartholomew felt that by the time the state made the decision to take over the facility on Friday, “The calvary was a bit late.”

As far as the residents go, Bartholomew is just as concerned for their welfare. “Many of these residents aren’t getting their first choice of where to go because of the expedited nature of this process (to close the facility).”

“We’ve already discharged three residents with another 11 scheduled on Monday.” Bartholomew said last Friday.

On Monday morning, County Commissioner Sue Jones said she had called the governor’s office to make an impassioned plea to Gov. Matt Mead’s chief of staff for more time to figure out the situation at Deseret. Jones and others in the community strongly believe that closing the facility isn’t in the best interests of any of the parties involved. “All I asked for was time. Give us time to work something out because what’s happening to these people is terrible.” Apparently Jones’ plea to the governor worked since according to WDH Public Information Officer Kim Deti, “At the governor’s request progress to transfer (residents) is being slowed down for at least a week.” Jones went on to relate how the state’s presence at the facility last week in its rush to move out all the patients may have actually hurt the process of finding a buyer. Joe Rude of Health Management Services, which operates out of Billings, Mont. had sent Administrator Kelli Rogee and Director of Nursing Lori Lebert from a facility he owns in Douglas, Wyo. over to the Saratoga facility last Wednesday to inspect the operation and was in contact with the DHG to discuss purchasing the financially destitute operation. Those negotiations were put on hold when Rude discovered that if he decided to buy out DHG and take over the facility he would be left with no residents or staff. Monday afternoon, WDH Director Tom Forslund held a “status update” press conference where he related that, “over the weekend I was approached by third-parties who were interested in assuming the ownership and/or resold interest in the facilities and so I’ve had discussions this morning with both groups and have let them know that time is of the essence.” Forslund also indicated that he had informed the interested parties that the state of Wyoming would expedite the licensing process for them in the event they decided to take over the facilities.

Forslund also confirmed during the phone conference that he had been contacted by the governor to cease all activities related to the transfer of residents from the facilities unless the residents themselves or their families request a transfer. “The governor has told me that he wants to reassess this on Friday ... But for now, we have a little breathing room,” Forslund said.

At the time this paper went to press there were only 11 residents remaining who now needed to make the tough decision to either find a new place to call home or double down on the state’s gamble that a new owner can be found in time to keep Saratoga’s nursing home open and operational.