The federal government has barred the Casa Real nursing home in Santa Fe from billing Medicare or Medicaid for newly admitted patients after the home was repeatedly cited for failing to properly care for its residents.
The Centers for Medicare and Medicaid Services also threatened to cut off all Medicare and Medicaid payments to Casa Real if it doesn’t come into substantial compliance with federal quality-of-care standards by Oct. 5. The action could be a significant blow to low-income Santa Fe residents seeking nursing home care in the area.
Casa Real and its sister facility, the Santa Fe Care Center, both for-profit care centers, are the only nursing homes in the city that accept Medicare and Medicaid payments.
The operator of the two facilities — Preferred Care Partners Management Group of Plano, Texas — declined to comment on the federal agency’s action against Casa Real, which was notified early last month.
In an Aug. 2 letter to Casa Real, the Centers for Medicare and Medicaid Services said it would deny payment for all services to new patients, as of July 5, that normally would be covered by the insurance programs for low-income people and seniors. The denial of payment would continue until Casa Real complies with resident care rules or is terminated altogether as a Medicare and Medicaid provider, the letter said.
The action came just after The New Mexican published a report detailing a long history of troubles and claims of poor care at the two nursing homes. They both have received the federal agency’s lowest rating — one out of five stars — and have been cited repeatedly by state inspectors for serious deficiencies in resident care in the last 15 years.
The centers also have faced hundreds of patients’ complaints and several lawsuits in recent years.
And the state Attorney General’s Office is suing their operator, Preferred Care, alleging it has defrauded Medicaid by having insufficient staff to meet the needs of residents at its Santa Fe nursing homes, as well as its facilities in five other New Mexico communities. Preferred Care has denied the allegations.
As the basis for its recent action, the Centers for Medicare and Medicaid Services cited state inspections of the nursing home in April, May and June that turned up a long list of problems, including medication errors, expired food and drugs on shelves, unreported resident injuries and assault, poor care of bed sores, nursing understaffing and inadequate safeguards against the spread of dangerous infections.
In May, the Centers for Medicare and Medicaid Services designated the nursing home as a “special focus facility” because of its poor compliance record, and said Casa Real will be subject to more frequent inspections as a result. The designation is given to the nation’s poorest-performing nursing homes.
Keila Thomas, who said she was director of nursing at Casa Real from May to August, said the nursing home was inspected a fourth time this year, on Aug. 3, just a day after the Centers for Medicare and Medicaid Services alerted the facility that it would be denying billing claims.
That inspection, Thomas said, found that Casa Real was continuing to fail to monitor residents on psychoactive medications for potential side effects. The nursing home had been cited for the same issue following the April and June inspections.
Casa Real fired her, Thomas alleged, in part because she complained to superiors that a manager at the nursing home had forged patient records in an attempt to bring the nursing home into compliance with the medication-monitoring regulation.
Thomas, who is black, also alleged she was dismissed because she had complained of racial harassment.
A resident of Port St. Lucie, Fla., Thomas said she has been a registered nurse since 1993 and specializes in helping to turn around troubled nursing homes, including those on federal special focus status like Casa Real.
When she was brought in as nursing director, she said, she found inadequate staff and poor training at Casa Real.
“It was a whole lot of room for improvement,” she said in a telephone interview, adding that she was successful in addressing nearly all the problems cited by inspectors.
Casa Real operator Preferred Care didn’t respond to a request for comment on her allegations.