Beach nursing home's Medicare funds in jeopardy

VIRGINIA BEACH

A nursing home that has been on a list of the worst long-term-care facilities in the country is in jeopardy of losing Medicare funding, a rare move that often results in closing or a change of management.

Beacon Shores Nursing and Rehabilitation first landed on a list of poor-performing nursing homes in February of 2008 when it was tagged as a "special focus facility" by the Centers for Medicare and Medicaid Services. The federal agency lists nursing homes that have chronic problems that continue even after facility officials are given the opportunity to make improvements.

Two state health agencies informed the facility last week that proceedings had begun to end Medicare and Medicaid payments to the facility. However, Denny Barnett, director of operations for the management group that runs the facility, said the company's lawyers met with CMS lawyers Tuesday and had come to an agreement to stop those proceedings.

Barnett said three of the center's residents have moved out since the center received a letter about its certification being in jeopardy, but 123 residents have opted to stay.

Chris Durrer, director of licensure and certification of nursing homes for the Virginia Department of Health, said facilities on the special focus facility list must be inspected twice a year instead of once, in hopes of improving the quality of care. The Virginia Beach home had not improved sufficiently, which is why the Medicare termination proceedings began.

Under the notification sent by state health officials last week, Medicare would not make payments for patients who are admitted on or after April 6. Medicare would pay reimbursements for patients admitted prior to that time until May 6.

Medicare, a federal insurance program that funds care of the elderly and disabled, requires facilities to maintain certain safety standards.

Beacon Shores was also informed by the Virginia Department of Medical Assistance Services, which determines eligibility for Medicaid, that proceedings had begun to stop payments for that program, which is a shared state and federal insurance for the poor and disabled. Withdrawal of Medicare and Medicaid funding from nursing facilities is rare. Durrer said 12 nursing facilities in the state have lost Medicare funding since 1995. The most recent was a Richmond nursing facility that had its Medicare contract terminated in 2007.

He said some facilities continue to operate until they get to a point where they have improved enough to get Medicare funding again, but many close down because of the loss of funding.

Inspection records posted by the Centers for Medicare and Medicaid Services show Beacon Shores, at 340 Lynn Shores Drive, had 28 deficiencies, compared with the average of nine for Virginia nursing homes.

Deficiencies included failure to make sure residents were well-nourished, protected from abuse and punishment, and cared for by people who did not have records of abuse and neglect. The nursing home also was cited for not informing family or doctors when abuse, injury or change in health to a resident had occurred.

Currently, there are 135 nursing homes on the special focus facilities list, including three in Virginia. The only one in Hampton Roads besides Beacon Shores is Norfolk Health Center at 901 E. Princess Anne Road, which was put on the list two months ago.

According to CMS, about half the nursing homes in the special focus program improve their quality of care within 24 to 30 months, and about 16 percent are terminated from Medicare and Medicaid.

The idea behind the federal initiative was to give people more tools in selecting nursing care and to provide an incentive for facilities to improve.

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com