Long-term nursing home care in Connecticut is still reeling from the COVID-19 pandemic. Short staffed and under-funded, Athena Healthcare is also dealing with lawsuits in three states.
WSHU’s Ebong Udoma spoke with CT Mirror’s Dave Altimari to discuss his article written with Jenna Carlesso, “Lawsuits, fines, complaints put pressure on Athena nursing homes,” as part of the collaborative podcast Long Story Short.
WSHU: Athena Healthcare is based in Farmington, Connecticut, and is facing multiple lawsuits in Connecticut, Rhode Island, and Massachusetts, the three New England states where it operates. Could you tell us a little bit about the company and what these lawsuits are all about?
DA: Sure. Athena’s biggest number of nursing homes are in Connecticut, there are 21. They also have some in Massachusetts and Rhode Island. There are several issues that they are facing, including financial issues and short staffing, which is a big issue for all nursing homes. There's just not enough workers. The way that they're trying to offset that is hiring these temporary employment agencies who are basically charging astronomical rates because they know that nursing homes are desperate. Six of those companies have filed lawsuits against Athena, because they have not paid them for employees that they provided during the last roughly 18 months since COVID. So they've got multiple lawsuits on that front, there's a federal lawsuit out of Iowa, by a company that helps them with their health insurance, Athena is self-insured. And basically, the lawsuit in effect is saying that Athena is not paying health insurance benefits for their employees, and that they owe over $6 million in benefits that they have not paid. So if you're a worker here in one of their places, you're probably working an astronomical number of hours. And in some cases, your health benefits aren't being paid by the company.
WSHU: And they've also been sued by patients and families of patients for problems they've had with the nursing staff.
DA: Yes. There are five consent orders that have been issued against them by Departments of Public Health in the three states. When the Department of Public Health issues a consent order, that means that they have found some significant shortfalls in taking care of the patients. And in some of these cases it had to do with poor COVID protocols at a place in Massachusetts. There's one place here in Connecticut, Middlesex Healthcare, where the state felt they needed to put an independent nurse in charge to oversee everything from staffing to how medicines were allotted, and that that consultant is still in place, as we speak, doing weekly reports to DPH on how that nursing home is doing. There's also this case out of a Massachusetts nursing home where one patient literally beat his roommate to death with his walker. And the Massachusetts DPH investigated, they issued a fine, but the person who was arrested was found not competent to stand trial. But the family of the man who was murdered, he was literally lying in his bed and the guy was beating him when his walker, has filed a wrongful death lawsuit against Athena that is pending in Massachusetts courts.
WSHU: They’re alleging that there was inadequate staffing and that if they had better staffing it might have been prevented.
DA: Part of the lawsuit alleges that they did not have enough staff to properly monitor the patients and the registers. And that no one realized that this guy was literally beating his roommate to death with a walker until it was too late.
WSHU: So basically, the staffing problems are pretty acute. We generally have a situation right now where finding adequately trained workforce is more and more difficult. So is this reflecting a larger problem in the long-term nursing care industry?
DA: No question Athena is a microcosm for the issues facing all of them. They'd happen to be the biggest one and, you know, the most prominent one. But there are staffing shortages throughout the industry, budget concerns. Athena is not an isolated case. It's a system-wide issue going on with nursing homes right now. And I believe it is something that the state is probably going to have to address, as they did at the beginning of COVID.
WSHU: COVID also showed that we might have a problem being able to have full occupancy in many of these nursing homes because of how many people died during the height of the COVID pandemic.
DA: That also plays into it. There are people who are, and in some ways, I think afraid to go into nursing homes because of what happened during COVID. So their numbers are down, the number of residents. Many of them were over 90% occupancy, pre-COVID. Some of them are now down in the 70s or lower. Some have bounced back. But overall I think the industry is certainly down percentage wise, the number of residents that they have in their facilities. So you have less residents, you have higher costs, you have less staff, that all leads to financial issues for Athena down to the mom and pop guys that run one or two facilities.
WSHU: Is Athena thinking of getting out of the business? What is Athena’s response?
DA: Their owner is a guy named Lawrence Santilli. And he indicated to us that they were trying to work through some of their financial issues, and that they have no plan to sell. They have 21 nursing homes in Connecticut, and he said they had no plans to sell any of their nursing homes, and that they're working to repay the health benefits that they're behind on. They're working it out with the companies, the temporary employment companies, and that he doesn't anticipate having to sell any of those facilities,
WSHU: Even though in Massachusetts, they had the highest fine possible, $1.75 million?
DA: Yes, they just had to pay a $1.75 million fine to the Massachusetts Attorney General. And that had to do with the fact that they were taking in patients with substance abuse issues, and didn't have the proper staff to take care of people with substance use problems. And they had in the AG’s words, "numerous overdoses." So they have worked out an agreement with them, they've paid this fine and put in place staff to address this particular type of patient that has a substance abuse issue. But that was the largest fine in Massachusetts history for a nursing home company.
WSHU: Santilli said he still feels it's a viable business.
DA: He does. He didn't get into specifics, all he told us is that he does not plan on selling any of his facilities. And that he's working out the debts that he owes. I think that they're hopeful that the state is going to step in and possibly offer some help. That hasn't happened yet, as it did at the beginning of COVID when the state, at least twice, stepped in and gave the nursing homes some financial aid. I think that while we are in a different crisis than COVID, we are in a crisis in our long-term care facilities, or they are certainly headed to one, and it's an issue that clearly the state is going to have to address again. I believe the problems just highlight what is certainly occurring in nursing homes across the state.
WSHU: For the nursing home industry to continue to be viable, there has to be more state involvement.
DA: I think for right now, the state may have to get involved again. Long term, I'm not quite sure what the answer is. But I do think short term, there is enough of a concern about patient's health in these facilities that the state may have to get involved with long-term care. The ombudsman told us that they had gotten over 500 complaints from families and patients in Athena nursing homes. And that complaints in general are up across the board. And a lot of it plays into the staffing issue. There's just not enough staff in these facilities to take care of people.
