Officials from the Centers for Medicare and Medicaid Services have fined the directors of the closed Northview Village nursing home in north St. Louis more than $56,000 for violations over three days late last year, when the facility abruptly closed overnight.
The Dec. 15 closure unexpectedly scattered approximately 170 residents to different nursing homes in the St. Louis region, and some family members were not able to track down residents for days after the closure.
In a letter to Northview directors Makhlouf and Lorraine Suissa and Eric Rothner, officials with the federal agency said the nursing home violated the safety and administration requirements. The letter’s authors cited an unsafe evacuation, administration problems and the facility’s failure to keep residents safe from hazards and accidents.
The three directors named in the letter are based in Illinois. The Suissas own several other nursing homes in the St. Louis region and downstate Illinois. Members of the Rothner family own or operate other facilities in Illinois, according to Medicare data.
The CMS letter to the nursing home cites a Missouri Department of Health and Senior Services report, which found the nursing home put its residents in jeopardy during the closure.
The three directors could not immediately be reached for comment.
CMS levies such fines when nursing homes fail to comply with Medicaid and Medicare participation regulations. Any facility that receives Medicaid or Medicare payments has to be in compliance with those rules.
Some of the fines are returned to states, which can use the money to pay for projects that benefit nursing home residents and staff, including assistance to support people who worked or lived at a nursing home that closed.
The DHSS report’s authors wrote that Northview “failed to take measures to ensure security of the residents and staff during the evacuation and failed to secure resident belongings from theft. The failures jeopardized the health and safety for all residents and staff.”
The report told of residents who were disoriented and crying. Emergency personnel needed to sedate at least one resident who did not want to leave, according to the report.
According to the report, one staff member threw up during of the chaos.
Another resident with a diagnosed mental illness was unaccounted for until weeks later, when a member of the public spotted him at a restaurant near the closed facility, according to St. Louis police reports.
Some said that instead of levying a fine, CMS should investigate the other facilities the owners operate in the region.
“It’s really small, it's like a slap on the wrist for folks like this,” said Sam Brooks, the director of public policy at Consumer Voice, an advocacy group for residents in long-term care.
“I've seen million-dollar fines,” he said. “And even that is a cost of doing business. ... If they're not fit to own and operate nursing homes, they shouldn't be. That's the penalty that they should be facing."
Such fines are not enough to deter more violations, said Richard Mollot, director of Long Term Care Community Coalition, an organization that advocates for better conditions in long-term care facilities.
Stronger action is needed, he said.
“Given the egregiousness of what happened here and the extent to which both residents and staff have suffered, it doesn't really send a message to the industry,” Mallet said.
Mallet said it's relatively rare for federal officials to issue fines to nursing homes. Monetary penalties are the main regulatory lever that federal and state health officials can use to punish owners for wrongdoing, he said.
That leaves lawsuits from residents, their families or state attorneys general, Mollot said.
