New Owner For Hanover Nursing Home

Valley News Staff Writer
Published: 5/27/2016 11:59:43 PM
Modified: 5/27/2016 11:59:53 PM

Hanover — An investor with an ownership or management role in seven nursing homes in the northeastern United States has purchased the trouble-plagued, 100-bed Hanover Terrace Health and Rehabilitation Center.

“We are totally committed to quality,” said Lisa Sofia, who in a brief telephone interview identified herself as the chief executive of Northern Hills Senior Living Centers, a limited liability company formed by the new owners who took control of Hanover Terrace on May 22. “We are totally committed to (making) this into a No. 1 facility.”

Poor quality of care and performances on health inspections have been recurring issues at Hanover Terrace, which in November was declared a “special focus facility” by the Centers for Medicare and Medicaid Services.

That’s the label CMS puts on facilities with “a history of persistent poor quality of care” that are subject to more frequent inspections, higher penalties and expulsion from the Medicare and Medicaid programs. Hanover Terrace is the only New Hampshire nursing home currently subject to enhanced scrutiny by regulators.

Jake Leon, a spokesman for the New Hampshire Department of Health and Human Services, which inspects nursing homes, confirmed that ownership of Hanover Terrace changed hands on May 22, but said the nursing home remains a special focus facility.

Hanover Terrace’s recent problems are spelled out in a 20-page report on an inspection that occurred in January and lasted three days. That inspection uncovered a December medication error that resulted in a resident’s hospitalization for three days and intubation,

The January inspection found found nine deficiencies at Hanover Terrace, the most among facilities in New Hampshire that receive funds from programs operated by CMS.

Sofia declined to comment on the inspection, which occurred under the previous ownership. That ownership included another limited liability company — CH-Hanover — and a nonprofit corporation called Chestnut Health Care and Rehabilitation Inc., both of which used Florida and Pennsylvania addresses.

Alan Silverman, the Pennsylvania accountant who signed CH-Hanover’s corporate filings and Chestnut Health’s fiscal 2014 tax return, said he was unable to talk because he had just had knee replacement surgery, and referred questions to Mel Beal, an employee of a West Palm Beach, Fla., firm called Airamid Health Services. Beal did not respond to a message left at his office.

There currently is a sign in front of Hanover Terrace that identifies it as a not-for-profit facility. However, in August, Terry Knowles, assistant director of the Charitable Trusts Unit of the New Hampshire Attorney General’s Office, wrote the facility to ask its operators to provide information so that officials could determine whether the owners had complied with state nonprofit registration and disclosure requirements.

On March 29, Knowles said that Hanover Terrace’s owners had not yet submitted information regarding the facility’s nonprofit status, and that she had last spoken with the nursing home’s administrator on March 16. Knowles could not be reached for comment on Friday.

The sale of Hanover Terrace promises to at least clarify the facility’s status as a nonprofit, which entitles it to exemption from federal income taxes. “We are a ‘for profit,’” Sofia said, speaking for the ownership. The sign identifying it as not for profit eventually will be taken down, she added.

Sofia declined to elaborate on the plans of the new ownership. She said she would be available for an interview after about six weeks. “Give us some time to get to know the staff, get to know the residents,” she said.

In the meantime, Upper Valley health care users and providers can get to know Northern Hills as well as NSL Hanover LLC, which in March registered to use the Hanover Terrace trade name. Both Northern Hills and NSL, which are incorporated in Delaware, in February registered to do business in New Hampshire. All of the filings used the address of Highfield Gardens Care Center of Great Neck, N.Y., and were signed by Jonathan Bleier, that nursing home’s chief financial officer. Sofia confirmed that Bleier is part of the new ownership.

Bleier recently was in the news as the 35-percent owner of an investor group that received New York regulators’ approval to purchase for $15.2 million the county-owned, 160-bed Genesee Center for Nursing and Rehabilitation near Buffalo.

Bleier already has an ownership interest in six other nursing homes in New York, Pennsylvania and Massachusetts, according to filings with the New York Public Health and Health Planning Council. Those homes and Highfield Gardens, where Bleier is chief financial officer, have a total capacity of 1,199 beds, according to the CMS website.

Nursing home inspections are funded by CMS but conducted by state agencies. In New Hampshire, the Health Facilities Administration visits homes for so-called surveys in response to complaints and applications for license renewals. Reports on those visits are supposed to be publicly available and are used by CMS to compute star ratings on a nursing home’s recent performances overall and on health inspections, staffing and care quality.

The homes where Bleier has stakes have varying ratings. Highfield Gardens has the maximum of five stars, denoting much above average, for its overall, staffing and care quality performances, and four stars, or above average, for health inspections. At the other six homes, ratings ranged from one to four stars for overall performance, health inspections and staffing, and from two to five stars for care quality. Three stars is average.

The lowest-rated home in Bleier’s portfolio is a Catskill, N.Y., facility where, according to New York Public Health and Health Planning Council records, he has only had an ownership stake since December. That facility received the lowest rating of one star, or much below average, for overall performance, health inspections and staffing; and two stars, or below average, for care quality.

Hanover Terrace currently has three stars for its staffing levels, but only one star for its overall rating and for its care quality and performance, on recent health inspections.

The January inspection at Hanover Terrace noted a Dec.15 medication error by an employee who had worked at the home for “only a few months” and had been hired when training “was a weak point.”

The report does not describe the nature of the error or identity of the victim. However, it says that he or she was taken to an emergency room, hospitalized until Dec. 18 and “intubated for a day and a half.”

The report categorized the Dec. 15 medication error as an isolated deficiency that caused “actual harm that is not immediate jeopardy.”

The report also described how, on Jan. 15, a staff member was sent home after twice being notified by an inspector that the staff member had left a medication cart unattended with some medicines and syringes unsecured, and then walking away a third time.

Other report findings were  isolated deficiencies or patterns of deficiencies with “no actual harm (but) potential for more than minimal harm (but) not immediate jeopardy.” Deficiencies included improperly written orders for restraints or medications, dishes that were improperly rinsed, and medications and patient records that were left unsecured.

The inspectors also identified several rights violations.

After a resident refused medication on Dec. 2, a nurse dissolved the medication in apple juice, which violated the resident’s right to decline treatment, the report said. A group of residents told the inspector that they had attempted to call state authorities, but a notice posted by the home listed phone numbers for state licensing and inspection offices that were not in service.

Hanover Terrace also failed to screen and train new employees on “abuse prohibition,” the report said.

Inspectors noted a host of problems with the physical facility, including the smell of urine at various locations, “malodor in the hallway,” torn or missing wallpaper, exposed wood on window sills, holes in bathroom doors, rusting radiators with chipped paint, broken chair rails, stained couches and seat cushions, dusty and dirty work stations, missing tiles, unfinished Sheetrock and broken light fixtures.

According to the inspectors, an administrator attributed some of the problems to a “facilitywide construction project.”

On Feb. 17, Hanover Terrace administrator Malcolm Dean signed a plan of correction for the deficiencies identified during the January inspection. All of the problems were due to be addressed by Feb. 29, according to that filing.

Sofia declined to comment on conditions and inspections under the previous owner, but said that the new owners “will be doing a lot of upgrades to the building.”

Inspectors looking at patient care weren’t the only ones with complaints about the previous ownership at Hanover Terrace. Mohamed Basha, owner of TLC Nursing Associates, said his firm is trying to collect nearly $300,000 in unpaid invoices for staffing services provided this year.

Rick Jurgens can be reached at or 603-727-3229.

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