Nursing Home Firm Questioned

Valley News Staff Writer
Published: 6/3/2016 11:58:09 PM
Modified: 6/6/2016 11:17:25 AM

Montpelier — Vermont health care regulators fired a barrage of questions Thursday at representatives of a corporation that wants to add five nursing homes in the state to its nationwide portfolio of more than 500 facilities.

“We really want to work with you,” said Con Hogan, a member of the Green Mountain Care Board.

The board is being asked to sign off on Genesis Healthcare Inc.’s $39-million deal to buy the 102-bed Springfield Health and Rehabilitation Center and four other Vermont nursing homes.

Reports and data showed problems with patient care and staffing at some of the four Vermont nursing homes that Genesis already owns, according to Hogan.

“I would like to see a written plan on how you are going to change them,” Hogan said at Thursday’s hearing.

Hogan expressed concerns about the number of falls resulting in injury, residents showing symptoms of depression and residents with pressure ulcers at some Genesis facilities. He asked for more detailed reports from Genesis which, if the deal is approved, would become Vermont’s largest nursing home owner.

“This is serious stuff,” he said.

Linda Cohen, a lawyer representing Genesis, said that some of the information Hogan was seeking was covered by a “legal privilege of non-disclosure for quality improvement activities.”

Cohen also defended Genesis’ refusal to provide the board with information that the company viewed as in the purview of ratemaking authorities.

“A regulated entity needs a single set of rules to follow,” she said.

But Genesis officials did promise to work to increase hospice usage and raise staffing levels despite a tight nationwide labor market and a shortage of nurses and nursing assistants that is especially severe in central Vermont.


Genesis has its headquarters in Pennsylvania. Its current Vermont properties include homes in Newport and St. Albans and two in Rutland.

Dick Blinn, Genesis’ executive vice president in charge of its northeast region, said on Thursday that state legislatures in Massachusetts, Connecticut and Rhode Island had appropriated additional funding that was passed through directly to the paychecks of caregivers. A similar measure “may be necessary up here,” he said.

The five Vermont nursing homes that Genesis wants to buy — in Burlington, Berlin, Bennington and St. Johnsbury as well as Springfield — were included in a $240-million deal with Revera Assisted Living, a Canadian nursing home operator that is exiting the United States market. Genesis, which owns a Lebanon facility and is already the largest nursing home operator in New Hampshire, agreed to buy 24 former Revera facilities in nine states.

All of the non-Vermont properties have changed hands. On Dec. 1, Genesis took over day-to-day operations at the five Vermont facilities under a management contract with Revera, Cohen said.

In 2015, Genesis posted a net loss of $526.8 million on revenue of $5.6 billion. In the first three months of 2016, the loss was $71 million on revenue of $1.5 billion on a portfolio of 512 nursing homes and other facilities in 34 states.

Those losses didn’t get mentioned at Thursday’s two-hour hearing. Instead, Genesis officials emphasized their history and affinity in New England markets.

Expanding into Vermont is “a good geographic and cultural fit for us,” Blinn said, noting that Genesis had acquired its first property in the state in 1995. “There is a team here in New England to operate our centers.”

Al Gobeille, the chairman of the Green Mountain Care Board, asked Genesis officials why they wanted to include in the current transaction a Berlin nursing home at a cost of $6.1 million.

The facility, Gobeille said, had the lowest quality rating from the U.S. Centers for Medicare and Medicaid Services and is losing money.

Revera offered the present package on an “all or nothing” basis, said Ken Cullerot, a Genesis financial executive.

That prompted Gobeille to ask whether any of the properties would be “run on their balance sheet alone?”

Genesis officials shook their heads.

“I just wanted to get that on the record,” Gobeille said.

Board members noted Genesis plans to eliminate 52 beds across four of the nursing homes being acquired.

All of those beds are empty, and the decision to reduce capacity would respond to market trends in which patients seek to avoid nursing home placements and stay for less time, Blinn said. Eliminating the beds would also allow Genesis to meet growing demand for private rooms, he said.

Jackie Majoros, director of the Long Term Care Ombudsman Project of Vermont Legal Aid, filed a last-minute letter urging the board to condition its approval of the deal on two years of follow-up reports by Genesis on staffing levels and patient care quality.

Majoros noted that the acquisitions would leave Genesis with control of 30 percent of Vermont’s nursing home beds and “a direct bearing on the lives of the more than 900 residents in its care.”

Genesis’ existing Vermont properties provide 13 to 29 minutes less than the state average of certified nursing assistant care, and residents in three of its four homes had higher than average weight loss and depressive symptoms, she wrote.

Majoros also expressed concern about what she characterized as Genesis’ “practice of denying access to individuals who have a psychosis or significant behavior issues.”

That could make it harder for patients with behavioral problems to find care and add to the burden at other nursing homes, she added.

Cohen, the Genesis lawyer, acknowledged Majoros’ letter but did not directly respond to her request that conditions be attached to the board’s approval of the sale.

The board will take public comment for 10 days.

Editor’s note: To share your expeirence with Upper Valley nursing homes with a reporter, click here.

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


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