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This Boise nursing home to close after inspectors cite poor-quality care, patient harm

Idaho Statesman - 4/22/2021

Apr. 22—A Boise nursing home that has provided skilled nursing care and rehabilitation services for 64 years will close next month after a federal agency canceled its contract, citing operating deficiencies that sometimes harmed patients.

Residents and staff of the nonprofit Good Samaritan Society-Boise Village, located off West State Street at 3115 Sycamore Drive, were told Tuesday that the federal Centers for Medicare & Medicaid Services had terminated its contract and would no longer reimburse the 127-bed home for services after May 20.

"We know this is a significant loss for the community and for the residents who call Boise Village home and for the dedicated employees who provide high quality and compassionate care every day," Randy Fitzgerald, executive director of the Evangelical Lutheran Good Samaritan Society, which operates the home, said by email. "For 64 years, we have provided essential services and mission-centered care in the community of Boise."

An undated termination letter, obtained by the Idaho Statesman, listed six areas where the agency said the nursing home failed to comply with program requirements. Those dealt with quality of care, nursing services, resident assessments, administration, infection control and comprehensive care plans.

"During the past year, and particularly in the past seven months, Good Samaritan-Boise Village has not been able to meet those requirements," Niki Forbing-Orr, spokesperson for the Idaho Department of Health and Welfare, said in an email to the Statesman. "The facility has been out of compliance for six months and has lost the ability to bill Medicare or Medicaid for services. Therefore, the organization has chosen to close the building and relocate residents."

Boise resident Jessica Benson said she was shocked when she received a phone call at 4:30 Tuesday afternoon asking her to join a conference call a half-hour later to explain what was happening. Her sister-in-law, Jennifer Benson, had moved into the home in December 2019 after suffering a head injury.

"We had no indication whatsoever of any impending problems, so it was crazy to hear that," Benson said by phone. "The staff was crying. It was just as hard for them, as they love a lot of these residents who have been there forever."

Benson said her family is scrambling to find another place for Jennifer. Thirty days isn't much time to find a place with an opening and to do a background check, she said.

"We're kind of freaking out about where to put my sister-in-law," she said. "We're putting all of our energy into that."

A Jan. 7 inspection conducted by the state Department of Health and Welfare's Division of Licensing and Certification, on behalf of the federal agency, found that the home had not followed doctors' orders for three residents. Each violation was classified as causing actual harm.

One resident had a foot injury that had worsened because of a delay getting him seen at a Veterans Affairs Medical Center foot clinic. The home said the VA had limited the number of people who could be seen at its Boise hospital because of the coronavirus pandemic.

The doctor who was treating the man had stressed with Good Samaritan staff the importance of getting the man seen at the VA clinic. He was not seen at the VA until Dec. 8, 40 days after the doctor ordered the referral.

In another case, a doctor ordered the staff to notify the doctor if a resident's blood sugar levels became too low. Despite five instances in early November where blood sugar readings were significantly lower than what the doctor had pegged for notification, the doctor was not contacted.

Good Samaritan, based in Sioux Falls, South Dakota, merged in 2019 with Sanford Health, another nonprofit, also based in Sioux Falls. Sanford operates more than 200 senior care homes. Three other Idaho nursing homes operated by Good Samaritan, in Idaho Falls, Moscow and Silverton, will remain open.

A third resident's doctor likewise was not notified when blood sugar readings were low.

"The facility failed to ensure professional standards of care were consistently maintained as it relates to following physician orders," the inspector wrote.

Most of the deficiencies, Fitzgerald said, were minor.

"Despite our best efforts to address these and demonstrate our commitment to quality and safety, the state of Idaho and CMS found us to be out of compliance," he said. "Unfortunately, on April 20, we were informed that our Medicare Provider Agreement would be terminated."

Without Medicare and Medicaid reimbursement, Fitzgerald said Good Samaritan could not afford to keep its Boise home open.

Medicaid pays for about 50% of the nation's nursing home costs, according to the American Council on Aging. Because of that, the agency is able to negotiate discounts. It pays about 70% of the price charged to residents who can pay the full amount.

The annual cost of the average nursing home room with two residents in Boise is $109,500 per person, the council said.

Medicare pays only for short-term care, paying 100% of costs for the first 20 days and 80% for the next 80 days. After 100 days, it pays nothing.

Good Samaritan remains committed to the health and well-being of its residents and staff as it works to place residents in other nursing homes, Fitzgerald said. It is being assisted in those efforts by Health and Welfare's Division of Licensing and Certification, the Division of Medicaid and the long-term care ombudsman at the state Commission on Aging.

Jessica Benson said her family was pleased with the care Good Samaritan provided to her sister-in-law, who declined to speak with the Statesman.

"They did just bout everything they could to accommodate her," Benson said. "They put in outdoor raised garden beds for her to use and to get out and about in the community as much as possible. We were just really impressed with them."

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