Arden House Fights To Stay Open

Louis Rosselli, a veteran of 23 years on the Hamden police force, has been living at Arden House for 11 years, and they treat him very well. Good thing: If anyone on the skilled nursing and rehab staff ever bothered him, he joked, he’d kick the crap out of them.

Nurse Sheryl Bergstresser said there is more love at Arden House than in a tier one hospital.

There’s a good chance the patient and the nurse won’t be able to continue there if, based on recent inspections and ratings, the state proceeds with plans to close Arden House, Hamden’s second largest employer, along with other homes around the state, due to declining numbers of patients in the beds and lower ratings in several evaluation categories.

Thursday afternoon, Hamden Mayor Curt Leng, accompanied by state politicians, officials, staff, reps from Local 1199 SEIU, the New England health care employees union, and patients in wheelchairs gathered in the recreation room at Arden for a press conference and a rally to send a message to Gov. Ned Lamont: ​“Fix This Wrong.”

At issue is new legislation, part of the state’s biennial budget, that would reduce certain nursing homes across the state in their Medicaid reimbursement if they have occupancy below 70 percent or have past incidents related to quality of care.

Arden House, which is owned by the Hartford-based for-profit Genesis HealthCare, has been cited for lapses in patient care over the years.

The 40-year-old community institution has 300 health care employees and another 70 working in food and administrative services. Licensed for 360 beds, Arden has only 274 filled and that puts it below the 70 percent occupancy rate that the new rules mandate is the minimum just to keep reimbursement flat. And even flat funding would pose a serious financial challenge, according to Arden Administrator Patrick McDonnell.

A cut in reimbursement rates — 90 percent of the 274 patients are on Medicaid — puts the institution, patients, staff, and community in jeopardy of there not being an Arden House any more.

“Our goal has to be to eliminate that reduction,” said State Sen. George Logan.

“Our message today is that we want a stay, an opportunity for the issues to be worked out and to try to find an equitable solution.”

McDonnell acknowledged that the state has 3,000 more beds in skilled nursing care than needed. That, in part, reflects a new landscape in health care, he said: Hospitals are sending patients home faster, and to home, not to places like Arden for rehab.

His colleague Nancy Slocum, the regional Genesis director of sales and marketing, said that Arden has been trying to adapt to the changes using some of the beds for other purposes. There’s a hospice now at Arden and also a dialysis unit.

Still, from the state’s point of view, the nursing beds don’t justify continued reimbursement rates.

McDonnell has run the facility for the last four years. He said the fastest way to address the matter is to have the state revisit and ​“de-license” some of the beds.

“We’re at 68 percent occupancy. If we get to 70 percent occupancy, we won’t be affected by the reduction,” he said.

McDonnell and Slocum also bewailed a rating system by which Arden recently was dubbed a ​“one-star” nursing home by state inspectors.

The star ratings are based on three measures: 26 quality care measures, health inspections, and staffing. ​“We are four out of five stars” in the quality of care measures,” he added.

As nurse Sheryl Bergstresser put it, people choose to work at Arden because they want to care for people and care for them well. Still in a large institution, things happen. ​“This entire facility is being based on three bad days. What about the good days! I give Genesis credit for keeping the human in health care,” she added.

The dozen or so patients and staff members who spoke up during the press conference echoed those sentiments. They described profound economic, stress-related ripples that would ensue if people lose their jobs or patients, whose families live nearby, are transferred miles away.

John Dana lived across the street from Arden for 40 years. Now it has been his home for the past eleven.

“Every large place has some complaints,” he said. Dana himself reserved his not for Arden but for the state and its regulations.

“This place feeds people,” said 16-year Arden certified nurse’s aide Cassandra Williams. She said she is, proudly only two days, from being certified as a licensed practical nurse. ​“You’ve got to fight this. There has to be a resolution,” she said.

“You should be on our team,” replied Leng.

Jennifer Sherrod, who has been at Arden only three months, said her daughter could no longer care for her after she blacked out twice with seizures. The nursing home she ended up in was at best so-so. Daughter didn’t want her there, and then they found Arden. ​“Arden House took me in,” she explained to the officials, with gratitude. If the place weren’t here, would she end up on the street?

“Yes,” Leng replied, ​“You’re talking about patients, employees, their families, thousands of lives” that will be affected if the status of Arden changes.

Leng said that last week he wrote to Gov. Ned Lamont about the matter. He promised to follow that up in the coming days with another call, bolstered both by the day’s press conference and an upcoming rally showing union support for a re-consideration of the legislation.

One longtime Arden employee and union activist, who did not want to be identified, pulled a reporter aside to say she reads the tea leaves differently. She described Genesis as the ​“country’s largest bed holder.” She said she thinks Genesis wants a chance to play this all out, ​“so that they can bow out [of Arden House as it is] gracefully, and let the state take the fall.”

Find below, Leng’s written appeal to the governor and state health department officials, followed by a response from the Governor’s office:

Mayor’s Appeal

For those of you who have not heard, the State of Connecticut is considering closing several nursing homes around the state by eliminating the Medicaid reimbursement for poor senior citizens. They are targeting facilities that have declining utilization and lower ratings in the many categories of evaluation.

Senior citizens are an important part of our community and population. They have paid the price in times of war and in times of rebuilding America. Our seniors have woven the fabric of community and their importance can’t be understated. It is our responsibility as a government and as a society to do everything we can to take care of them, especially our most vulnerable, those who are poor, in bad health, and who are part of the growing population of individuals suffering with Dementia and Alzheimer’s.

Arden House is one of the locations that could close as a result of recent considerations by the state to save money. I want to tell you why it is important as a community for all of us to roll up our sleeves and solve the real problem of geriatric care, which will not be solved by simply closing nursing facilities.

Arden House and other facilities present a challenge that comes from over-building nursing beds over the last 25 years. The movement of keeping seniors in their home, or having them discharged from hospitals, has reduced the need for beds that are subsidized by the State. But there are new challenges in the areas of Dementia, Alzheimer’s and in Hospice Care. As people live longer these needs are greater.

Here are some important reasons to work together on this problem:

1. There are roughly 250 seniors or other disabled folks at Arden House, the vast majority who could not stay if not for State subsidies. They are largely local people that if dislocated would be separated from their families;

2. The Arden House is Hamden’s 2nd largest employer (after Whitney Center), including well over 300 employees in direct health care and another 60 – 70 in food service or administrative functions. Many of these are lower paid caregivers. There are not enough jobs at other facilities, nor enough beds for the seniors, to fulfill the void that would be left by closing Arden House. A large number of workers are part of key labor unions who are actively at the table seeking solutions to avoid this catastrophe;

3. Loss of Tax Revenue: The Town of Hamden would stand to lose significant tax revenue if Arden House were to close.
 
Arden House has already begun to innovate at the facility to solve their problems. The recently opened Hospice Wing has been a great success. They have enlarged their memory care facilities to address this growing area of this practice. In these cases they are able to take those units off the list of state funding, as they often require different payment sources. If Arden house were given the time to continue their efforts to grow in these areas, they would be able to get off this proposed list for closure because they would increase their overall utilization of subsidized beds and they would be able to put their resources towards improving their rating. After consulting with the Director of Arden House, I have learned that they are due for a new rating in the next couple months. They need a chance to keep their improvement going and the workers and patients deserve the reprieve to avoid such disruption for all.
 
I have consulted with our Director of Economic and Neighborhood Development, Dale Kroop as well as the Hamden Regional Chamber of Commerce. I am reminded how important the Health Care Cluster is in Hamden and in the region. I propose working together, actively with the Town and Chamber Health Care Cluster groups to strategize, along with other nursing facilities, on how to strengthen our nursing facilities. I have been in touch with our delegation and their concerns are my concerns, to protect the vulnerable seniors and to preserve the jobs that would otherwise be lost.

I call on Governor Lamont and DSS Commissioner Dr. Deidre Gifford to delay implementation of this policy and allow Nursing homes likes Arden House and their communities’ time to develop new and innovative ways to address the growing need for Hospice and Memory care services across the state. I offer my time, my staff, and resources to work on this important issue. Let’s not miss out on an opportunity to save a valued care provider and community asset.

For further information, please contact Deputy Chief of Staff, Patrick J. Donnelly, at 203 – 287-7009 or [email protected].

Gov. Lamont’s Office’s Written Response

Connecticut has been a national leader with long-term care for years with programs such as Money Follows the Person, providing robust support for Medicaid-funded home and community-based services, and the availability of high-quality, skilled nursing homes across the state. In order for us to provide the type of care our residents want and to continue to provide high quality care, we must adapt and respond to the information at hand. This rebasing initiative, passed by the General Assembly in June, will allow us to meet consumer demand, increase rates to 96% of providers, and improve the long-term care experience for our residents and their families.