ROCKY HILL — The nursing home at 60 West St. seemed to offer a solution to a vexing problem for the state of Connecticut: reducing burgeoning long-term care costs for sick and elderly prison inmates and mental patients.
State officials were confident Medicaid would pick up 50 percent of the cost of care if prison inmates were moved into a privately owned nursing home.
So far, that has not happened, and may never happen.
The Centers for Medicare & Medicaid Services, a division of the Department of Health and Human Services that administers Medicare and Medicaid, upheld a 2014 decision this summer denying Medicare/Medicaid certification to the nursing home.
The state is appealing but in the meantime, the determination leaves the state responsible for the full cost of the inmates' care.
The owner of the nursing home, SecureCare Options, receives $500 per patient, per day, a fee established at the time the patients were first admitted in May 2013, plus payment for services such as rehabilitation, that otherwise would be reimbursable.
As of Thursday, 58 patients were being cared for at 60 West St. All but three were placements by the Department of Mental Health and Addiction Services or Department of Correction, according to Gian-Carl Casa, undersecretary for legislative affairs for the state Office of Policy and Management.
The Department of Correction patients [do] not meet Medicare program guidelines, J. William Roberson, regional administrator of federal Medicare services, wrote in the denial issued June 30.
"Some of these inmates live in a secure unit with no medical justification to support this placement. When an inmate no longer meets the criteria for release as stated, the inmate returns to the custody of the commissioner of Correction.
"These practices do not comport with a long-term care facility's duty to protect and promote resident rights to a dignified existence, resident transfer and discharge rights and rights to be free from restraints imposed for purposes of discipline or convenience and not required to treat medical symptoms."
Rep. Tony Guerrera, D-Rocky Hill, said the Medicare decision reflected long-standing concerns he and others share about the facility.
"We've been talking about this since day one," he said. "We've had concerns, first over public safety, and second over whether the state will be saving thousands of dollars in federal Medicaid, and Sen. [Paul] Doyle and I had doubts because they are still prisoners.
"We put the cart before the horse. I know there is an appeal and they could win, but what if they don't? Where do we go from here?"
Among current patients, 16 are Department of Correction placements and a dozen are listed on the state sex offender registry.
"We think the [Centers for Medicare & Medicaid Services'] decision will be overturned on appeal,'' Casa said. "In the long run, this type of facility has and will continue to save the state money when compared to the costs of caring for individuals … in prison infirmaries or through admissions to John Dempsey Hospital or care in state psychiatric hospitals."
Heather O. Berchem, a New Haven attorney with the firm Murtha Cullina who represented the owners of 60 West St. in their Medicare services certification application, declined to discuss the appeal.
Maintaining security over the enfeebled, medically compromised Department of Correction patients was a condition set by the mental health, social service and correction departments in seeking an extended-care facility.
The agencies accepted a proposal in the fall of 2012 by iCare Management of Manchester to purchase, then reopen an older nursing home licensed for 120 beds that had been closed in 2011 under court receivership.
The planned opening of the re-licensed 95-bed home, the first in Connecticut to care specifically for state patients who are difficult to place in traditional nursing homes, stirred up a hornet's nest in Rocky Hill.
Town leaders, reflecting the sentiments of residents, tried unsuccessfully to prevent the opening. Several lawsuits related to the facility are pending.
At the crux of the town's argument was that 60 West St. does not serve a traditional nursing home clientele, and should not be allowed to operate in a residential area without prior zoning approval.
The owners had claimed that by operating as an arm of the state, the home had sovereign immunity, freeing it from local interference, an argument rejected by the Connecticut Supreme Court in January.
Attorneys for 60 West St. and the town are currently in mediation over the town's request for a permanent injunction. SecureCare in the meantime, is fighting a cease-and-desist order issued in 2013.
Neighbors have also filed suit against SecureCare, claiming the operation of 60 West St. has decreased the value of their properties. ..Source.. by DAVID DRURY
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