They described a nightmare.
Months after Woodland Behavioral and Nursing Center was put on notice that it could lose its federal funding over major violations that officials claimed had threatened the lives and safety of the hundreds of residents living there, problems at the Sussex County nursing home continued to mount.
The state, which is seeking to take control of the long-troubled facility, detailed in a complaint and lengthy brief on Tuesday that things were not getting any better at Woodland, despite the ongoing oversight by a monitor the Department of Health put in place earlier this year:
- Last month a resident with a feeding tube was transferred to a hospital and found to have a bowel impaction. That had led to aspiration pneumonia, determined surveyors for the state, because the tube feeding had nowhere to go due to the blocked colon — other than back up through the oral cavity and down to the lungs.
- Earlier this month, another hospitalized Woodland resident with a similar blockage was never properly assessed, leading to the possibility of a perforated colon, sepsis, and death.
- The facility’s COVID precautions failed to protect residents day after day, officials said, pointing to the failure of Woodland’s staff to wear necessary personal protective equipment, isolate those who were infected with the virus, or even come up with adequate infection control plans.
- And as recently as Monday, an altercation between two residents resulted in serious bodily injury requiring surgery.
At the same time, they disclosed Woodland is teetering on the edge of bankruptcy, according to the Superior Court filing in Sussex County which sought the appointment of a receiver to take over the facility.
“Woodland continues to violate standards of health, safety, and/or resident care and appears to be in acute financial distress or at risk of filing for bankruptcy,” wrote attorneys for the Department of Health.
Because of the ongoing violations, and the “acute financial distress,” they said there is substantial risk that federal regulators will soon terminate Woodland’s Medicare and Medicaid provider agreement. That would immediately shut down a facility licensed for more than 500 beds.
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Gov. Phil Murphy said New Jersey will not tolerate long-term care facility operators who cannot provide the care its most vulnerable residents need.
“It has become crystal clear that the people running this nursing home refuse to take responsibility for the people in their care,” the governor said.
The move to assume control of the facility through a court-appomted receiver marked an extraordinary step for the state.
Attorney Paul da Costa of Roseland — who represents number of families in lawsuits charging New Jersey with gross negligence and incompetence over its handling of the COVID outbreak in the state’s veterans’ homes, called it a bold step given the uniqueness of it and the “astoundingly poor care” that inherently was at the core of the decision.
“Patient safety must be the paramount objective of the operators of all long-term care facilities and all other medical institutions. This decision by the state hopefully is not a one-off move. Rather, the state should devote more resources and money to allow the Department of Health to hold all bad actors fully accountable,” he said.
And the unfortunate reality, he added, was that Woodland “certainly is not the only bad apple in the bunch.”
The attorney said the state should methodically pick through all of the bad apples and not allow them to needlessly endanger the vulnerable residents who live in these facilities.
“The governor has an opportunity to show the rest of the country how to protect the vulnerable population that inhabit these facilities and make sure that there is a true and full accounting for all nursing home residents that have been needlessly endangered and had their safety and well-being jeopardized,” da Costa said. “If nothing else, COVID-19 has offered us an opportunity to not allow the status quo in nursing homes be good enough.
Deborah R. Gough, a Hackensack attorney who sued Woodland after a resident with dementia was able to walk out in sub-zero weather without anyone noticing, said it was long overdue for Woodland to be held accountable for their mismanagement.
“People have faith that their loved ones will receive proper care in these facilities. When they don’t fulfill their responsibilities, it is devastating, and can at times be deadly,” she said, hoping that the state could transform the Woodland “into a place that can be reliable and trustworthy.”
U.S. Rep. Gottheimer, D-5th Dist., who has repeatedly pushed for the facility to be shut down, applauded the move by the state, saying if Woodland cannot properly care for its residents, then it needs to be investigated and revamped or closed.
“It’s clear that investigations, fines, and promises of improvement from the current owners of Andover Subacute haven’t been enough,” he said. “Families should have confidence that older relatives and veterans will be well cared for in their later years, whether residing in private or state-run long-term care facilities.”
Woodland’s is owned by Alliance Healthcare Holdings of Lakewood, whose officers include CEO Chaim “Mutty” Scheinbaum and Louis Schwartz, the eldest son of Joseph Schwartz who was charged in January in a multi-million dollar federal tax fraud scheme in connection with Skyline Healthcare, his failed multi-state nursing home chain that had once sought to purchase the long-term care facility.
But while the nursing home in Sussex County is licensed and operated by Alliance, the property itself is owned by a limited liability company and leased to Alliance.
The facility’s attorney and its administrator did not respond to requests for comment.
A MAKESHIFT MORGUE
Woodland has a long history of health and safety violations, along with documented shortcomings in residential care issues, the state said in its filing, noting specifically the nationwide media coverage and scrutiny by federal and state representatives and regulators after police in April 2020 discovered 17 bodies in a temporary makeshift morgue at the nursing home.
Once known as the Andover Subacute and Rehabilitation Center, the facility changed its name to Woodland Behavioral after the bodies were discovered. (An adjacent, sister facility under the same ownership, known as Andover Subacute I, was renamed Limecrest Subacute and Rehabilitation Center.)
The U.S. Centers for Medicare and Medicaid Services later fined Woodland $220,235.
The facility again came into the spotlight in February after a state inspection report issued a warning of “imminent jeopardy” to the residents of Woodland — including the failure to make any effort to resuscitate a 55-year-old resident found in cardiac arrest and not breathing on New Year’s Day.
In a separate incident, that report noted that a nursing aide reportedly left a resident soiled in feces for ten hours overnight. The unnamed resident already had a pressure ulcer, or bedsore, that would have been exacerbated by moisture and susceptible to infection.
And during one two-week period from late December into January, not a single day went by when there were enough certified nurse aides on duty to care for its residents, regulators found. At times, the nursing home operated with only half the staff required under state mandates.
According to the court filing on Tuesday, there were approximately 33 complaints investigated by Department of Health from April 2020 to November 2021 at Woodland. At the end of November 2021, the state surveyors visited Woodland to investigate after a resident committed suicide.
At the same time, the state said Woodland appeared to be “in acute financial distress or at risk of filing for bankruptcy protection.”
They noted the facility had a negative cash flow, limited borrowing capacity and they questioned its real estate leasing structure, as it faced a new deadline over the possible loss of its federal funding.
As of January 31, Woodland’s balance sheet showed total assets of approximately $15.8 million and total liabilities of approximately $19.8 million. It said there was doubt as to Woodland’s ability to pay its debts as they become due.
“There is substantial doubt as to Woodland’s capacity to borrow funds to address its financial distress,” the state’s attorney wrote in their court filing.
Disability Rights New Jersey, a nonprofit created under federal law to represent the legal interests of people with mental and developmental disabilities, said it supported the Department of Health’s decision to seek receivership at Woodland.
“Our ongoing investigation of abuse and neglect at the facility has identified not just unacceptable conditions and lack of proper treatment, but also extraordinary obstruction from the facility administrators,” the group said in a statement. “We call on the Department of Health to identify a receiver who can promptly remedy the long list of violations of residents’ rights, including the basic provision of care, freedom from unnecessary restraints, and specialized care for those with serious mental illness, developmental disabilities, or traumatic brain injuries.”
They added that special attention must be paid to residents who wish to move to another facility or move to a more integrated community-based setting.
“While our investigation continues, our investigators have repeatedly heard that many residents living in this segregated institutional setting ended up there because there were no other options for them,” the group said. “While receivership is a major step in the right direction to improving conditions at Woodland, part of the long term solution will be improving our state’s capacity to serve people with disabilities in their own homes or community-based settings without the need to segregate them from the rest of society in these large nursing homes and other institutions.”
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Ted Sherman may be reached at tsherman@njadvancemedia.com. Follow him on Twitter @TedShermanSL
Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio.
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