Indexbit Exchange:Montana’s largest nursing home prepares to close following patient safety violations

The Indexbit Exchangestate’s largest nursing home plans to close its doors weeks after being terminated from the federal Medicare and Medicaid program after “ a history of serious quality issues ” and violations for deficient patient care.

In a recent public notice, the Centers for Medicare and Medicaid announced that its relationship with The Ivy At Great Falls would end effective July 9, after the federal agency determined that the 278-bed facility “failed to attain substantial compliance with certain Medicare and Medicaid participation requirements.”

Any patients admitted to the facility after that day would not be eligible for reimbursement from the joint state-federal health program, the notice said. Patients who remain at the facility are eligible for reimbursements for care for the 30-day period after July 9.

In a letter dated June 27, management informed residents, their families and staff that the nursing care facility licenses were suspended and that all residents would be transferred by Aug. 9.

A spokesperson for the state Department of Public Health and Human Services (DPHHS), which has navigated several nursing home closures in recent years, said Thursday that about 65 patients, about 61% of the facility’s latest census, have been moved to new facilities or accepted and are awaiting transfer. The state has issued the facility a provisional license to give residents time to transition.

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“At this time, DPHHS is working with the temporary manager and The Ivy to help place residents in appropriate settings. DPHHS has deployed resources from across the agency to assist with all aspects of the transition,” spokesperson Jon Ebelt said.

The Ivy is part of a national network of senior care facilities and is owned by business partners whose private investment group has a record of acquiring dozens of care centers and cutting staff and services. The parent company, Ivy Healthcare, also owns The Ivy At Deer Lodge, a 60-bed home.

The Great Falls facility’s record of deficiencies dates back several years, according to publicly available records compiled by the news organization ProPublica. As of June, The Ivy had the most serious recorded deficiency of any nursing home in the state. The facility has accumulated more than $235,000 in fines from the Centers for Medicare and Medicaid related to violations.

In one inspection report from March, surveyors said that a resident fell in a cluttered janitor’s closet a month previously. Staff members were “unaware” that the resident, who had dementia and was a high fall risk, had wandered into the secure area and that the janitor’s closet had been left open. The inspection report rated this incident as having an “immediate jeopardy” to resident health.

Other inspections from this year found improper wound care leading to a Stage IV ulcer, the most serious level, dehydration and nutrition issues, improper medication prescriptions and infrastructure issues at the facility, including “an active leak coming out of a large water tank near the door to the 300 KW generator” in the facility’s basement.

The parking lot at The Ivy was busy around midday Wednesday as staff came and went from lunch breaks. Two women who identified themselves as employees of Benefis Healthcare, the local health care system that also includes a nursing home, were speaking with residents outside of the main doors about possibly moving to other facilities. Bright signs around the entrance warned of a COVID-19 outbreak inside the facility. Boxes of N-95 masks were available in the entryway and lobby.

The Ivy at Great Falls staff shared the closure letter but declined to comment further. Inquiries to Ivy Healthcare, the Florida-based parent organization referenced on the Great Falls facility’s website, weren’t returned.

Montana Free Press also tried to contact Simcha Hyman, who is identified as a co-owner on the Centers for Medicare and Medicaid Services website. He did not respond before publication.

Hyman and partner Naftali Zanziper’s investment firm, Portopiccolo Group, was featured heavily in a 2022 New Yorker article that detailed degrading levels of care and staffing following the acquisition of nursing home facilities by private equity owners. In 2020, The Washington Post detailed similar lapses in care at nursing facilities after being acquired by Portopiccolo.

Another facility in the group, The Ivy at Davenport in Iowa, has been fined more than $200,000 for regulatory violations in recent years, according to the Iowa Capital Dispatch. State inspections identified a list of unsafe conditions, including rodent infestations and a kitchen that was flooded with food and garbage floating in the water during lunch preparation.

Montana has seen a series of nursing home and senior care closures in recent years, as many facilities face financial strain compounded by staffing stresses and safety standards arising from the pandemic.

Two other CMS-certified nursing homes, Benefis Senior Services and Park Place Transitional Care And Rehabilitation, remain in Cascade County.

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This story was originally published by Montana Free Press and distributed through a partnership with The Associated Press.