Sea View Nursing Home Case Heats Up

Sea View Nursing Home is going on the offensive in a struggle to restore its reputation and retain funding for its Medicaid patients.

Sea View attorney Maria Hodge said Thursday she is preparing a demand for discovery of documents from the federal Center for Medicare and Medicaid Services aimed at determining how and why the agency decided on policies that her client claims have made it impossible for it to continue operations, to comply with CMS directives, to hire a temporary manager or to complete a sale of the St. Thomas facility.

The demand for documents will include email exchanges related to Sea View.

Earlier this week, Sea View expanded its suit against CMS and the U.S. Department of Human Services to include the V.I. Department of Human Services and its commissioner-designee, Anita Roberts.It also added a claim for $994,734 it says the V.I. department owes it under an agreement to provide nursing care services on behalf of the local government and another $250,000 for what it alleges were “unlawful” actions by Roberts and Human Services in physically removing Medicaid patients from Sea View in September.

There were 19 residents at Sea View in September, 16 of whom were Medicaid patients, when DHS suddenly and unexpectedly transferred three of them to the Roy L. Schneider Hospital emergency room and most of the rest to the Queen Louise Home for the Elderly.Officials at both those entities said at the time that they had no advance notice of the transfer.

The action caused a public furor and prompted a legislative hearing in early October.

The amended complaint charges that Roberts lied at the hearing when she said that she had consulted with federal Housing and Urban Development officials about making the transfers, and that HUD representatives say she did not seek their opinion but only called the department late in the day of the transfer and advised them it was underway.

Most of the residents who were transferred have been returned to Sea View where, as of this week, there are 15 residents, according to the amended suit.

The transfers were made “without notice to or consent of the residents, their families or guardians or Sea View” and they “constitute illegal intentional interference with the future contractual relations in the amount of $25,000 as for each contract involved for a total of $250,000,” according to the complaint.

Sea View enjoyed a good reputation until 2013 when CMS found a long list of deficiencies at the facility.Dr. Alfred O. Heath, president of St. Thomas Health Care Management Inc., the general partner of St. Thomas Nursing Home Prime Ltd. Partnership, which does business as Sea View Nursing Home, has said he tried to correct the problems and did resolve some of the issues.

In 2015 he and CMS reached a settlement under which CMS dropped some penalties and Heath agreed to hire a temporary manager and to sell the facility. Heath says he tried to do so but that CMS thwarted those efforts.

The suit says Sea View negotiated with two qualified entities, Larken Community Hospital and Whittier Health Services, to act as temporary manager and oversee the correction of the still outstanding deficiencies. Larken was also interested in purchasing the facility, but only if CMS would guarantee future funding for Medicaid patients there, which it has refused to do.

CMS rejected Larken as a temporary manager because it proposed to manage the facility through regular site visits and electronic communication, rather than being onsite.It rejected Whittier, which offered a team approach, because the Whittier representative who would be on-site was not a “licensed nursing home administrator.”

According to the suit, that condition came up at the last minute.It was not in the agreement CMS and Heath had made, it is not required under V.I. law, and CMS had never challenged the credentials of the current administrator, who is not a licensed nursing home administrator.

Whittier even offered to have another member of its team – one who is a licensed nursing home administrator – be the onsite representative, but CMS rejected that offer, saying it came too late.It was made a few days after the CMS-imposed deadline for having the temporary manager in place.

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