Nursing a home
A troubled home for the elderly could find some unlikely saviors -- its employees
Cityscape by Sarah McNaught
"Are they going to take our home away from us?"
Anna Peters sits at
the long wooden table in the recreation room of the Union Square Nursing
Center, in Allston. The comfortable four-story building, with its green floral
curtains and rose-and-green-wallpapered walls, is the only home the petite
senior citizen has known for the past 10 years.
"Do you know if they are going to put me out on the street?" she asks
earnestly. "I won't survive, you know."
It's a bright late-April morning, and Peters is surrounded by handmade posters
emblazoned with appeals to state officials. Her silver hair is combed into
curls around her face, and her tiny hands are folded neatly on her lap. She and
several of her fellow residents are preparing to venture to the State House,
where they will stage the latest of several rallies aimed at gaining the
governor's support for their cause: keeping their home from shutting down.
The residents of Union Square Nursing Center are caught in the middle of a
tangled legal fight that has drawn in City Hall, the state legislature, and
even the governor's office. This is a tough time for nursing homes in Boston:
four have closed their doors in the past three years. But Union Square has
unique problems. The state claims that the owner, New Jersey businessman
Michael Konig, owes $2.4 million in misspent Medicaid funds; there has
been no indictment, but in 1995, he was barred from operating nursing homes in
Massachusetts. Konig, who has a history of turning his back on his own
businesses, denies the charges. In an effort to keep the center open, a group
of employees decided in May 1995 that they would try to buy it themselves -- if
the state would help them out. Now the employees have until May 28 to strike a
deal with the state and purchase the nursing home from Konig, or Union Square
will be closed.
The employees have gained the support of several city councilors and state
representatives, as well as financial relief from the mayor. Still, residents
fear the worst -- that they will be sent away from their home and their loved
ones.
The crisis began three years ago when ADS Consulting, the firm Konig had hired
to manage the home under orders from the state Department of Public Health,
resigned; company officials said Konig had not paid them or provided necessary
financial support. ADS had pleaded for assistance in fixing a severely damaged
roof, refurbishing rooms flooded by leaks in the ceiling, and making other
capital repairs, but Konig declined to invest any money in the building. ADS,
which had already participated in the closing of two of Konig's nursing homes
and the sale of two others, saw where the situation was heading.
"They'd been down that road before with Konig and knew that his lack of
interest meant one thing -- the center was doomed just like the others," says
James Divver, Union Square's administrator.
In order to keep the center open, the state placed it under
receivership in July 1995: the home was granted operational funding until April
29, 1998. The receivership has just been extended to May 28, after which the
court will decide whether to extend the receivership again or let the home go
under. Although the money helped keep the home afloat, Divver says, about
$300,000 worth of work still needs to be done. The only way to ensure the
center's survival is for someone to buy it, but potential buyers have shied
away from the property because of a legal principle known as successor
liability. Any new owners would have to take over all the debts of the previous
owner -- in this case, the $2.4 million Konig owes the state.
"The home itself is only valued at $1.3 million," says Divver. "No one is
going to want to take on a debt almost twice what the building itself is
worth."
Compounding the financial burden, employees argue, is the need for increased
Medicaid reimbursement. The center is 90 percent funded by Medicaid because few
elderly nursing home residents have their own money or personal insurance.
Based on a system created by the state in 1980, every nursing home in
Massachusetts receives money for each Medicaid resident based on the patient's
physical health. The state average is $115 per patient per day, but Union
Square receives just $91 a day for each Medicaid patient. Divver says that's
because many of the home's residents are in relatively good physical health,
but he points out that they still need costly care; the state reimbursement
rate, he says, does not factor in patients with psychiatric conditions, who
often require specialized medical attention.
But the employees of Union Square are willing to take on risks that other
potential buyers are not. In their determination to keep the center open, they
have stayed on even though they have received no pay raises in three years and
never got the retirement fund they were promised; they now earn an average of
$3500 a year less than other nursing home employees in the area. Instead of
moving on, however, they made a plan. With the assistance of their union,
Service Employees International Union Local 285, they offered the state
$500,000 as payment for Konig's debt and drafted a proposal asking for $112 a
day in reimbursement for their Medicaid patients. Employees have never taken
over a nursing home in Massachusetts, but nurse's aide Matta Sherrod, a 20-year
Union Square veteran, says something had to be done.
"The number of nursing homes in this city is quickly depleting," says Sherrod.
"These people need a place to live."
In January, the union signed a purchase-and-sale agreement with Konig for
$1.5 million. But for the plan to work, the union needs the state
Department of Medical Assistance -- the agency that handles Medicaid funding --
to accept $500,000 as repayment for what Konig owes. Only the governor can
decide whether the state will accept less than $2.4 million. After
numerous unanswered pleas to Paul Cellucci's office, the union was finally
granted a meeting this week with William O'Leary, the state's
secretary of health and human services, to discuss the employees' options.
Divvers describes the May 5 discussion as productive; though O'Leary made no
promises, he vowed to work with the governor and the Department of Public
Health to address the needs of residents and employees.
"Cellucci doesn't have time to [meet with us] personally. He just has to
remember that he is going to get old someday, and God forbid he is put in a
home that can't afford to care for him," says Sherrod. "Who knows -- we may be
the ones taking care of him."
Fortunately, other politicians have already come to the union's aid. Mayor
Menino, for instance, awarded the home $50,000 for operational costs last year,
with an agreement to provide $50,000 more if the union becomes the new owner.
City councilor Brian Honan and his brother, state representative Kevin Honan
(D-Brighton), have attended several rallies staged by the nursing home. So have
state senator Warren Tolman (D-Watertown), state representative Steven Tolman
(D-Brighton), and councilors-at-large Stephen Murphy and Mickey Roache. They
are also working with state medical agencies to ensure that Union Square
remains open.
"My grandmother owned three nursing homes, and I saw at a young age the need
for quality care," says Councilor Honan. "We need to get the governor to
realize the importance of this problem to the future of the community."
Back in the lounge, a sprightly old man sits in the corner, tugging on the
brim of his baseball cap with one hand and tapping out an inaudible tune on his
thigh with the other. "Hey, are you here to move us out?" he asks a visitor --
mainly in jest, with just a hint of suspicion. "No? Well, then, do you want
some candy?" The other people in the room laugh.
But though residents are keeping their spirits up, staff members fear that
what happened at another Konig nursing home will happen at Union Square.
According to Divver, 90 patients were relocated when a home that Konig owned in
Lenox, Massachusetts, was closed in 1990.
When elderly people are moved around, they often suffer from "transfer trauma"
-- a condition that causes depression, loss of appetite, and even death.
No one is sure what happened in Lenox. All staffers know is that just three
months after the center was closed, eight of the residents had died.
Sarah McNaught can be reached at smcnaught[a]phx.com.