Medicaid battle turns to court

[Times photo: Kristen Schmid] Amelia Nazario, a resident of Rehabilitation and HealthCare Center in Tampa, joins about 29 other people outisde the center protesting the state's decision to cut Medicaid funding to the facility. Her sign says "Don't make me leave. This is my home."

By JEFF TESTERMAN

© St. Petersburg Times, published October 6, 2000

TAMPA -- Nursing home giant Vencor Inc. is challenging a move by the state to cancel Medicaid contracts at six nursing homes and force the relocation of 628 elderly or disabled residents by the end of the month.

In a complaint filed Wednesday in U.S. District Court in Tampa, Vencor says the Florida Agency for Health Care Administration violated federal regulations and its own administrative procedures by canceling the contracts Monday.

The company wants a judge to issue a temporary restraining order while the case is decided. No court hearings had been scheduled as of Thursday.

Vencor says the state action will create pandemonium at nursing facilities, destroy businesses and traumatize patients.

"It's outrageous," said Vencor attorney Morris "Sandy" Weinberg Jr. "It appears the state is using these nursing homes, and more importantly, these patients, for political means.

"These (Vencor) homes are in substantial compliance with state requirements, but the state has had its agents in these facilities since Monday trying to relocate people when they're happy to be there."

Gov. Jeb Bush said Thursday that the state had tried to work with the six homes before deciding to cancel the contracts.

"It was a provocative act," Bush said. "We decided to do it because of the chronic nature of the problems we saw."

At Vencor's Tampa Bay facilities, however, there was discontent with the state's action.

Outside Vencor's Rehabilitation and HealthCare Center in Tampa, relatives of nursing home patients waved placards and protested the state's relocation order.

At the company's Abbey Rehabilitation Center in St. Petersburg, patients fretted about where they will go and why they must leave.

Ann Green, a resident at the Abbey for six years, said she doesn't know where she will end up. She has discussed moving in with her daughter, who lives in Boston, but said, "making a change is very difficult."

The state announced the action against the six nursing homes at a news conference Monday attended by Gov. Bush and Ruben J. King-Shaw, secretary of the Agency for Health Care Administration.

King-Shaw said state Medicaid inspectors reviewed two years of complaints at each of the state's 675 nursing homes and selected the six as "chronic, traditional bottom performers."

Three of the six are among the 20 nursing homes in Florida run by Vencor, which is based in Kentucky.

The three Vencor homes, which are the plaintiffs in the federal complaint filed Wednesday against King-Shaw and his agency, are the Rehabilitation Center in Tampa, the Abbey in St. Petersburg and Colonial Oaks Rehabilitation Center in Fort Myers.

The three Vencor facilities have a total of 330 patients. Three-quarters of those, 249 patients, are poor enough to receive Medicaid and are subject to the relocation order.

When the 249 leave, the rest will be forced out, too, Vencor says, because the facilities will have no choice but to shut down.

The non-Vencor facilities facing cancellation of Medicaid funding are Crystal Springs Nursing and Rehabilitation in Thonotosassa, the Magnolias in Pensacola and Greenwood Rehabilitation in West Palm Beach.

At the Abbey, at 7101 Ninth St. N in St. Petersburg, inspectors visited a year ago and found some residents in soiled wheelchairs and others in wet undergarments or lying in feces.

At the Rehabilitation Center, at 4414 N Habana Ave. in Tampa, state inspectors reported that residents with open sores were left unattended and patients were oversedated because employees failed to adhere to medical plans, according to a 1998 inspection.

For the most part, all six homes took corrective action after the inspections, but they have substandard records of fines and penalties, state records show.

Vencor acknowledges that its facilities, like a majority of the state's nursing homes, have been cited for deficiencies at their last annual inspections. But the company says the Abbey and Colonial Oaks homes had "no uncorrected deficiencies" when the state canceled their Medicaid contracts, while the Rehabilitation Center in Tampa had received only oral notice of deficiencies.

Under federal rules, Vencor says, the state has no legal authority to void Medicaid contracts with facilities in compliance with state guidelines.

A day after the state announced the cancellation of the six Medicaid contracts, Vencor's representatives met with King-Shaw and asked him to rescind the action. King-Shaw declined, and emphasized that the state would not permit Vencor any administrative appeal, according to the Vencor complaint.

Officials at the health care agency had no comment.

Weinberg said that two years ago, the state fined Vencor $270,000 for trying to evict 54 Medicaid patients at the Rehabilitation Center in Tampa to make room for private-pay patients.

One of the issues then was "the transfer trauma Vencor was causing," Weinberg said. "Now, two years later, the state is evicting these residents who want to be there.

"It's preposterous."

- Staff writers Jounice Nealy and Julie Hauserman contributed to this report.

© 2006 • All Rights Reserved • St. Petersburg Times
490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111

Contact the Times | Privacy Policy
Standard of Accuracy | Terms, Conditions & Copyright