Called 'the social safety net in Providence,' this nursing home is closing. Will RI step in?

PROVIDENCE – The Charlesgate Nursing Center is slated to close by the end of the summer, and workers at the nursing home are calling on the state to intervene.

"For those that don't know, we care for some of the most vulnerable residents in Rhode Island," Carolyn Clark, who has worked at the facility for 15 years, said at a Thursday news conference organized by SEIU 1199 New England. "To put it plainly, we are there for them when other facilities will not take them in."

Charlesgate primarily serves low-income patients who are covered by Medicaid, "as well as homeless and severely ill individuals suffering from HIV, hepatitis and other complex medical conditions," the union said in a news release. Speaking on Thursday, executive vice president Jesse Martin described it as "the social safety net in Providence."

Located on North Main Street, the Charlesgate complex also contains an assisted-living facility and several apartment buildings that offer "independent living." Officials say that only the nursing home is closing, and that the other facilities will not be affected.

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Why is Charlesgate closing?

Davenport Associates, which owns the Charlesgate Nursing Center, cited "severe staffing shortages and shortfalls in state funding to sustain adequate care for its residents."

Neil Shunney, the company's president, said in a statement that the shortage of nurses was particularly acute, and that the nursing home was facing an "insurmountable challenge."

“We recognize the challenges that this decision may cause, but there was no other option due to current industry conditions,” Shunney said.

John Gage, CEO of the Rhode Island Health Care Association, said that he didn't know the specifics of Charlesgate's financial situation.

But he noted that the vast majority of residents are covered by Medicaid, meaning that the nursing home was reimbursed by the state for their care. Those reimbursement rates have not kept pace with inflation.

"So they’re losing money every single day on every single resident that lives in that facility, because of chronic underfunding by the state’s Medicaid program," Gage said.

Rhode Island passed the Nursing Home Staffing and Quality Care Act in 2021, which was intended to give Rhode Island nursing homes some of the highest staffing levels in the nation. The RIHCA, which lobbied against the bill, has repeatedly said that most nursing homes can't meet the minimum requirements, and could be driven out of business by hefty fines.

The Department of Health has yet to impose fines on nursing homes that are out of compliance, so that wouldn't have directly contributed to Charlesgate's closing, Gage said. However, the prospect of facing those fines in the near future is "hanging over everyone's heads."

SEIU 1199 said Charlesgate staff won "ground-breaking staffing language as well as significant wage and benefit increases" through a contract they secured in 2020.

In a news release, the union cited other factors for the nursing home's instability, including the "preferential use of costly agency staff" and fines for deficiencies in care. Regulators imposed over $77,000 in fines in October, after identifying a number of problems with residents' treatment.

Martin said on Thursday that Rhode Island allocated $30 million in American Rescue Plan Act funds to nursing homes in 2022, and that 80% was supposed to go to direct-care staff. "Not a single member, a single direct-care staff person in this nursing home, received a penny of that government money," he said.

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What will happen to Charlesgate residents and employees?

The Charlesgate Nursing Center has 120 beds and, on average, houses 76 patients, according to data from the Center for Medicare and Medicaid Services.

Shunney said in a statement that the nursing home will work with patients and their families to secure housing in other facilities. He said other nursing homes in the area have already contacted Charlesgate "to extend invitations for residents to relocate to their facilities."

Gage said that while there are enough empty nursing home beds in the state to house the displaced residents, "the issue is whether or not facilities have adequate staff to meet the needs of additional residents from Charlesgate."

A total of 90 employees at Charlesgate – including registered nurses, certified nursing assistants, "med techs" who handle medications, and dietary and housekeeping staff – are represented by SEIU 1199. The union expects that all or nearly all will lose their jobs when the facility closes.

"All we received was a letter saying, 'Thank you for your service,'" said Oprah Page, a CNA at Charlesgate. She said that workers were not receiving any severance payments.

Shunney said in a statement that the company's human-resources department "will work with employees to provide assistance in securing new positions or applying for state benefits.”

He said that other nursing homes have inquired about hiring Charlesgate employees and that "we were pleased to discover that there are many opportunities for our employees to secure employment in the same field."

Martin said that while some staff members may have found new jobs, some have worked at Charlesgate for as many as 41 years and don't want to start over.

"Why should they have to go somewhere to start over again?" he asked.

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What is the state doing?

Martin said that the union is asking the state "to go to the same extraordinary measures they've gone to in the past." Years ago, the state put Bannister House in receivership and "found an owner that can operate that facility with the dignity and respect that the residents and the staff deserve," he said.

"We're asking the state to do the same thing here for our Charlesgate community and for the staff that care for them," he said.

The state Department of Health, which regulates nursing homes, "does not broker ownership changes," said spokeswoman Annemarie Beardsworth. She said the department had not yet cleared Charlesgate's closure plan, and was waiting on additional information from the facility.

"The long-term care ombudsman is actively involved and will be working with the facility to find residents new homes, considering both the residents' needs and choices," Beardsworth said. She said the Department of Health "will be monitoring the facility during the closure plan, which may include unannounced visits."

This article originally appeared on The Providence Journal: Charlesgate nursing home to close; employees ask RI to intervene