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‘Generally a last resort’: Medicare agreement with The Citadel Salisbury terminated

The Secretary of Health and Human Services cited a failure to meet the program’s basic health and safety requirements.
According to CMS, the nursing home failed to meet Medicare’s basic health and safety requirements.
Published: May. 5, 2022 at 2:50 PM EDT
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SALISBURY, N.C. (WBTV) - The Medicare program will no longer pay for services at The Citadel Salisbury, according to reports from the Centers for Medicare & Medicaid Services.

According to CMS, the nursing home failed to meet Medicare’s basic health and safety requirements.

The termination of the Medicare agreement takes place on May 19. Medicare will not pay for services for Medicare and Medicaid beneficiaries admitted after May 19, but will pay for up to 30 days for patients admitted before that date.

“We are closely monitoring the relocation of Medicare and Medicaid patients to other facilities,” a release read, in part. “CMS requires facilities to meet certain health and safety standards to be certified as a Medicare provider. Involuntary termination of a provider agreement is generally a last resort after all other attempts to remedy the deficiencies at a facility have been exhausted.”

Concerns have been raised about the nursing home’s quality of care for at least the last two years.

[Family members: Conditions have not improved at The Citadel]

Allegations of poor treatment and not providing medication on time were reported by WBTV in 2020.

The Center for Disease Control visited The Citadel Salisbury months later. The location was one of four across North Carolina where “strike teams” from the CDC came in following large COVID-19 outbreaks.

By Sept. 9, 2020, 168 cases and 21 deaths from the virus had been reported.

The next year, a class-action lawsuit was filed. The suit was filed by Wallace and Graham, P.A. on behalf of two of the nursing home’s residents and family members, citing “severe systematic understaffing at the Citadel nursing home.”

[Class action lawsuit filed against The Citadel in Salisbury, site of NC’s largest COVID-19 outbreak]

Upon hearing the nursing home’s participation in the Medicare program had been terminated, Mona Lisa Wallace and Olivia B. Smith, attorneys at Wallace and Graham, released the following statement:

“Since early 2020, Wallace and Graham has had significant concerns over the quality of patient care at the Citadel Salisbury nursing home. As laid out in public court filings, our concerns over quality of care extend not only to this facility, but also to the other 36 North Carolina facilities under common ownership, affiliated with the Portopiccolo Group and managed by Accordius Health. Our law firm previously filed a lawsuit that sought to enforce the North Carolina nursing home resident bill of rights, including the right to adequate care and patient safety. Since the Citadel Salisbury’s change of ownership in February 2020, residents and families’ concerns over patient care have only escalated. In 2021, our firm filed a class action lawsuit which alleges that the company’s cost-cutting business model has led to chronic understaffing and decreased quality of care.  After exhausting all other attempts to remedy the deficiencies at the facility, as a last resort Medicare has ultimately terminated the facility’s provider agreement. Our firm continues to represent residents and families affected by this matter.”

A state inspection in April 2022 was filed days before the termination was announced but didn’t paint the nursing home in a better light.

According to the report, staff would not help a resident after they were propositioned for sex acts by another.

[Disturbing report on The Citadel raises questions about options for families]

The report also noted one employee working 22 hours straight. The reason? Low staffing – an issue previously mentioned in the 2021 lawsuit.

A resident’s wound dressings went weeks before it was changed.

Medication errors were plentiful.

“Just imagine if it was your mother or your father or one of your relatives, in that situation, you want them to get the best care possible, I find it pretty bad,” said Robert Lattimore of Salisbury told WBTV in April.

To learn more about the termination process, click here.

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