Health and safety violations at Van Duyn Center for Rehabilitation and Nursing at 5075 W. Seneca Turnpike in Syracuse increased after a for-profit company purchased the nursing home in 2013, public records show.

Family members and residents of Van Duyn have raised concerns about the nursing home’s quality of care in recent years. The New York State Department of Health has received more than 500 complaints about the nursing home since 2016, over twice the state’s average per bed.

Onondaga County once owned Van Duyn, but turned over the nursing home in late 2013 to Upstate Services Group, a company that provides administrative services to nursing homes.

Since the company took over Van Duyn, NYSDOH has substantiated an average of 13 complaints of health and safety violations per year between Jan. 1, 2014 and Jan. 1, 2019, according to public records from the department. Between 2009 and 2013, the department substantiated an average of 3.2 each year.

The company’s purchase of Van Duyn mirrors a statewide trend of for-profit companies purchasing nursing homes that counties and nonprofits formerly owned.

Between November 2014 and November 2019, for-profit companies purchased 19% of all nonprofit nursing homes and 25% of those previously run by government entities, according to data from the Centers for Medicare and Medicaid Services (CMS).

Privatization of nursing homes is often associated with a drop in quality measures such as citations and staffing. For-profit nursing homes had nearly twice the rate of complaint investigations resulting in citations than their non-profit and public counterparts, according to NYSDOH data.

Adjusting for the types of residents at each nursing home, the average for-profit nursing home in New York state offered 49 fewer minutes of staff time per resident than the average nonprofit or publicly-run nursing home, without accounting for the size of the nursing home, according to CMS data from November 2019.

Family members of residents at Van Duyn say understaffing and negligence left their loved ones humiliated, in pain and without needed medications or help with daily tasks.

Gloria Dykes’ sister Beulah Mae Jones-Bestman was discharged to Van Duyn in spring 2017. Bestman died that August. Her living conditions at Van Duyn were smelly, unsanitary and undignified, Dykes said.

Dykes saved pictures from June 2017 that show trash strewn around on the bathroom floor of what she said was her sister’s room. Pictures also show a ring of scum lining the inside of a toilet and a stained hospital gown discarded in a corner.

One day, Dykes said she walked into her sister’s room and found her lying with her gown pulled up, her back exposed.

“How inhumane, how degrading — isn’t that awful?” Dykes said of her sister’s experience at Van Duyn. “No one deserves any kind of neglect like this.”

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Dykes said sometimes the food her sister was served was moldy or unfit to eat. Between February 2016 and January 2020, NYSDOH repeatedly cited Van Duyn for nutrition- and food-related violations, including a citation in July 2019 for failing to serve food that was “palatable, attractive, and at a safe and appetizing temperature.”

Mary Chappell, the daughter of a deceased former Van Duyn resident, Edna, said her mother fell often after being admitted to Van Duyn in July 2018. On her lawyer’s advice, Chappell asked The Daily Orange not to use her mother’s last name.

Several falls are noted in Edna’s medical records within her first month at Van Duyn, including one in which she suffered a “3×2 cm skin tear” on her right elbow. Chappell took pictures shortly after one of the falls, showing her mother with a large bruise covering the side of her face. Only after multiple falls did staff give Edna wedge cushions to keep her from rolling off her bed at night.

Chappell’s mother also lost more than 15 pounds during her time at Van Duyn. This was partly because staff didn’t give Edna the help she needed to open packages, and spoon food into her mouth, Chappell said.

“If we weren’t there for her meals, she never would have eaten,” Chappell said. “They’d just come in, plop the tray down, and leave.”

Van Duyn Administrator Amy Mahoney said in a May 2019 email statement that some of the nursing home’s residents have been with Van Duyn for many years.

“We understand (the families) want the best for their loved one and again we cannot thank them enough for trusting us year after year,” the statement read.

Mahoney did not comment on the specific cases raised in this story or on questions regarding medical care, staffing and complaints. She did not respond to multiple requests for an updated comment.

The effect of understaffing in nursing homes is apparent to Jeff Parker, regional coordinator of the New York State Office of the Long Term Care Ombudsman Program, a state-mandated team of resident advocates. The program, mandated by state law, sends volunteers into every nursing home to investigate complaints and mediate between residents, families and administrators.

It’s difficult for the ombudsman program or NYSDOH to enforce appropriate staffing levels, Parker said. That’s because New York, like many states, doesn’t have a required minimum staffing level. Current state law requires only that nursing homes have “sufficient” staffing, according to The Buffalo News.

It makes sense that for-profit nursing homes would likely have the minimal amount of staff necessary, said Parker.

“The privately-owned facilities are for profit. So, their goal is to make money. They look to cut costs — not quality, necessarily — but they look to cut costs wherever they can,” Parker said.

Staffing levels are important because residents often depend on others for their daily needs, said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care, a nonprofit group that promotes residents’ rights.

When facilities are short-staffed, residents don’t always get the help they need going to the bathroom, eating, drinking and moving around, Grant said. This can lead to bed sores, infections from sitting in soiled clothing, and malnutrition or dehydration when residents aren’t able to feed themselves.

“It’s not just the physical impact, because there’s a real psychological and mental toll that this takes,” Grant said. “When [residents] have to lie in their own waste, there’s just a huge lack of dignity — they’re just embarrassed, humiliated.”

The National Consumer Voice is one of several long-term care advocacy organizations that support requiring a 4.1-hour minimum total time with nursing staff per resident. The specific number comes from a 2001 CMS report that studied the link between staffing and quality of care.

The report found that care improved with staff increases “up to and including” 2.8 hours with nursing aides, 1.3 hours with licensed practical nurses and registered nurses combined and 0.75 hours with registered nurses alone.

Like many for-profit nursing homes, Van Duyn falls short of the 4.1-hour mark. In particular, residents at Van Duyn only get an average of about 25 minutes per day with registered nurses, just more than half of the recommended minimum.

Van Duyn is far from unique. Of the 606 New York state nursing homes that reported staffing data to CMS in 2019, just over 17% met the 4.1-hour staffing standard.

Lawmakers in Albany have considered mandating the 4.1-hour minimum CMS recommended, but instead decided to fund a NYSDOH study that would look at how staff ratios affect quality of care, according to The Buffalo News. Industry groups oppose minimum requirements in part because of the cost of hiring additional workers.

NYSDOH announced in February that it was finalizing its study on staff ratios and expecting to release the report shortly, The Daily Gazette reported. The study has not yet been released on the NYSDOH website as of March 8.

“The big problem across the board is staffing, and not having enough,” Parker said. “I find that virtually every issue that comes up, in some manner, filters back to that.”

Published on March 9, 2020 at 12:38 am

Contact Madeleine: mdavison@syr.edu