Fairfield’s Prestige Care Center cited for regulatory violations

A Fairfield nursing home that’s owned in part by a man accused of defrauding taxpayers has been cited for 19 regulatory violations.

One of the alleged violations that state inspectors recently uncovered at Prestige Care Center in Fairfield involves a nurse who, according to state records, openly diluted a patient’s morphine with tap water to compensate for the portion of narcotic that was missing.

According to state records, the incident occurred last September after a medication aide questioned a registered nurse about a shortage of liquid morphine painkiller that had been prescribed for one specific resident.

In response to the aide commenting that the narcotic count for the overnight shift was off due to the missing morphine, the nurse allegedly walked to a kitchen sink, turned on the faucet, filled the morphine bottle, tossed it to the aide and said something to the effect of, “That was easy enough. There. Now the count is right.”

In a separate matter, inspectors alleged someone had called the facility’s complaint hotline to report that a family member witnessed a staffer sticking their fingers into a bottle of morphine and then licking it off their fingers. When questioned, the worker allegedly admitted that she had run her fingers around the bottle’s edge and then licked her fingers.

Prestige Care Center was also cited for failing to ensure a resident received only those medications prescribed to him and failed to ensure another resident wasn’t subjected to a significant medication error.

That violation stems from an incident that took place in October 2022 when a male resident began demonstrating neurological changes, was slurring his words and was incontinent. It was later discovered that the staff had mistakenly given each of two residents medications that were intended for the other resident.

The home was also cited for violations related to COVID-19 vaccinations. According to inspectors, the home had no records to indicate that 11 different workers at Prestige had been vaccinated against COVID-19.

The state proposed a fine of $8,250 for inadequate nursing services and a fine of $7,500 fine for inadequate resident safety. Both state fines have been suspended so the federal Centers for Medicare and Medicaid Services can determine whether a federal penalty is warranted.

CMS’ Care Compare website indicates the most recent federal penalty imposed against Prestige Care Center was in December 2021 when a $98,833 fine was levied. In the past three years, Prestige has been fined nine times by CMS.

Care center owner accused of defrauding the government

According to CMS data, Prestige Care Center is a for-profit operation owned by Ephram Lahasky and Yisroel Kaplan of New York, and is doing business in Iowa as Sunnybrook Operations.

Four months ago, New York Attorney General Letitia James filed a lawsuit against Lahasky, accusing him and several partners of defrauding the government of more than $18 million while understaffing and neglecting residents at The Villages, a 120-bed facility in northwestern New York.

Lahasky and his partners in The Villages allegedly obtained mortgages to finance the original purchase of the facility, then obtained a $15 million loan to refinance the mortgage. They then claimed $4 million as a cash distribution of loan proceeds.

In 2020, the facility was again refinanced through the U.S. Department of Housing and Urban Development, and an additional $3.6 million was withdrawn as profit for the owners, according to the New York attorney general. The care facility then had to repay the inflated costs of the mortgage out of its operating account, which allegedly led to a dramatic decrease in the quality of care while creating the false impression of a cash-strapped nursing home.

Lahasky has also been part owner of Brighton Rehab and Wellness Center in Pennsylvania, where authorities have accused the operators of falsifying staff hours and overcharging for resident care.

In 2022, MarketWatch reported that of the 97 facilities Lahasky then had a stake in, only two had an overall five-star rating from CMS, compared with 23% of all nursing homes. More than two-thirds of the facilities where Lahasky had an ownership stake had one- or two-star ratings, the publication reported.

Other nursing homes cited

Other Iowa care facilities recently cited for violations include:

Accura Healthcare, Pleasantville – According to inspectors, a resident of the home fell in January and required surgery to repair a broken leg. The facility failed to report the injury to the state as required and the administrator later stated the home did not have a policy related to the reporting of major injuries.

Inspectors also reported that in January, two certified nurse aides were repositioning a resident who was suspended in the air in a mechanical lift when one of the aides took out her vape pen and blew vapor directly into the resident’s face. The other aide reportedly questioned her colleague, asking what would happen if the resident had an allergic reaction, to which the aide with the vape pen responded, “Not my problem.”

The facility was cited for failing to immediately report the abuse to the state. State fines totaling $8,000 have been held in suspension so CMS can determine whether a federal penalty is warranted.

Park View Homes, Sioux City – On Jan.17, a 35-year-old intellectually disabled female resident of this intermediate care facility was apparently knocked to the ground while disembarking from a van. The resident was reportedly up all night that evening, unable to lie down, and was crying and moaning in pain.

A supervisor later told inspectors she wasn’t sure why the staff didn’t take the woman to a hospital for an evaluation. The next morning, the staff transported the woman to a hospital where it was discovered she had a fractured clavicle that required surgery. The state imposed a $5,500 fine.

The facility was also fined $500 for repeatedly failing to administer medication in accordance with physician’s orders. According to inspectors, that failure affected 11 of the 16 residents who had been prescribed the medication Clozaril, a medication commonly used to treat schizophrenia and other disorders.

This article first appeared in the Iowa Capital Dispatch.