A blue closed sign shows through a glass door
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A 5-star, three-generation family owned nursing home just outside Connecticut’s capital was granted the right to close Friday. It’s a move the owner pursued as the state embarked on a campaign to eliminate some 1,000 beds from state rolls.

Sam Flaxman, owner of Hughes Health and Rehabilitation Center in West Hartford since January, said he’d been unable to work out a sale for the 170-bed facility and was facing $10 million in needed renovations. He also said he’d been losing $10,000 to $30,000 a month while maintaining a 4-star staffing rating amid a statewide staffing shortage, the Connecticut Mirror reported. 

After hovering around 50% during the pandemic, the facility’s census had dwindled to 47.6%, or 81 residents, as of last week.

The state, in its approval of Hughes’ closure plan, said the facility was “not viable” based on operating losses of $1.38 million for 2022 and the first four months of 2023. The state also noted that closing the nursing home is consistent with the state’s strategic rebalancing plan, which addresses bed need by geographic regions.

In fact, in his application to close and move his remaining residents, Flaxman noted there were 30 nursing facilities within 10 miles of West Hartford with more than 600 beds available. 

This tale of a reluctant seller who tried to keep his facility open but found no takers is a cautionary one for what might be to come, nursing home advocates in the state said.

The closure of this highly regarded nursing home demonstrates the need for a vision and a plan for the future of nursing home care in the state,” Mag Morelli, president of LeadingAge Connecticut, told McKnight’s Long-Term Care News on Monday. “Members of LeadingAge Connecticut have been supporters of the state’s rebalancing effort, but our nursing home sector needs to work together with the state to create a plan that will incentivize high quality nursing homes to continue to provide this level of care.

“We can’t just sit back and hope for the best. We need to provide the resources and incentives for good nursing homes to not only survive, but to thrive in their communities and provide high quality nursing home care to those who need and choose that level service,” Morelli added. “The state is currently phasing in a new acuity-based nursing home reimbursement system that will have as its basis a true rebasing of the costs. This will be the first true-up of nursing home rates in many, many years, and we just hope it won’t be too late to help and encourage the highly staffed, quality nursing homes to stay in business.”

Fill beds or give them up

Connecticut officials have said they want to trim as many as 1,000 beds from the state’s skilled nursing sector. In March, they proposed a new rule that would institute a second financial penalty on providers that cannot maintain 90% occupancy, a harsh standard considering staffing limitations and some facilities’ use of private rooms despite holding licenses that would allow them to double up residents.

At the time, Social Services Commissioner Andrea Barton-Reeves said the intention of the new rule was to move providers to either fill the beds or reduce their licenses.

But policies that reduce spending on skilled nursing care to shift funds to home- and community-based services might eventually leave patients with a true need for inpatient skilled care with few good options.

“We say you shouldn’t over-rely on facility-based care,” Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, told The Mirror. “But if you have a policy that over-relies on home- and community-based care for this ever-exploding population, when there’s a known dearth of caregivers, then it’s going to fail. The consequences of that can be dramatic and harmful, including a five-star nursing facility moving to close and residents essentially being evicted from their long standing home.”

McKnight’s Long-Term Care News’ attempts to reach the Barrett and owner Sam Flaxman were unsuccessful Monday. The main phone number for the nursing home rang unanswered.

But Flaxman, who recalled walking the hallways of the building as a little boy, expressed regret to the Mirror over being forced to close and lay off his staff.

“The staff is the reason this was a 5-star facility. I mean, who cares about my family’s legacy at the end of the day,” said Flaxman, who inherited ownership in January after his grandmother died. “It’s the staff that have been there and put their hearts and lives into it. At the end of the day, that is the saddest thing about Hughes closing.”