Federal judge to troubled operator: Exhaust other options before you make a federal case

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A facility with a history of safety deficiencies must exhaust its administrative options before seeking relief in the courtroom, a district court judge ruled. Moreover, the requested temporary injunction would probably fail to prevent a shutdown even if the operator had followed protocol, the court ruled.

Athens Healthcare Inc. made the appeal to the U.S. District Court for the Middle District of Pennsylvania. But the court said that Athens had not first exercised its options through the Centers for Medicare & Medicaid Services. Therefore, a “practical equivalent of a total denial of judicial review” was not a suitable label for the immediate termination of Athens' Medicare agreement, said Judge Malachy E. Mannion. Even if the court did have jurisdiction, Mannion added, the provider would not qualify to obtain a temporary restraining order.

Athens was put on the federal Special Focus Facility watch list for extremely troubled facilities in October 2010. Inspectors have continued to cite multiple safety deficiencies, including two “G” level deficiencies in April 2013, according to reports. On May 2, CMS ordered Medicare termination, effective May 31.

Among other observations critical of Athens, Mannion said that CMS had a greater interest in protecting residents at a repeatedly cited facility than worrying about Athens' business interests, which include threats of foreclosure and staff layoffs, among other speculations.