The Medicare payment system for SNFs has become increasingly broken, a report states.

An ownership group with links to COVID-era investigations and recent charges of inflating staffing reports is facing public criticism as it attempts to purchase five skilled nursing facilities in Vermont.

Comprehensive Health Management principal Ephram “Mordy” Lahasky appears on loan documents related to the pending purchase, according to financing documents submitted to state regulators and obtained by a Vermont newspaper.

But it’s Lahasky’s wife (not the man himself ) who is listed as one of three potential buyers on the actual application, meaning state officials reviewing it may not have cause to review Lahasky’s complicated web of long-term care investments.

The homes for sale have more than 500 beds, or about one-sixth of all available in Vermont, and are currently owned by Genesis HealthCare.

Two of the prospective buyers, David Gamzeh and Akiva Glatzer, own Priority Healthcare Group, an administrative consulting group which has co-owned facilities with Lahasky in the past. Priority is already providing management services to the Vermont facilities now up for sale.

The third buyer would be Akiko Ike, whom the Seven Days weekly newspaper identified as Lahasky’s wife. 

The trio’s application to transfer the homes’ ownership does not indicate a business relationship with Lahasky, nor does it list any affiliation with the troubled Pennsylvania facilities he has headed.

Lahasky and his business partners have been widely criticized previously for their use of related companies in a nursing home chain that operates in multiple states under multiple names.

Pennsylvania prosecutors allege that a director at one of Comprehensive Healthcare Management’s facilities falsified records regarding staff requirements in the years before the pandemic. That violation was found as state and federal officials investigated a massive COVID-19 outbreak at Brighton Rehabilitation and Wellness Center, where more than 80 people eventually died. The state later took over management of Brighton.

Lahasky has declined most opportunities to comment on his business practices. An attempt by McKnight’s to reach him at a number once associated with his company and better understand his potential role in the Vermont deal was unsuccessful Thursday.

State’s position weak

Vermont law gives officials the power to review nursing home sales and block purchases by buyers who are “financially or otherwise unfit,” Seven Days reported. 

But the public is given no opportunity to review or comment on applications, leaving approval up to state Human Services Secretary Mike Smith.

Eldercare advocates told Seven Days the need to hold nursing home operators accountable is “especially urgent in light of COVID-19.”

“We can’t ignore the chronic and ongoing problems in nursing homes that the pandemic exposed,” said AARP Vermont director Greg Marchildon.

The state is working to replace an outdated Certificate of Need oversight system, and two state officials told the newspaper they regretted not having a better process in place before such a major deal. Working group recommendations that called for a financial review overseen by the Department of Vermont Health Access, and a new, enhanced licensure process under the Department of Disabilities, Aging and Independent Living were put on hold during the pandemic. 

That process could “provide a deeper examination of factors that may influence quality outcomes to residents at the time of a change in ownership,” the group wrote.

For now though, “when push comes to shove” the state “is in a tough position to reject an applicant that demonstrates that they have the financial backing to run this business,” said group member and long-term care ombudsman Sean Londergan.