Confusion Reigns After Government Intervention at St. Thomas Nursing Home

Heavy handed tactics carried out by government officials on Sept. 26 disrupted daily life at Sea View Nursing Home. The acting commissioner at Human Services said she had to act after getting a letter from the Department of Housing and Urban Development. But the only thing HUD asked for, an emergency plan, was never submitted.
Photo provided by Judi Shimel. [hr gap=”2″]

ST. THOMAS — A health care professional in charge of indigent seniors said their abrupt  removal from Sea View Nursing Home terrorized patients and threw the staff and management into turmoil. A top official from the Department of Human Services called it a relocation that was part of an executive action she authorized under federal directive.

But the owner of Sea View says the U.S. Department of Housing and Urban Development never told Human Services to take the patients away.

The chief executive officer of the Schneider Regional Medical Center was also disturbed by the sudden turn of events. Dr. Bernard Wheatley said his medical staff was not given enough information about why the residents were sent to the emergency room prior to them being dropped off.

In a conference call that took place Monday Wheatley and SRMC Medical Chief Luis Amaro were told the three patients were coming from Sea View in critical condition. A subsequent evaluation by the emergency room staff showed they were not, he said.

So the residents lay in emergency room bays for two days without ever being hospitalized, until they were returned Wednesday evening, the medical center chief said.

“Patient one presented, patient two presented and patient three presented,” Wheatley said. “Once the patients presented, using a 911 modality, we have no choice but to evaluate the patients. Once we evaluated the patients, based on the history we were given as to why they were critical. As it turned out none of the patients had any diagnosis in their work up in the ED that deemed them to be admittable to the hospital.”

Ten patients in all were taken off the premises around dinner time on Sept. 26. Sea View Administrator Adeline Connor said the removal violated protocols surrounding the transfer of patients. In one instance, the administrator said it also violated a court order against taking patients off the premises.

By Thursday morning, three of the patients were back at Sea View and Connor said she expected the remaining seven back by day’s end. One DHS official, speaking through an assistant said, “We have no intention of returning the seven patients to Sea View.”

The administrator said neither she nor Sea View principal owner, Dr. Alfred Heath, received  prior notice about a patient transfer.

Acting Human Services Commissioner Anita Roberts spoke to reporters Tuesday and offered an explanation for the abrupt maneuver. Roberts said she undertook an executive action after receiving a letter from HUD. The letter expressed concern for the well being of 19 patients living at Sea View and asked Human Services to produce an emergency removal plan within 24 hours.

“In light of the urgent demand from HUD, the Department of Human Services, concerned about the health and safety of the residents decided it must act immediately to protect the 18 residents at Sea View,” Roberts said.

The first sign that something had changed, Connor said, came when two Human Service officials and a doctor from St. Croix showed up around midday Monday.

“A team from DHS came up here, including Ms. Monique Simmonds, Assistant Commissioner Kyza Callwood and Dr. Cintron from St. Croix. They came and they said they were conducting an assessment by requirement of Commissioner Roberts. That’s all that was said,” Connor said.

At the time there were 18 residents in the rehabilitation unit, ages 56 to 104. A nursing home administrator said the 19th and oldest resident died a few days earlier, shortly after celebrating her 105th birthday.

Callwood, Cintron and Simmonds then began interviewing patients and asking to visit with others. Connor said no other information was shared with her. By evening another set of DHS officials appeared accompanied by vans and ambulances. That’s when the removals began, the administrator said.

The second team of officials said they were told all patients had to be removed by 5:30 pm, but all were not taken. Those who were taken were not given an opportunity to have dinner, which was about to be served. Nor were they given a chance to gather any personal possessions.

Patients began crying, Connor said. Some started asking to go home. One of the eight remaining residents carefully packed their possessions and set them down neatly at the end of their bed.

Financial pressures, loss of certification and funding from the Centers for Medicare and Medicaid Services cast Sea View into uncertainty since Aug. 1.

HUD Director of Residential Care Facilities Roger Lewis, alluded to those problems in his letter to Roberts. “As the government entity in charge of oversight of the facility and its operating accounts, we deem it critical that you are made aware of following continuing critical issues at the facility,” Lewis wrote.

The HUD director called Sea View an unlicensed, unregulated facility that had no plan to resolve its current issues. Cash shortfalls were making it hard to meet the bi weekly payroll and staff members were leaving. There was no liability coverage, federal taxes were going unpaid, as was the HUD backed mortgage.

To restore Medicare and Medicaid reimbursements to residents living in the rehabilitation wing, CMS officials said they would have to be moved to another federal certified nursing facility.

Sea View’s principal owner Dr. Alfred Heath protested, saying the HUD letter only called for development of an emergency plan. He also said that DHS funding to support indigent residents had not come through in almost a year. If it had, the nursing home owner said, Sea View would not have defaulted on its HUD-backed mortgage.

Roberts, with the backing of the Mapp administration, agreed. “The decision to move the residents of Sea View was not made lightly, as the the welfare of our own residents is paramount, and that is what guided this action,” the acting commissioner said.

Two days after the botched intervention, and along with the panic and confusion it caused, one more miscommunication surfaced. According to a HUD official in Miami, the emergency action plan requested from the Virgin Islands never arrived.

“We are waiting for a formal response to the letter,” said HUD public information officer Gloria Shannahan.