Salisbury, NC (WBTV) – The Salisbury Citadel has closed. The Julian Road facility in Salisbury was the site of the largest COVID-19 outbreak in the state and recently lost its Medicare payment agreement.

According to the Centers for Medicare and Medicaid Services (CMS), the nursing home did not meet basic Medicare requirements for health and safety.

In a June 14 statement to WBTV, a spokesperson for CMS said: Access to safe and quality health care is a top priority and responsibility of the Centers for Medicare and Medicaid Services (CMS). Federal law requires facilities that meet certain health and safety standards to be certified by CMS as a Medicare and Medicaid provider.

As of August 24, 2020, The Citadel Salisbury has been included in the CMS Special Focus Facility (SFF) program as inspectors have identified cases of poor care and actual harm to residents. The SFF is a program designed for nursing homes that have a history of serious compliance and quality issues to incentivize improvements in the quality of care in the facility. Salisbury Citadel previously participated in the SFF program from 18 June 2014 to 4 February 2015.

Salisbury Citadel remains non-compliant after multiple on-site health and safety checks (February 19, 2021, September 2, 2021, and March 4, 2022) recorded non-compliance with several federal requirements.

Despite numerous opportunities to correct its non-compliance, The Citadel Salisbury has not demonstrated that it can ensure the health, safety and well-being of its residents. The institution had a cyclical pattern of immediate danger, poor care, and actual harm to residents.

CMS sent The Citadel Salisbury a letter of involuntary termination on May 4, 2022 stating that the Medicare and Medicaid provider agreement would expire on May 19, 2022 based on a March 4, 2022 survey that found substandard service and real damage to residents.

CMS prioritizes the safety and quality of medical care for residents. Forced termination is usually the last resort after all other attempts to correct the non-compliance have been exhausted. CMS will work with the agency to ensure residents are properly relocated within 30 days of termination, when payments continue for residents admitted prior to April 5, 2022.

The institution has the right to appeal the CMS decision. In addition, The Citadel Salisbury may reapply for Medicare/Medicaid certification, which will require correcting current underlying quality issues and demonstrating sustained compliance with Federal Participation requirements.

Although the facility will no longer receive payments for Medicare and Medicaid residents after the 30-day period, the facility may continue to serve patients who are privately paid or insured by other insurers. However, the State of North Carolina will determine whether the provider retains the state license to operate as a dual-participation nursing facility in the State of North Carolina.

CMS has held discussions with both the North Carolina Department of Health and Human Services and local authorities about the availability of beds and services for residents affected by this situation to ensure that the health care needs of the population are met.

Concerns about the quality of nursing home care have been raised for at least the past two years.

[Family members: Conditions have not improved at The Citadel]

Allegations of poor treatment and late delivery of medicines were reported by WBTV in 2020.

A few months later, the Centers for Disease Control visited Salisbury Citadel. The location was one of four in North Carolina where “strike teams” from the CDC arrived in the aftermath of major COVID-19 outbreaks.

By September 9, 2020, there were 168 cases and 21 deaths from the virus.

A class action lawsuit was filed the following year. The lawsuit was filed by Wallace and Graham, Pennsylvania on behalf of two nursing home residents and their families, citing “a severe systemic staffing shortage at the Citadel nursing home.”

[Class action lawsuit filed against The Citadel in Salisbury, site of NC’s largest COVID-19 outbreak]

Upon learning that the nursing home’s Medicare participation was terminated, Mona Lisa Wallace and Olivia B. Smith, attorneys for Wallace and Graham, released the following statement:

“Since the beginning of 2020, Wallace and Graham have been deeply concerned about the quality of patient care at Citadel Salisbury Nursing Home. As outlined in public court filings, our concerns about quality of care extend beyond this facility to 36 other North Carolina community-owned, Portopiccolo Group, and Accordius Health-operated facilities. Our law firm previously filed a lawsuit seeking to enforce a bill of rights for residents of nursing homes in North Carolina, including the right to proper care and patient safety. With the change in ownership of Citadel Salisbury in February 2020, residents and families’ concerns about patient care have only intensified. In 2021, our firm filed a class action lawsuit alleging that the company’s cost-cutting business model has led to a chronic understaffing and reduced service quality. After exhausting all other attempts to correct the facility’s shortcomings, as a last resort, Medicare eventually terminated the facility’s provider contract. Our firm continues to represent residents and families affected by this issue.”

The state inspection in April 2022 was carried out a few days before the announcement of the cessation of activities, but did not present the nursing home in the best light.

According to the report, the staff did not help the resident after another suggested they have sex.

[Disturbing report on The Citadel raises questions about options for families]

The report also notes that one employee works 22 consecutive hours. Cause? Staff shortages are an issue previously cited in the 2021 lawsuit.

According to the report, one resident’s wound dressings were gone weeks before they were replaced, and there were many errors in treatment.

“Just imagine if it was your mother, or your father, or one of your relatives, in that situation you want them to get the best possible care, I find that pretty bad,” Salisbury’s Robert Lattimore told WBTV in April.

To learn more about the termination process, click here.

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