A federal agency terminated its agreement and decertified the Ivy at Great Falls, which is currently in the process of relocating residents.
The Centers for Medicare and Medicaid Services issued a notification July 9 that the agency was terminated its agreement between the Secretary of Health and Human Services and the Ivy, which is located at 1130 17th Ave. S., as a skilled nursing facility in the Medicare program.
The Montana Department of Public Health and Human Services also terminated the the facility from the Medicaid program, as of July 9
“These actions are taken because CMS has determined that Ivy at Great Falls failed to attain substantial compliance with certain Medicare and Medicaid participation requirements,” according to the CMS notice.
Montana DPHHS has issued a six-month provisional state license to Ivy to allow time for the relocation of residents, Jon Ebelt, DPHHS spokesman, told The Electric.
As of July 18, 61 percent of residents, or 65 of the 106, had either been relocated or accepted, but not yet moved, to a new facility and the remaining 41 had referrals that were being followed up on, Ebelt told The Electric.
DPHHS is working with Ivy’s temporary manager to help place residents in appropriate settings, Ebelt said, and is assisting with the transition, through the long term care ombudsman program, determining Medicaid eligibility for residents when necessary and coordinating transportation needs. The agency’s complex care coordinators are also assisting as needed.
“DPHHS staff with the Money Follows the Person program are engaged in the process. This is a federal grant program through CMS that enhances access to home and community based services by assisting Medicaid individuals with moving back into the community from an institutional setting. MFP has received several referrals for individuals living at the Ivy and is working to assist individuals with moving into the community,” Ebelt said.
According to the July 9 CMS notice, federal financial participation is not available to the state for any Medicaid residents who were admitted to the facility on or after July 9 and for those admitted prior to that date, federal financial participation may continue to be made for up to 30 days of covered services to qualified residents furnished on or after July 9.
Ebelt said that CMS notified DPHHS and the state agency is required to assist the temporary manager.
“When CMS terminates a provider agreement, the regulations require a safe and orderly transition of all residents to the most appropriate facility or other setting in terms of quality, services, and location, taking into consideration the needs, choice, and best interests of each resident,” Ebelt said.
DPHHS handles CMS certifications under federal law and licensure of healthcare facilities under state law, both of which falls under DPHHS’ Office of Inspector General.
The OIG-Certification Bureau conducts health surveys on behalf of CMS on the minimum standards set by the federal agency, according to DPHHS.
CMS reviews a facility’s status, survey history and severity of deficiencies, along with its ability to correct and sustain corrections for cited deficiencies after each survey and determines if a facility will be recertified or if the federal contract will be terminated, according to DPHHS.
In this case, CMS decertified Ivy at Great Falls.
In April, CMS released the list of nursing homes that “have a history of serious quality issues and are included in a special program to stimulate improvements in their quality of care,” in the specialty focus facility program.
The Ivy was included on that list.
When nursing homes don’t meet CMS’ healthcare or fire safety standards, these instances are cited as deficiencies, and we require that the problems be corrected.
Most nursing homes have some deficiencies, with the average being six to seven deficiencies per standard health inspection, but some have:
- more problems than other nursing homes;
- more serious problems than most other nursing homes (including harm or injury experienced by residents), and
- a pattern of serious problems that have persisted over a long period of time (as measured over about three years before the date the nursing home was first put on the SFF list)
Those nursing homes may sometimes correct those problems on one inspections, significant problems would often resurface later, and “facilities with a ‘yo-yo’ compliance history rarely address underlying systemic problems that give rise to repeated cycles of serious deficiencies, which pose risks to residents’ health and safety,” according to CMS, so it created the SFF program.
The Ivy was included on the April list of current SFF facilities and included the most recent inspection results as met or not met. Met means the facility met the graduation criteria on its most recent survey and is on track for graduation. Those criteria must be met on two consecutive surveys to be eligible for graduation, according to CMS.
Not met means the facility did not meet that criteria on their most recent survey and must restart the process.
The Ivy’s last inspection had been October 2023 and was listed as “not met.”
The Ivy has not responded to The Electric’s request for comment from July 1.
A March 2024 inspection had 12 deficiencies.
A January 2024 complaint report found three deficiencies.
The October 2023 inspection found 20 deficiencies and the Ivy was fined $17.872, according to inspection documents.
*Ivy at Great Falls photo
