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Facing closure, The Ivy at Great Falls sues Montana DPHHS

The Ivy At Great Falls
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The Ivy at Great Falls, the state’s largest nursing home that faces closure due to a long record of quality issues, is suing the Montana Department of Public Health & Human Services.

The federal Centers for Medicare and Medicaid (CMS) initiated the pending closure of The Ivy in June. The agency terminated The Ivy’s participation in the health care reimbursement programs after numerous inspections revealed unsafe conditions and lapses in patient care.

The Ivy informed residents June 27 that its license was suspended and that it would be moving all residents by August. As of last week, some 65 residents had already been moved.

The Ivy filed its lawsuit July 19, more than three weeks after it began removing people from the facility. The company targeted DPHHS, the state-level agency, over claims that The Ivy had no opportunity to correct its noncompliance or review the termination, according to the lawsuit filed in Cascade County District Court.

“CMS has declined further to review the matter, or to order DPHHS surveyors to determine whether the Center has corrected any previously cited deficiencies. DPHHS, for its part, says its hands are tied by CMS,” The Ivy’s lawsuit says.

While Medicare is fully administered by CMS, Medicaid is jointly run by state and federal agencies. State health department employees often inspect local facilities participating in Medicare on behalf of the federal government. The state agency is also responsible for licensing health care facilities and nursing homes.

In addition, The Ivy’s lawsuit warns of “transfer trauma” among residents. The phrase refers to the potential harm caused by an abrupt change in living situations and regular caregivers for people needing regular health care observation. The lawsuit also provided statements from health care providers and one family member who are concerned about the impact on residents by the nursing home’s closure.

The family member, Trena Lewis, described in a declaration that her mother required memory care but had shown improvement at The Ivy. Lewis wrote that she worried that the transition would lead to her condition worsening.

The lawsuit said that as of July 4, nearly two dozen residents had been refused by “nearly every other facility in the state.”

The attorney representing The Ivy didn’t respond to a request for comment. A spokesperson for DPHHS didn’t respond to a request for comment by Tuesday afternoon.

The Ivy’s troubled inspection history dates back years and has led to more than $235,000 in fines from the CMS related to specific violations. These include cases of poor wound care, patient dehydration and nutrition issues and one episode in which a resident fell in a janitor’s closet that had been left open.

For all of the documented inspections and complaints, The Ivy has submitted plans of correction, which are recorded and can be viewed on a state website.

A notice of termination from CMS said that DPHHS conducted surveys in March, May and June and found the facility was “not in substantial compliance” with Medicare participation requirements. The action was the “result of our concerns regarding the health and safety of residents,” according to the notice.

The Ivy had been on a federal list of noncompliant nursing homes for nearly two years.

The Ivy’s lawsuit briefly addresses its quality issues, saying that it has had an “inconsistent survey history (at least partially due to its very large size and challenging resident population).”

The Ivy is operating under a provisional license while it assists in transferring residents. The facility is also being run by a temporary manager from a company called Vivage Senior Living.