The state’s Executive Office of Elder Affairs allowed a boarding house in Athol to function as an assisted living facility for 2½ years without being certified by the state.
The required certification process administered by Elder Affairs is designed to assure the health, safety, and well-being of assisted living residents in the state. Elder Affairs regulates more than 200 assisted living facilities that care for close to 14,000 seniors, most of them in their mid-eighties and many with dementia.
In February 2012, Elder Affairs was informed by the Athol Board of Health that a boarding house in the town, Providence Cliff Senior Residence, may be operating an assisted living facility without being certified. Assisted living facilities help residents with activities of daily living in apartment-style housing.
“There are about 20 residents there, some are active and able to come and go as they please,” wrote health agent Deborah Karan to Paula Edmonds, an ombudsman at Elder Affairs. “But other residents appear to have more serious conditions.” Karan expressed particular concern for the lack of controls in helping residents take their medications — an important regulated component of assisted living.
Elder Affairs visited Providence Cliff, which is owned by Newton resident Dejun Xuan, and determined that the entity was indeed operating an assisted living facility without being certified. But officials believed that the residents were not in any danger and did not seek to shut the facility down or fine its owner. Instead, Providence Cliff was told that it needed to submit an application for certification, which it did in 2012. The certification has been denied twice, most recently this month. Xuan is appealing the latest denial. A number of requests for waivers of certain requirements have also been denied.
Peter Antonellis, a compliance officer at Elder Affairs who has been critical of the agency’s oversight functions, said the situation has dragged on too long. “I think that right at the outset Providence Cliff should have been given 90 days to shut down and a plan developed to relocate the residents,” he says. “Instead, the matter has dragged on for 2½ years and we’re still dealing with it. It has been a huge waste of our limited resources.”
Providence Cliff, referring to itself as an “Assisted Living Center,” has run ads as recently as this year in the Athol Daily News about open houses at the facility. The ads include a list of assisted living services the company offers along with the statement that its application for assisted living certification is pending. Under state law, a facility cannot admit assisted living residents until it is certified.
Xuan, the Providence Cliff owner, tells callers that he is accepting residents for assisted living. When a reporter inquired about his responses to callers, he declined comment.
In a report in February 2013 to Duamarious Stukes, the director of the assisted living program at Elder Affairs, Antonellis called attention to Providence Cliff having units with inadequate square footage, unlockable doors and windows, and poor ventilation.
The bathrooms were a major problem as well. “Residents are occupying units that do not currently appear to meet minimum requirements of the state sanitation code regarding bathrooms,” Antonellis wrote. He noted an insufficient number of bathrooms as well as bathrooms without shower/tubs or toilets. When the units did have them, they were often inadequate.
Antonellis noted that a number of the residents were wheelchair-dependent, one of whom was seemingly incoherent.
At various times, the town of Athol cited Providence Cliff for such things as electrical violations, windows being sealed shut, the use of space heaters, inadequate ventilation, and one bathroom having no door.
“How much longer will you allow them [Providence Cliff] to continue to operate without the needed certificate?” Antonellis asked Stukes at one point in an email. “Will you require them to move out a number of the residents?”
Stukes never responded, according to Antonellis. “Elder Affairs continued to allow Providence Cliff to operate as an uncertified assisted living facility under dangerous conditions,” he said.
“The Providence Cliff situation is a blatant example of Elder Affairs’s failure to enforce its own regulations,” says Rebecca Benson, an elder law attorney. She says that even though the agency has the explicit authority to seek an injunction against an unauthorized operator, as well as a civil penalty of $500 for each day of unauthorized operation, it has not done it.
Elder Affairs spokeswoman Martina Jackson said “For us, the major issue is the safety and security of the residents. We want to be sure that the assisted living facility that is seeking certification can meet the requirements of the regulations.”
CommonWealth recently reported that Elder Affairs receives about 6,500 reports a year of abuse, neglect, falls, and other incidents, but there is little evidence the agency is using the information to detect patterns, either in general or at specific facilities.
Elder Affairs has rebuffed repeated efforts to review the incident reports along with the agency’s process for handling them, as well as reports submitted by the assisted living facilities that reveal violations of the sanitary code, the state building code, and fire safety regulations. The agency has also resisted entreaties from an advisory board for access to data.
Antonellis said Elder Affairs does virtually no analysis of the data it collects. He said that historically the agency has not kept track of how many residents have fallen down, wandered off, been abused, or exploited, and there are no policies and procedures in place on how to handle incident reports as they come in.
At the insistence of the Elder Affairs Advisory Council, Elder Affairs Secretary Ann Hartstein on Tuesday presented some basic data on incident reports. For the period Sept. 15 to Sept. 22, she said, there were 149 incidents reported by the operators of assisted living facilities. The incidents consisted of falls (112), acute health incidents (29), abuse and neglect (3), wandering off (2), deaths (1), and medication problems (2).
Asked how the reports were analyzed and investigated, Hartstein said: “I don’t have that right now. . . . We’re just starting to work through the data we have and figuring out how to make it useful to us.”
In a memorandum he sent to top officials at the elder affairs agency as well as to John Polanowicz, the governor’s secretary of health and human services, Antonellis said he believed poor management at Elder Affairs was endangering the safety of residents living in assisted living facilities. The agency’s incident reporting program is “nothing more than a hollow and dangerous façade,” he wrote.
Providence Cliff House is a safe, secure, comfortable and affordable Assisted Living Facility to be certified by the Commonwealth of Massachusetts.
On September 23, 2014, Mr. Colman Herman wrote an
article online titled: “Elder Affairs lets Athol facility
remain open-Providence Cliff lacks certification for assisted living.” On September
26, 2014, Mr. Herman published another article online “A critic from
within-Peter Antonellis cites Elder Affairs shortcomings.” The third article “Elder Affairs worker
placed on paid leave-Antonellis raised concerns about agency oversight.” appeared
online on October 14, 2014.
All
three articles have one thing in common. They cover Peter Antonellis, a
Compliance Officr at Executive Office of Elder Affairs of The Commonwealth of
Massachusetts, who uses Providence Cliff House in Athol as an example, in his
ongoing dispute with the Office he has worked for.
In
the first article, Mr. Herman quoted Mr. Antonellis extensively on Providence
Cliff House. Mr. Antonellis alleged “Elder Affairs continued to allow
Providence Cliff House to operate as an uncertified assisted living facility
under dangerous conditions.” The second and third articles repeated Mr.
Antonellis’s characterization of Providence Cliff House as “unsafe”.
Providence
Cliff House is a safe, secure, comfortable and affordable Assisted Living
Facility to be certified by the Commonwealth of Massachusetts.
Mr.
Antonellis’s allegation about Providence Cliff House is false. He misleads
through omission, exaggeration, generalization, and misinterpretation of the
law.
Mr.
Antonellis omits the fact that at the very beginning, he demanded that
Providence Cliff House convince Elder Affairs that it can operate itself as an
Assisted Living Facility before being certified as such. Providence Cliff House
started its application to Executive Office of Elder Affairs for Certification
of Assisted Living Facility in March, 2012, by engaging a law firm and a
consulting company, both specializing in senior care industry. Mr. Antonellis
has been the contact person at Elder Affairs in the application process.
Mr.Antonellis
omits that Providence Cliff House has a professionally licensed and trained staff that looks after its residents around the
clock. The staff is comprised of a Master of Business Administration (MBA), a
Register Nurse (RN), licensed Certified Nursing Aides (CNAs), licensed Home
Health Aide (HHA), and professional chef. Furthermore, he omits that he has
inspected Providence Cliff House’s personal files many times, and he has been
satisfied with the quality of staff every time. In the second article, Mr.
Antollis revealed that “human services has been my life for the past 15 years.”
Therefore, he knows better than anyone else the quality of staff plays a key
role in the safety of residents in an Assisted Living Facility.
Mr.
Antonellis omits that Providence Cliff House has developed Policies and
Procedures, and Documentation System for an Assisted Living Facility. Staff at
Providence Cliff practices the policies and procedures and documents their
actions every day. He further omits that he has inspected and has been
encouraged by the documentations every time.
As a compliance officer, he should know the importance of Policies and
Procedures, and Documentation System in an Assisted Living Facility for the
safety of its residents.
Mr.
Antonellis omits that Providence Cliff House has cured all sanitary code deficiencies.
In the first article, Mr. Antonellis alleges sanitary code deficiencies, “unlocked
doors and windows”, “poor ventilation”, “rooms do not meet state sanitary code”,
“electric violations”, “windows being sealed shut”, “use of space heater”,
“inadequate ventilation”, and “one bathroom has no door”. He blurs the past
tense and current tense when he speaks.
Mr.
Antonellis generalizes the rooms that are inadequate. There are 27 rooms at
Providence Cliff House. Our application for certification seeks only 19 rooms
to be certified, excluding all rooms without bathrooms that also happen to be
too small. In the first article, Mr.
Antonellis alleges “insufficient number of bathrooms” and rooms with
“inadequate square footage”.
Mr.
Antonellis misinterprets the law he knows better than most of the people. 651
CMR 12.04.(4), part of the law governing Assisted Living Facility, allows an Assisted Living Facility to have
residents who need skilled nursing care, as long as the skilled nursing care is
offered by a different service provider. In the first article, Mr. Antonllis laments
some residents are “wheelchair-dependent, one of them was seemingly incoherent”
at Providence Cliff House. He should know that the “wheelchair-dependent”
residents only need assistance sanctioned by the Assisted Living Law. Nursing
homes are much more expensive than Assisted Living Facilities. While some
people who need constant nursing care do need to stay at a nursing home, many
residents currently at nursing homes do not require nursing care. It becomes a
tremendous financial burden to keep those residents at nursing homes. The
residents are better off financially, emotionally, and physically to stay at
Providence Cliff House. The taxpayers are better off to avoid more expensive
and unnecessary skilled nursing bill eventually footed by the taxpayers.
Mr.
Antonellis further misinterprets the law on bathing facilities. 651 CMR
12.04(1)(c) allows exemption to bathing
facility requirements, if an applicant demonstrates a public necessity, a
financial hardship, and an otherwise home-like environment of the facility.
Providence Cliff House labored to apply for a waiver to bathing facilities. In
the first article, Mr. Antonellis accuses Providence Cliff House of having
“bathrooms without shower/tub”.
Mr.
Antonellis also grumbles Providence Cliff House’s application “dragged on for 2
½ years, huge waste”. He should know that Providence Cliff House falls a victim
of the cumbersome and random nature of permitting process. It takes nine month
just to secure a variance to local zoning ordinance to allow Assisted Living
Facility at Providence Cliff House. Providence Cliff House should be lauded for
its perseverance in its pursuit.
Mr.
Antonellis mischaracterization is based on deliberate omission, exaggeration,
generalization, and misinterpretation. Mr.
Herman’s articles have upset staff at Providence Cliff House.
Sandra
Hokom has worked at Providence Cliff House for over 2 years. Sandra is a
certified Home Health Aide (HHA). Sandra points out “I would not be able to,
morally and ethically to work for Providence Cliff House, if this was an
unsafe, uncaring, and unprofessional place for our very special residents, who
deserve and do receive the best care from all of us at Providence Cliff House.”
Roxanne
Valardi is a chef at Providence Cliff House. “I am very disappointed with Peter
Antonellis. I truly feel he should not be in the positions they are in. He is
not truthful in the article. How can anyone trust someone to make decisions who
is not truthful? Especially in the positions he holds.” Roxanne comments.
After
the first article was published, Providence Cliff House owner, Mr. Dejun Xuan,
who shuns publicity, felt compelled to respond. Mr. Xuan invited Mr. Herman to
visit Providence Cliff House, to observe the house operation, and to interview
staff, residents, family members, and people in the local community. Mr. Herman refused categorically. “I do not have time. I have three articles to
write. I can only meet with you somewhere in Boston, like Boston Public
Library. You cannot dictate how I do my work.” Mr. Herman said.
If
Mr. Herman is sincere about a truthful, unbiased, and balanced story about
Providence Cliff House, he should have accepted Dejun Xuan’s invitation and
written a sequel titled “Why not Elder Affairs lets Athol
facility remain open”.
Sincerely
Dejun
Xuan
President
Providence
Cliff House
Athol,
MA 01331
617
733 4412
Note
1: Providence Cliff House has moved out all residents as of January 31, 2015,
while continuing its application to be certified as an Assisted Living Facility
(ALF).
Note
2: Dejun Xuan can be reached at 617 733 4412 and through email at
Dejun_xuan@yahoo.com
If the first comment is too lengthy, the following is an abridged version.
For whatever reason I do not want to speculate, Mr. Antonellis
deliberately misleads through omission, exaggeration, generalization,
and misinterpretation of the law. Mr. Herman’s article quotes Mr. Peter Antonellis extensively. Mr. Peter Antonellis used to be an Inspector for the Executive Office of Elder Affairs of Massachusetts, and was removed from the office in late 2015.
Contrary to Mr. Antonellis’s false allegation, Providence Cliff House is a safe, secure, comfortable, and affordable Assisted Living Facility to be certified by the Commonwealth of Massachusetts. In my following comment, there is an overwhelming collection of facts that counter Mr. Antonellis’s accusation.
Mr. Herman, a reporter of CommonWealth Magazine, fails to live up to the high standard of professional journalism. He made a half-hearted effort to seek my comments without revealing to me what his article entails. Once his article was published, he refused to accept my invitation to visit Providence Cliff House and write an sequel to reflect truths beyond Mr. Antonellis’s mischaracterization.
It was a pity that a former public servant made a self-serving and malicious accusation against a responsible small business run by diligent management and staff with integrity, and a journalist deliberately allowed one-sided story to be published without a through investigation.