SentosaCare, LLC is New York state's largest for-profit nursing home network, with at least 25 facilities and nearly 5,400 beds. Its affiliated nursing homes have had a record of repeat fines, violations and complaints for deficient care in recent years.
Despite that record, SentosaCare founder Benjamin Landa, partner Bent Philipson and family members have been able to expand their nursing home ownerships in New York, easily clearing regulatory reviews meant to be a check on repeat offenders.
That unhindered expansion highlights the continued weakness of nursing home oversight in New York, an investigation by ProPublica found, and exposes gaps in the state's system for vetting parties who apply to buy shares in homes.
State law requires a "character-and-competence" review of buyers before a change in ownership can go through. To pass muster, other health care facilities associated with the buyers must have a record of high-quality care.
The decision-maker in these deals is the state's Public Health and Health Planning Council, a body of appointed officials, many from inside the healthcare industry. The council has substantial leverage to press nursing home applicants to improve quality, but an examination of dozens of transactions in recent years show that power is seldom used.
Moreover, records show that the council has not always had complete information about all the violations and fines at nursing homes owned by or affiliated with applicants it reviewed. That is because the Department of Health, which prepares character-and-competence recommendations for the council, does not report them all.
"The law establishes mechanisms for at least a moderate review of an applicant's character and competence," said Richard Mollot, director of the Long Term Care Community Coalition in New York. "The failure to provide complete information on a provider's past performance fundamentally undermines the review process."
Mollot's group published a recent report saying the Health Department has one of the nation's lowest rates of citing nursing home operators for deficiencies in care. New York is also among a minority of states that don't mandate minimum staffing ratios, even though research shows a strong link between nursing staff and residents' well-being.
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