NEAL P. GOSWAMI
BENNINGTON -- A male nurse is alleged to have punched a resident of the Vermont Veterans Home in the nose on Sept. 11, leading to a deficiency that requires corrective action ahead of a Sept. 28 deadline to achieve compliance with federal regulations or face the loss of about $12 million in Medicare and Medicaid funding.
The state-run home is under intense pressure to correct at least three deficiencies, including the alleged assault, which have been identified by the state Division of Licensing and Protection. The division serves as an agent for the Centers for Medicare and Medicaid Services (CMS).
The alleged assault occurred the day before the board of trustees met to discuss the potential loss of federal funding, which accounts for more than half of the home's revenue. The board revealed last week that the home faces federal decertification because of issues identified during several inspections since March. If federal funding is cut, the home would likely lose all of its Medicare- and Medicaid-funded residents. That would drop the census from about 155 residents to about 50.
CMS has already cut funding for new Medicare or Medicaid residents. Cutting off funds for existing residents could be a debilitating step, officials said.
Bennington Police Chief Paul Doucette said the nurse, Bennington resident Mark Demasi, 58, has been cited to appear in Bennington Superior Court Criminal Division on Oct. 1 for a misdemeanor charge of simple assault. Any other charge will be determined by the Bennington County State's Attorney's Office, he said.
New board President Joseph L. Krawczyk Jr. -- selected for the role at the Sept. 12 meeting -- called the alleged assault a "very serious" matter, and said the board and administrators at the home are working to resolve it.
"We had an individual veteran, an older fella, who on the evening of the 11th, in my words, was real disruptive. A number of nurses tried to calm him down. A male nurse went in and the veteran slugged the guy in the groin. The nurse turned around and slugged the veteran in the face. That's unacceptable. It is a violation of all our things. He's been charged with assault. The nurse was removed immediately from the facility. The veteran was taken to the hospital for examination," Krawczyk told reporters on Thursday.
Demasi is a member of the Vermont State Employees Association, so the incident must be handled according to the union's labor contract, Krawczyk said. "We'll have to take a look at what the union contract says, because it is a union employee -- what we can do and what we can't do. We're in the process of doing that," he said.
VSEA officials did not return messages seeking comment.
The union has faulted Veterans Home Administrator Melissa Jackson and the administrative staff for creating a schedule that is understaffed and leaves nurses overworked. Jackson said Thursday that the alleged assault was not the result of an overworked employee.
"There was no hiding this. It's an employee who has been in very good standing with us. Despite rumors in the building, he has not been working an exorbitant amount of hours. He works very little overtime," she said.
The deficiencies identified by CMS since March include failure of medical staff to report a change in medical condition to a physician, improperly dressing a wound and abuse of a resident.
According to the CMS report on the assault, following a clinical review, staff interviews, observations and review of the home's abuse prevention policy, CMS determined that "the facility failed to prevent staff to resident physical abuse ." The facility also failed to create a comprehensive plan of care that accurately reflected the resident's behavior history, according to the report.
Meanwhile, the board of trustees met again on Thursday morning for a personnel issue. Following an executive session, the board voted 11 to 1 to approve an action recommended by Jackson. The action was not specified, but is expected to be made public this morning after a notification time period expires at 9 a.m., according to Krawczyk. He said Thursday's action was "not a direct connection" to the alleged assault by Demasi.
"This is based on what we're seeing as we have folks coming in here and assisting us," Krawczyk said. "We want to make sure that this place functions at the highest level possible. We've identified some shortcomings that we feel that we have to take action on now."
The action approved by the board on Thursday "may have occurred even without decertification hanging over our head," Krawczyk said.
The Veterans Home has already received a termination letter from CMS. However, Jackson said it is likely CMS will allow for one more inspection of the facility before the Sept. 28 deadline. CMS would "never promise that," Jackson said, but officials have been led to believe that one more inspection will take place.
Krawczyk said the state's congressional delegation, as well as the administration of Vermont Gov. Peter Shumlin and local lawmakers are working on the home's behalf.
Bennington County Sen. Dick Sears, a member of the Joint Fiscal Committee, said the Veterans Home was a topic of discussion during a Committee meeting on Tuesday. Most members were just learning the extent of the problem, Sears said.
"I think that most of the committee had no idea. I suspect it was somewhat of a surprise to some. I think the committee expressed concern, but also recognized that we would be hard-pressed to come up with $11 million to fund the veterans home if the funds were lost, if CMS decertifies the vets home," he said.
Still, administration officials have indicated support for short-term state funding if CMS cuts federal money, according to Sears. He said Secretary of Administration Jeb Spaulding and Commissioner of Finance James Reardon both indicated that the state may be able to fund the home in the short-term while seeking expedited recertification.
"Nobody wants to see the Veterans Home have to lose 100 people and have 100 vets looking for alternative places," Sears said.
If federal funding is lost, lawmakers could use the annual budget adjustment bill to cover some of the costs in the short-term, while expedited recertification is sought, Sears said. "I think that that's something that is certainly doable and would be worth a try," he said.
Administrators and staff are continuing to address problems to avoid losing funding. A "Rosie the Riveter" poster was hanging Thursday in a common room with a message below it: "We are family." Jackson said the staff is committed to turning things around.
"The staff here is very dedicated and continues to provide quality care. We have hit a series of unfortunate events that have just kind of snowballed into where we are today. But, the staff continues to be great. The staff is insanely dedicated to correcting this. I mean, I hear it all day every day," she said.