Hacienda agrees to oversight by state
Move allows troubled facility to remain open
One day after Hacienda HealthCare announced it would close its intermediate-care facility where a patient was raped, the state has stepped in to keep it open.
“Given the high medical risks associated with transferring these patients, moving this medically fragile community is the option of last resort and not the state’s goal,” says a joint statement from the Arizona Department of Economic Security and the state’s Medicaid program.
Officials with those two state agencies on Friday pushed back on Hacienda’s announcement that it would close the 60-bed facility at 1402 E. South Mountain Ave. and instead gave the nonprofit entity an ultimatum: Bring in a third-party manager or allow the state health department to assume licensing authority. Hacienda had until 4 p.m. to respond.
Hacienda HealthCare chose the latter, allowing the Arizona Department
of Health Services to assume licensing authority over Hacienda’s intermediate-care facility for people with intellectual disabilities, though state officials stressed that an agreement between the two entities still needs to be reached.
Allowing the state to have that authority gives it more oversight over the operations, said Heidi Capriotti, a spokeswoman for the Arizona Health Care Cost Containment System, which is the state’s Medicaid program.
The facility is not currently licensed by the state due to a 1997 Arizona law that exempts intermediate-care facilities from state licensing. Two Arizona senators introduced a bill this session to remove that exemption after the news about Hacienda came to light.
The patient who was raped is a 29year-old member of the San Carlos Apache Tribe who has a seizure disorder and is described in court documents as being non-verbal, incapacitated and needing a “maximum level of care.”
On Dec. 29, the patient gave birth to a boy as staff from the facility called 911 and indicated they had not known she was pregnant.
On Jan. 23, one of her caregivers at Hacienda was arrested. Licensed practical nurse Nathan Sutherland, 36, has been charged with one count of sexual assault and one count of vulnerable-adult abuse.
The state’s numerous directives to Hacienda over the last month have been “often rushed and onerous,” Hacienda board President Thomas R. Pomeroy wrote to AHCCCS and DES in a letter dated Friday.
In light of the state’s demands on Hacienda, “we appreciate you telling us that the state did not intend to close down” the intermediate-care facility, Pomeroy wrote.
“We could not agree more that the safety and well-being of our residents are of paramount priority and that we should collectively work to ensure that our residents and their families have maximum flexibility in choosing where they reside.”
Among improvements made at the facility, Pomeroy wrote that Hacienda has retained three armed off-duty police officers 24 hours per day, seven days per week, and has installed 30 internal cameras to capture all common areas and entrances and exits from the building.
In addition, Hacienda is continuing with 15-minute checks on all patient rooms, and is in the process of retaining a director of security, Pomeroy wrote.
“This is good news and the best immediate outcome as it means Hacienda patients and families would be allowed to say in the home they’ve known for years while ensuring new and enhanced protections and oversight are put in place,” Patrick Ptak, a spokesman for Gov. Doug Ducey, said in a released statement.
“Due to the medically fragile condition of this community, keeping patients where they reside was always our preferred choice and the safest option for patients.
“Our agencies will continue to work with Hacienda to implement a voluntary regulatory agreement with strong oversight and accountability measures that ensure safety and quality care going forward for patients.”
Ducey on Tuesday called on Arizona Attorney General Mark Brnovich to investigate patient care, financial fraud and sexual-harassment claims at Hacienda HealthCare. In the letter, Ducey wrote that Hacienda HealthCare’s “lack of cooperation with the state to assure the care of this vulnerable population is concerning and must be addressed.”
Hacienda had been ordered to install a third-party manager, and for a few days Benchmark Human Services of Indiana was on site and assumed operating authority. But Benchmark and Hacienda did not reach an agreement, and by the end of the week the Indiana company left Hacienda. Benchmark confirmed with The Arizona Republic on Wednesday that it would not be returning to Hacienda.
A statement from the Arizona Department of Health Services said an agreement between Hacienda and the state health department “will ensure the ongoing safety of the residents at Hacienda.” The state health department says it is asking Hacienda to:
❚ Contract with a third-party healthcare consultant to evaluate operational practices and oversee the operations of the facilities until state health officials determine the facility is in compliance.
❚ Employ an on-site evaluator for the intermediate-care and skilled-nursing facilities to ensure necessary changes are implemented and to monitor accountability to ensure health and safety.
❚ Identify an independent review team to assess the level of acuity and care required for the residents.
❚ Within 90 days, develop a longterm plan and timeline for the facility and its operations that prioritizes health and safety.