This troubled nursing home has most deaths in N.J. But there were problems long before deadly outbreak. – NJ.com

For years, Andover Subacute and Rehabilitation Center in northern Sussex County has been the focus of mounting complaints and enforcement actions over its care of the elderly.

There have been fines, survey reports placing it among the lowest rated nursing homes in the country, and lawsuits. Still, the death toll there seemed to catch many by surprise when the facility became a national focal point over the deadly impact COVID-19 was having on so many places like it.

Today, the 699-bed facility remains under mounting scrutiny ever since the discovery on Easter Sunday of 17 bodies that had been stored in a temporary morgue on site, after the viral outbreak there spun out of control. To date, at least 57 of its residents have died from the coronavirus — the most of any nursing home in the state.

New admissions have been barred. The facility was ordered to retain a new infection control specialist and other key personnel. The Centers for Medicare and Medicaid Services is investigating.

Still, Sussex County Freeholder Anthony Fasano, charing that the state is not doing enough to address the ongoing crisis there, has asked for the National Guard to be sent in to provide “critical protocols, staffing and resources.”

New Jersey Attorney General, Gurbir S. Grewal, meanwhile, is separately looking into what happened at the nursing home, which has hired one of the state’s top lawyers to represent it, former Attorney General Christopher Porrino.

In a statement responding to questions from NJ Advance Media, Chaim “Mutty” Scheinbaum, 37, the CEO of Alliance Healthcare of Lakewood, which owns the facility, said that nursing home patients and their health care professionals nationwide were hit hardest by the coronavirus pandemic. He said Andover was “working with the New Jersey Department of Health to ensure we have the resources necessary to support and protect our residents, health care professionals and staff.”

The state has taken no action to move anyone out. But a review of federal inspection reports, complaints, lawsuits and interviews with families as well as those who worked there, painted a dark picture of a facility beset for years by ownership changes, staffing shortages, struggling even before the COVID-19 crisis to meet the needs of a large and vulnerable population.

“We are still waiting for all the facts as to what allegedly happened at Andover during this pandemic. But, if their prior disregard of the state and federal rules and regulations governing nursing homes is any indication, we should be very concerned,” said Deborah R. Gough, a Hackensack attorney who sued Andover after a resident with dementia was able to walk out in sub-zero weather without anyone noticing.

Located in a mostly rural area of northwestern New Jersey marked by ponds, trees, some golf courses and a few condo developments, Andover Subacute includes two separate buildings. Andover I is a smaller, low-rise facility on one side of Mulford Road in Andover Township. On the other side of the road is Andover II, a larger two-story beige brick complex with a red awning framing the front entry, that is set up for dementia and Alzheimer patients and those with mental health issues.

At the front, an American flag streams at half-staff. Visitors are prohibited and family members can do little more to connect with their loved ones than video chats, or brief conversations by phone with medical staff — when they can get through at all.

Andover Subacute has gone through ownership changes in recent years, while coming under repeated criticism and enforcement actions during that time.

In 2017, then under the management of another company, Andover agreed to pay $888,000 to resolve allegations it provided substandard or worthless nursing services to some patients, federal authorities said. The nursing home allegedly billed New York Medicaid “for materially substandard or worthless nursing services provided to certain patients that failed to meet federal standards of care and federal statutory and regulatory requirements” between July 1, 2010, and Dec. 31, 2012, according to the U.S. Attorney’s Office in New Jersey.

Andover did not admit to any liability, but agreed to settle the case by paying $395,508 to the United States and $492,492 to the state of New York, and entered into a five-year corporate integrity agreement that included a mandate for a committee shall assess the nursing and mental health staffing provided at Andover and make recommendations regarding how to improve such staffing.

That corporate integrity agreement and its strictures remains in place, nursing home officials said.

Those former owners of the facility entered into a sales contract in late 2016 with Skyline Healthcare, a multi-state nursing home chain based in New Jersey headed by Joseph Schwartz, who operated the enterprise out of a second-floor office above a pizza parlor in Wood-Ridge in Bergen County. The deal was expected to close in the first quarter of 2017, officials said at the time. But Skyline subsequently collapsed, as it ran into financial troubles across the nation and failed to make payrolls and meet other financial obligations.

NEW MANAGEMENT

A spokeswoman for Andover said while Skyline had entered into an asset purchase agreement, the deal never closed. Instead, Scheinbaum became the owner of the facility on June 1, 2017, according to the spokeswoman.

The sale came just a day after the settlement with the U.S. Attorney’s office was finalized.

Federal and state records currently list both Scheinbaum through Alliance Healthcare and Louis Schwartz, a former vice president at Skyline Healthcare and the son of Joseph Schwartz, as holding ownership shares. Nursing home officials said Louis is only an investor and has no involvement in the facility’s operations.

In addition to Andover, Scheinbaum owns nursing homes in Pennsauken and Cinnaminson in New Jersey, and two other nursing homes in Pennsylvania, those records show. Under Scheinbaum’s management, however, Andover has continued to rank poorly by the government’s measure.

In its last inspection by the U.S. Centers for Medicare and Medicaid, Andover II was rated just one out of five stars, or “much below average.” Andover I ranked slightly better, with three out of five stars, or average.

Last year Andover received $22.3 million in state Medicaid funding. With a daily Medicaid rate of $206.83 at Andover I, and $192.56 at Andover II, the facility this year to date has so far received $7.9 million in Medicaid payments, according to the state Department of Human Services.

Staffing issues, meanwhile, have repeatedly surfaced in federal inspection reports at Andover.

In 2019,, a state investigation found staff members at Andover II failed to respond to a door alarm after a 76-year-old resident deemed at risk of leaving the building walked out undetected in minus 4-degree temperatures.

In a lawsuit filed last May in Superior Court in Essex County, attorneys for the woman, who suffered from advanced dementia, said the facility failed to provide sufficient staff and services to meet the needs or her and other residents of Andover.

At the same time, the lawsuit alleged and Andover and its management “actively sought residents with similar medical and nursing needs as Thompson in order to fill their empty beds and increase their rate of occupancy and overall revenue.”

The lawsuit alleged that the facility sought to increase its profitability by reducing expenditures needs for staff, training, supervision, supplies and care, and knew that because of poor staffing levels at Andover, the nursing staff could not provide even the minimum standard of care to the weak and vulnerable residents of the facility.

“On one of the coldest nights of the year, she was able to wander outside in the middle of the night, without wearing a coat, socks, or shoes, where she remained for 45 minutes and suffered severe frostbite,” said Gough, her attorney. “Despite the door alarms sounding when she exited the dementia unit, no one responded to the door alarms, no one knew Mrs. Thompson was missing, and no one went looking for her.”

Gough said on that night, the nursing home was again understaffed, leaving the nursing staff on duty in the untenable position of having too many residents to care for without enough help.

“A perfect and preventable storm was brewing because the nursing home also allowed some of the locks on its doors that were meant to keep residents safely inside to remain broken for months,” she said.

Edouard Mezazeme, a nurse supervisor at Andover Subacute from February 2016 until he was fired last year, also complained of staffing issues. In a lawsuit filed in Superior Court in Union County earlier this year, he alleged unsafe understaffing of nurses and certified nursing assistants, “putting patients at risk.”

Mezazeme also claimed that he was promised an increase in pay to $35 from $28.85 hourly, after he was promoted to supervisor, but never received the money. According to the lawsuit, he requested leave under the New Jersey Family Leave Act after his child was born, but was told that “he must return to work because they were understaffed and that his leave was denied.”

A short time later, he said he was terminated.

His lawyer declined comment on the case. But the Centers for Medicaid and Medicare has repeatedly raised issues about staffing levels at the nursing home. At Andover II, CMS records show registered nurses spent on average 16 minutes with individual patients each day. The statewide average is 49 minutes. Overall, it was ranked “below average” for staffing. It ranked much below average in its health inspection rating.

Gough charged that Andover Subacute knew what needed to be done to keep its residents safe, “and simply chose not to do it.”

A spokeswoman for the facility said they could not comment on pending litigation.

In a statement, officials said: “Andover Subacute II has the appropriate level of licensed and qualified staff for normal operations, although the current pandemic has presented recent challenges. Our wonderful team of health care professionals and employees work tirelessly each day to provide the best care possible to the residents in our facility, who we consider to be part of our family.”

The state is now awaiting the findings of an inspection team sent by the Centers for Medicare and Medicaid Services.

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Ted Sherman may be reached at tsherman@njadvancemedia.com.