Focus officials face felony charges for nursing home neglect

Reduced staffing, pay cuts and disregarded warnings were among factors contributing to unsafe conditions when the Focus company managed the nursing home in the town of Otsego, according to a felony complaint charging the facility's former operators.

The state Attorney General's Office has filed multiple felony counts, including welfare endangerment, against Joseph Zupnik, Daniel Herman and CCRN Operator LLC, doing business as Focus Rehabilitation and Nursing Center at Otsego, the complaint filed in Otsego Town Court said.

Defendants were arraigned May 31 before Judge Gary Kuch and the next court date was set for July 18, officials said.

The case revisits issues about patient care provided by the previous owner of the nursing home off of state Route 28.

On Jan. 19, Centers Health Care announced it had taken over the local 174-bed facility, which now is known as Cooperstown Center for Rehabilitation and Nursing.

Centers Health Care isn't mentioned in the complaint, and Centers officials had no comment Thursday on the current court case.

Otsego County had owned and operated the nursing home before selling it in 2014 to Focus for $18.5 million.

Focus cut the staff of the nursing home from 298 to 225 employees, and patient-care and regulatory issues beleaguered the facility, which was put on probation by the federal Centers for Medicare and Medicaid Services in late 2016.

Zupnik was the 99-percent owner of CCRN, the corporation that held the ownership certificate for Focus Otsego from Oct. 14, 2014, to December 2017, the Attorney General's Office said, and Herman was a high-level manager at CCRN.

"Upon taking ownership and control of the home's operations in October 2014, Zupnik, Herman and CCRN cut staff payroll, cut staffing, and cut other necessary services and supplies needed to provide safe and adequate care to over 200 individual residents who were in the care of Focus through at least November 29, 2016, when Focus was designated as a Special Focus Facility by the Centers for Medicare & Medicaid Services," the complaint dated May 24 said.

Defendants had received but disregarded many communications from senior staff "that residents were at risk for harm," plus warnings from outside sources, according to the Attorney General's Office.

Charges under penal law against each defendant were three counts of first-degree endangering the welfare of an incompetent or physically disabled person, a class E felony, and two counts of second-degree endangering the welfare of an incompetent or physically disabled person, a class A misdemeanor.

Each defendant also was charged under state Public Health Law with three counts of willful violation of health laws, an unclassified misdemeanor.

"These are just allegations," Richard S. Harrow, attorney for Zupnik and the corporation, said Thursday. "We're working with the Attorney General's Office."

Jerry Solomon, attorney for Herman, echoed that discussions are underway with that office and said materials are being reviewed.

Zupnik, 36, of Spring Valley, and Herman, 41, of Teaneck, New Jersey, were processed before their arraignment by the Otsego County Sheriff's Office on behalf of the Attorney General's Office.

A call Thursday afternoon to the Attorney General's Office wasn't returned by 8 p.m.

According to the felony complaint, various counts pertain to care of the residents at Focus altogether and to two specific cases, involving patients "R.B." and "M.P."

The Attorney General's Office alleged that to cut payroll, staffing and other expenditures, Zupnik and Herman prohibited the administrators and directors of nursing to assign adequate staff to each shift. As a result, there weren't enough workers to provide adequate care and services to residents or sufficient supervision to ensure that the nursing staff provided adequate care.

However, Focus administrators, directors of nursing and senior licensed professional managers repeatedly requested more staff to be scheduled and warned that low wages and onerous working conditions were preventing them from filling staff vacancies and creating risks to residents, the Attorney General's Office said in the complaint.

Zupnik and Herman also diverted state Medicaid Program funds to benefit residents and "paid such funds for their own benefit through companies they owned or controlled," the complaint said.

According to the complaint, the defendants disregarded warnings including:

State Department of Health inspection surveys and reports that Focus was in "immediate jeopardy" status in July 2015 and June 2016. "Immediate jeopardy" is the highest level category of deficiency.

Warnings from senior managers about the impact of defendants' 50 percent cuts in payroll level and cuts in staffing levels.

About many incidents and accidents at the facility, including those documented in internal reports that illustrated abuse, mistreatment and neglect of residents.

Repeated communications from administrators and nursing directors that supervisors couldn't find enough willing staffers to work shifts because pay cuts and onerous double-shift requirements imposed by defendants.

Seven arrests were made of Focus staff and one of a Focus resident for crimes at the facility involving health care offenses, including neglect cases of residents "R.B." and "M.P.," in incidents between May 2015 and through August 2016.

In one case, about June 17, 2015, "R.B.," a 91-year-old man who had a documented medical history of falls, was admitted for rehabilitation after hip surgery. He didn't received a necessary fall assessment and as a result fall-prevention measures weren't in place.

On June 18, 2015, he was found on the floor by his bed, the court papers said. His condition deteriorated and he was taken to a hospital emergency room. He was diagnosed with a subdural hematoma, the complaint said. He died at the hospital about June 24, 2015.

In a 2016 case, a 94-year-old woman, "M.P.," was left in a recliner for nearly 41 hours between May 28 and May 30. During that time, staff didn't provide her with required care, feeding and other services, the complaint said, and she developed a pressure sore. Four staff members accused of neglecting her were convicted by guilty pleas and admitted to facts of the crimes arising from the lack of care for and falsification of records about "M.P."

Denise Richardson, staff writer, may be reached at drichardson@thedailystar.com or 441-7213. Follow her at @DS_DeniseR on Twitter.