In the month leading up to the demise of the Princeton Care Center, the only long-term care facility in Princeton, Mayor Mark Freda, and other local officials raised concerns about whether the state was properly prepared for the potential closure of the facility, according to emails obtained by Planet Princeton.
The state first contacted Freda and members of the New Jersey Legislature about the financial situation at the Princeton Care Center at 2:30 p.m. on Aug. 4, inviting elected officials to a brief call via Microsoft Teams at 4 p.m. the same day.
“We recognize this is short notice, but want to ensure you are aware of the situation,” wrote Rosie Driscoll, the director of policy, legislative services, and constituent relations for the New Jersey Department of Health.
A follow-up call was scheduled for Aug. 10 at 1:30 p.m. After the call, Freda highlighted several areas where he thought the state should take immediate action, according to emails. Freda said the New Jersey Department of Health should share with local officials how many other nursing home operators had been contacted about taking over the Princeton Care Center, and who was still left to talk to about the possibility. He also said the Department of Health should be calling other facilities to see what beds were available and what transport capabilities they had. He also said the Department of Health should provide a plan from EMS Task Force leadership on how to handle the situation. “No such details provided so far,” Freda wrote.
“DOH should identify for us from where they will pull in staff replacements as current staff walk out,” Freda wrote. “DOH should provide what other resources they are anticipating when they say other departments with the State will help us. Who, and with what?”
Health Officer Jeff Grosser agreed with Freda’s concerns in an email later that day and raised concerns about the fact that the nursing home’s emergency plan stated that the facility would contract with a transport service to evacuate residents.
“Clearly this won’t happen with the current financial situation,” Grosser wrote. “The operator is also expected to do a lot of what is listed..I agree, DOH should be handling these items.”
Grosser said the concerns listed by Freda needed to be addressed by the state to figure out what would happen next. “Particularly with providing enough time to execute such a move (along with what resources the State can provide),” Grosser wrote. “Is it worth getting these over to the NJDOH Commissioner’s office to get clarity?”
According to Grosser’s email, the New Jersey Department of Health was advising managed care organizers not to begin calling families about a potential closure of the facility. “NJDOH should utilize MCOs to begin consulting with families of those in PCC on where they can possibly be relocated since this must happen before ambulances are mobilized anyway,” Grosser wrote. “This is a timely process and should be started immediately due to the potential closure.”
Michael Yeh, the director of the municipality’s emergency services department, said the town didn’t need to compel the Department of Health to work with local officials to manage the situation. “They should lead and we can support them locally and county-wise,” Yeh wrote. “They should be keeping us updated on things.”
Freda asked Yeh for Princeton Care Center’s updated emergency evacuation plan. The plan on file with the municipality appeared to be out of date, Freda noted.
“I had never received a copy of their plan, but it seems it’s not helpful in any case,” Yeh wrote, adding that the issue was “Department of Health centered” and that the Department of Health should take the lead to determine when and if the facility was closed down.
“I would also compel DOH to work with Local OEM (Office of Emergency Management) to address occupants that can’t be cared for,” Yeh wrote. “We can work with the County OEM for other resources to move if emergent, but as already mentioned, what facilities are going to receive these occupants, and what financial agreements or DOH coverage will be provided?”
Instead of having a plan in place to supplement staff and ensure a smooth transition, the state allowed the facility to implement its emergency evacuation plan on Sept. 1 and transfer all the residents with less than 12 hours’ notice. But the emergency evacuation plan on file with the municipality called for a different procedure than the one that was followed by the Princeton Care Center on the Day of its abrupt closure.
Details of the Princeton Care Center emergency disaster plan
The Princeton Care Center was required to submit an emergency disaster plan to Mercer County every year. The latest plan the county had on file looked like it was copied and pasted together from various years, local officials have noted. Some pages had 2023 dates on them, while others had 2021 or 2020 dates on them. The plan was meant to go into effect for “natural disasters, technological disasters, national security concerns, or civil disorders.” An Aug. 4, 2023 list of residents was included in the plan.
Under the emergency disaster plan, in the event of an emergency evacuation residents were supposed to be transferred to one of three nearby nursing homes: Merwick Care and Rehabilitation at 100 Plainsboro Road in Plainsboro, Clover Meadows Health and Rehabilitation at 112 Franklin Road in Lawrence, and Spring Hill Acute Care of Princeton at 5000 Windrow Drive in Plainsboro. The emergency plan included transfer agreements with all three facilities that were signed in late 2021 and early 2022.
According to the emergency plan, Princeton Care Center had a transport agreement with Able Medical Transport in the event that an emergency evacuation was necessary. “Additional vehicles may be secured with the help of our local or county OEM,” reads the emergency plan.
Instead, residents and their families were asked to consent to the residents being taken to one of five long-term care facilities run by Allaire, the company whose leader was chosen as an interim receiver and was slated to take over the facility.
Payroll and other financial issues
In early August, Princeton Care Center had trouble making payroll and paid people a day late. The owners of the facility hadn’t paid rent to the landlord for the Bunn Drive property since February and owned various vendors hundreds of thousands of dollars each for items like medical supplies, medical tests, food, and physical therapy.
On Aug. 11, the state gave Princeton Care Center a notice of the state’s intent to suspend the company’s license to operate the nursing home, according to the emails obtained by Planet Princeton. But then on Aug. 12, the Department of Health told officials in an email that a deal had been reached to appoint a receiver, and the deal would be presented to a judge the following week.
“The court confirmed that they had received notice that the parties had come to an agreement on issues but the court had not received the recommendation for the receiver yet,” Driscoll wrote. “We are hopeful that this is all accurate and this happens on Monday. Deputy Commissioner Ford has also communicated with the Long Term Care Ombudsman, whose team members were onsite Friday and did not encounter any quality of care issues.”
According to the Aug. 12 email, the assistant commissioner of the New Jersey Department of Health’s Facility Survey and Field Operations and the director of the Office of LTC Resiliency also met with the Office of Emergency Medical Services. “NJDOH has a plan in place in the event that residents need to be transferred on Monday, but that seems much less likely to occur at this time,” reads the email from Driscoll. “Unless we are aware of any changes with the receivership or care issues identified at the facility occurring over the weekend, we will update the group again on Monday.”
Freda followed up and sent emails on Aug. 15 and Aug. 17 asking for an update. “Good morning. Checking in again,” Freda wrote. In response, on Aug. 17, Driscoll gave an update from the New Jersey Department of Health to local and state elected officials.
“On Monday, NJDOH was in contact with the licensed operator regarding a response to the Notice of Intent to Suspend,” Driscoll said. “The Administrator responded that the facility’s ‘lawyer spoke to the Landlord’s lawyer over the weekend and was told that the Landlord expected to finalize the appointment of the receiver [on Monday].’ He further stated that the expectation is that the receiver will cover payroll and other operational costs.”
According to the Aug. 17 email, there was a delay in finalizing contracts with the receiver due to the complexity of the transaction.
“The Survey Team as well as a representative from the Mission Critical Team remain on site. No quality of care issues have been noted,” reads the email from Driscoll. “At this time, we believe that the outreach from the licensed operator and the attorney for the landlord provides enough information to hold off on issuing the Summary Suspension of the license. We are still holding steady and will keep you updated when more information is available.”
On Aug. 18, Freda reached out to the state again to check in and make sure everything at the nursing home was stable. “Just checking in that the feeling is still that the situation is stable enough so there are not many worries about another weekend going by without this being resolved,” Freda wrote. “Someone has the pulse of the workers there?”
On Aug. 21, Driscoll wrote that the state received a signed binding letter of intent between the landlord, the owner, and the receiver and temporary manager, Ben Kurland of Allaire Health Services.
“We also received a copy of the wire transferring the amount due for payroll to the payroll account. The wire transfer has gone through and payroll was made,” reads the email from Driscoll. “At this time, NJDOH continues to hold steady. The Survey team and the Mission Critical staff have both reported back that the building and residents continue to remain in good condition, and staff do not seem to be aware of any payroll concerns.”
On Aug. 25, Driscoll wrote that state health officials were concerned about the situation at the nursing home, but were still in a holding pattern.
“As you will recall, the facility was supposed to have a manager in place by 8/23/2023. As of today, the landlord does not have the final agreements signed with Ben Kurland to take over the facility. DOH has been informed by the landlord’s attorney that they are trying to complete the agreements and have Mr. Kurland in place by Friday. The administrator believes that Mr. Kurland will be on site tomorrow,” reads the Aug. 25 email.
“DOH was also contacted by the 1199J Union representing CNAs, dietary, and housekeeping. They are aware of the pending manager and they are communicating with the pending manager regarding any outstanding debts to the union,” Driscoll wrote. “We have asked for assurances that payroll will be made next week. Survey is on site and reports that the care, services and food are all status quo. No issues. We are concerned with the lack of a deal at this point, but continue to hold steady.”
The abrupt closure of Princeton Care Center
At 11:05 a.m. on Sept. 1, Driscoll wrote an email to elected officials informing them that the New Jersey Department of Health had received an update regarding the Princeton Care Center that “represents a significant change to the owner’s previous plans.”
“Late yesterday afternoon, NJDOH was informed that the negotiation talks between the potential new operator, Princeton Care Center’s current administrator/owner, and the landlord have broken down, and the Letter of Intent has been rescinded,” Driscoll wrote. “Further, the Administrator notified NJDOH that payroll was not made, despite informing us earlier yesterday that payroll would be made.”
Driscoll wrote that at 11 p.m. Thursday, the Department of Health was informed by the Princeton Care Center that they were enacting their emergency plan to relocate all residents.
“They are coordinating with a long-term care system that is bringing in staff and transportation to support PCC in relocation of residents,” wrote Driscoll, who did not identify Kurland’s company Allaire as the long-term care system transporting and relocating some of the residents to their facilities in her email.
“This is a temporary relocation, and we have informed the Administrator that they must notify residents’ families. The Administrator has already identified facilities to which residents will be relocated,” Driscoll wrote. “Please note that NJDOH has not revoked the facility’s license or asked the facility to enact its emergency plan. However, facilities are required to provide notification to the department if they enact an emergency plan.”
Driscoll wrote that managed care organizers would follow up with the residents early the next week to determine the resident’s choice for a permanent new home.
“We have been assured that they have sufficient transportation for relocation. However, NJDOH will also notify the local OEM and EMS Task Force, should that change,” Driscoll wrote. ” Plans to staff the facility through 11 p.m. today have been shared with us, and the Administrator is working on a staffing plan for shifts after 11 p.m. today. We have communicated with the union, 1199J, and will check in again with them today.”
According to Driscoll, the state’s role at the time was to make sure residents were safe.
“NJDOH survey staff are onsite to ensure resident safety, and a staff member from our Mission Critical team who is an experienced nursing home administrator is in the building to assist as needed,” Driscoll wrote. “At this time, residents and their families and PCC employees should contact the operator/facility with any questions/information. A follow-up email will be provided with information on how to triage calls if you receive contact from families/residents/staff who are not able to get in touch with the operator.”
For families and residents, the day was full of trauma and chaos, with many families and doctors who provided care to residents learning of the closure from residents themselves. Local officials said the last resident was put on a bus and transferred to another facility at 11:30 p.m.