Princeton Care Center nursing home owners suspended from N.J. Medicaid program by state comptroller

Gail and Ezra Bogner, the operators of the Princeton nursing home that closed abruptly on the Friday before the Labor Day weekend of 2023, have been disqualified from receiving Medicaid funds and will also be prohibited from participating in several other state programs. The suspension, carried out by the Office of the State Comptroller due to the Bogners’ actions at the nursing home, goes into effect on March 28.

The Bogners, the longtime operators of the Princeton Care Center, closed down the Bunn Drive facility on Sept. 1, implementing an emergency evacuation plan that is normally reserved for situations like natural disasters. They only gave residents and their families a few hours notice that they had to find new nursing homes. Chaos then ensued at the facility, the only nursing home in the municipality of Princeton, as families struggled to pack belongings into garbage bags and figure out where to send their distressed loved ones. All 72 residents of the nursing home were moved to new facilities in under 12 hours.

Family members had to make quick decisions about new nursing homes, depriving them of the opportunity to conduct thorough research or visit facilities before making choices. Some residents sat in wheelchairs all day without having their diapers changed. Many were upset or confused and did not want to be separated from their friends or favorite staff members at the nursing home. The facility had a special wing for South Asian residents with dietary restrictions, and many of those residents had to be sent to nursing homes with a similar program about an hour away from Princeton. The last resident of the Princeton Care Center was transported to another nursing home on a bus at about 10:30 p.m. on the night of the closure.

“The Bogners’ recklessness, neglect, and incredibly poor judgment caused serious harm and trauma to the residents of Princeton Care Center,” Acting State Comptroller Kevin Walsh said of the Medicaid suspension Friday. “It presents too serious of a risk to allow them to have influence over any other Medicaid-funded nursing homes.”  

Gail Bogner, who owned the Princeton Care Center business, also owns a 23% share in the Fountain View Care Center in Lakewood, and a 24% share in the Tallwoods Care Center in Bayville, according to public records. Gail Bogner’s son, Ezra Bogner, was the administrator of the Princeton Care Center and has an active state nursing home administrator license that expires June 30, 2026.

Under the state’s Medicaid Program Integrity and Protection Act, the Medicaid Fraud Division of the Office of the State Comptroller can suspend and disqualify New Jersey Medicaid providers, including nursing home operators, when they provide poor quality care, commit fraud, or take other actions that are harmful to residents or the Medicaid program. Medicaid is the primary payer for nursing facility care in the United States. In 2019, Medicaid paid for 62% of long-term care residents in nursing homes, according to the Kaiser Family Foundation. If Medicaid funding is cut off at a facility, in most cases it means the facility won’t be able to operate because it is so dependent on that money.

The Medicaid Fraud Division recently suspended the owners of the former Woodland Behavioral and Nursing Center from receiving Medicaid funds at their other facility, Limecrest Subacute and Rehabilitation Center, because of the owners’ complete failure to protect the health and safety of Woodland’s residents. 

On Nov. 9, the Medicaid Fraud Division sent letters to the Bogners notifying them that the state was seeking to disqualify them from New Jersey Medicaid for their failure to protect the health and safety of residents at the Princeton Care Center.

The Medicaid Fraud Division then notified the Bogners on Dec. 19 that they were suspended from state programs that include Medicaid, Pharmaceutical Assistance for the Aged and Disabled, and any other programs run by the Division of Medical Assistance and Health Services.

“The Bogners were entrusted to maintain a safe environment for New Jersey residents and failed to meet this fundamental responsibility,” Walsh said. “We are taking action to protect other Medicaid recipients and the integrity of the New Jersey Medicaid Program.”  

Gail Bogner must divest from Fountain View Care Center and Tallwoods Care Center by March 28, or the facilities will no longer be eligible for Medicaid funding. It is unclear if Gail Bogner will contest the decision or divest from the two nursing homes. The suspension will remain in effect until any legal proceedings regarding it are resolved.

Planet Princeton reached out to the Bogners and their lawyers for comment Friday morning but did not receive a response as of early Saturday morning.

A timeline of the Princeton Care Center’s final months

The financial situation at the Princeton Care Center had deteriorated so much that in April 2023, the landlord filed a lawsuit in Mercer County Superior Court against the facility for repeatedly failing to pay rent and failing to properly maintain the facility under the terms of the company’s lease. The landlord asked the court to appoint a temporary custodial receiver to protect the safety of residents at the facility and manage its finances. In response, lawyers for Princeton Care Center said the company suffered significant financial losses from 2021 to 2023, but the Bogners were working to fix things. The court denied an initial request for a temporary receiver.

The situation continued to deteriorate regarding finances, and a temporary receiver for the facility was finally appointed in July of 2023. Princeton Care Center owed money to numerous contractors and businesses that supplied the facility with services, food, and medical supplies. Businesses filed lawsuits seeking what they were owed, and at least one was able to freeze some Princeton Care Center bank accounts in August.

The New Jersey Department of Health investigated a complaint about the facility around the same time. State workers were at the facility in June and July. On Aug. 9, 2023, the state issued both an order curtailing admissions at the facility and a corrective action plan that cited 27 deficiencies at the facility.

The Department of Health noted that the Princeton Care Center failed to have the necessary policies and procedures in place to protect residents from abuse, failed to have a system in place for staff members to identify a resident’s code status and follow physicians’ orders in an emergency, failed to follow hemodialysis standards, and failed to provide nursing-related services. The Princeton Care Center also repeatedly failed to have the minimum legally required direct care staffing levels at various points throughout 2022 and 2023.

Princeton Care Center was ordered to hire full-time consultants approved by the Department of Health to implement remedial measures aimed at addressing the violations. Additionally, the facility was required to provide weekly reports to the agency, updating officials on the progress made in resolving the violations.

Citing ongoing litigation between the Princeton Care Center, the landlord, and vendors who serviced the facility, the state issued a notice on August 10 of its intent to suspend Princeton Care Center’s facility license because the facility’s ongoing and significant financial distress imposed an imminent threat to the care of its residents.

Princeton Care Center failed to make payroll as scheduled in August, could not pay vendors for goods and services, and had to buy food from Instacart and Costco to feed residents because its food vendor was owed so much money that the vendor would no longer serve the facility.

The Department of Health warned that if Princeton Care Center did not rectify its financial situation, residents of the facility would be subjected to immediate jeopardy, and imminent harm to their health and safety would likely occur because the facility would not be able to provide its residents with necessary care and services. The state ordered Princeton Care Center to prove it could continue to meet its payroll and operating expenses or face being closed down.

On Aug. 18, the landlord for Princeton Care Center notified the court that Princeton Care Center had entered into a tentative deal to transfer its operation to another long-term care company and had secured funding to meet its operating expenses and payroll. The company, Allaire, was also serving as the temporary receiver for the facility. When the proposed agreement was terminated on Aug. 31, Princeton Care Center had no backup plan to meet its payroll.

Princeton Care Center notified the New Jersey Department of Health on the afternoon of Aug. 31 that it would be evacuating its residents because it could not meet its payroll obligation and claimed that it did not have sufficient funds to pay for its ongoing operations.

On the morning of Sept. 1, residents, family members, staff members, and doctors who had patients at the facility learned that the facility was closing, and residents would have to be moved to other facilities by the end of the day. Some family members said they were being pressured to sign papers granting permission for their family members to be sent to other nursing home facilities operated by Allaire. Many rejected this option because the facilities were located an hour away.

State Department of Health representatives were present at the facility on Sept. 1 to ensure an orderly evacuation of residents. The state did not intervene to prevent the evacuation or compel the facility to close with sufficient advance notice to residents. Princeton Mayor Mark Freda had repeatedly expressed concerns about the precarious situation at the facility and wanted a contingency plan in place in case the facility failed and residents needed to be moved. But whenever he contacted the state, he was reassured that everything was under control.

State law provides that at least 60 days before the proposed date of closing, a nursing home must notify, in writing, a resident of the facility, the resident’s legal representative, and the Department of Health of the closing or relocation of the facility. The law also provides that when a transfer or discharge of a resident on a nonemergency basis is requested by a nursing home, the resident or guardian must be given at least 30 days advance notice of the transfer or discharge. New Jersey appears to have no safety gap measure for taking over a nursing home in a situation like the abrupt closure of Princeton Care Center.

On Sept. 5, the Department of Health notified Princeton Care Center that its long-term care facility license had been voided because the facility had ceased operations.

On Nov. 9, the Medicare Fraud Division issued the Medicare disqualification notice to the Bogners.

On. Dec. 19, the Medicaid Fraud Division notified the Bogners that they were suspended from Medicaid and other state programs effective March 28.

Never again

Staff members from the New Jersey Office of the Long-Term Care Ombudsman were on hand at the Princeton Care Center the day it closed unexpectedly.

“There is no doubt that this abrupt closure traumatized the elderly and disabled residents of this facility,” said New Jersey Long-Term Care Ombudsman Laurie Facciarossa Brewer.

Her staff members followed up with every resident from the Princeton Care Center in the weeks after the facility closed.

“What we found was disturbing. Some transferred residents had an easier time than others adjusting to their new environment,” Facciarossa Brewer said. “All of the residents were confused about what had happened, some wondered if they had done something wrong and others were just frightened and withdrawn.”

Facciarossa Brewer said nursing home residents deserve high-quality care and an environment that promotes their dignity and well-being, but some nursing home owners and operators repeatedly fail their residents, as happened with Princeton Care Center. Facciarossa Brewer commended the ongoing efforts of the Office of the State Comptroller to identify and remove problematic owners from New Jersey’s long-term care system. She said she is pleased to be part of a coordinated effort with the Office of the State Comptroller and the state departments of Health and Human Services to demand accountability from long-term care facilities across New Jersey.

“Everyone agrees that what happened at the Princeton Care Center cannot be allowed to ever happen again in the state of New Jersey,” Facciarossa Brewer said.

Struggle ongoing for former Princeton Care Center residents, families, and staff members

Former Princeton Care Center residents and their families initially had to deal with the trauma of moving to new, unfamiliar facilities. Some elders failed to thrive in their new environments, and at least two former Princeton Care Center residents who were moved to new nursing homes have died.

Some families then faced hurdles in getting medical records and medication lists, and Princeton Care Center residents’ personal needs spending accounts could not be accessed after the move. Social security payments went to the Princeton Care Center for September and still have not been recovered more than four months after the facility’s closure, families said.

Staff members from the Princeton Care Center also said they have still not been paid for their final weeks of work.

Princeton resident Lisa Ferguson, whose mother was a resident at Princeton Care Center, was thrilled when she was told Friday about the state comptroller’s action against the Bogners. She praised the comptroller’s office but said she wishes other agencies would also take action to help residents and their families and that more actions had been taken sooner. Some families have consulted with a lawyer and are considering suing the Bogners for what happened.

“There’s still more work that needs to be done to recover residents’ social security money and personal needs accounts, but this action by the comptroller is a good first step,” Ferguson said. “We wish the state Department of Health would release a report about what happened that even allowed this incident to unfold. There should also be an external review of how the Department of Health allowed this to happen.”

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