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Karmenta Center

The 105-bed Karmenta Center on Madison’s East Side, the third-largest of Dane County’s 18 nursing homes, closed last week. It's the 11th nursing home in Wisconsin to close or announce a closure this year and among 30 to shut down since 2016, according to LeadingAge Wisconsin, which represents nursing homes.

Karmenta Center on Madison’s East Side, the third-largest of Dane County’s 18 nursing homes, closed last week, state officials confirmed Wednesday.

The 105-bed facility at 4502 Milwaukee St. is the 11th nursing home in Wisconsin to close or announce a closure this year and among 30 to shut down since 2016, according to LeadingAge Wisconsin, which represents nursing homes.

An additional 27 of the state’s 350 or so nursing homes are in receivership, a process similar to bankruptcy.

Low Medicaid payments and a shortage of qualified workers, along with a shift in demand from nursing homes to assisted-living facilities, are key factors in the closures and financial problems statewide, said John Sauer, president of LeadingAge.

“If we keep going the way we’re going, there will be a significant access issue to quality nursing facilities,” Sauer said.

He said he didn’t know why Karmenta, which is not a member of LeadingAge, closed. Paul Kenyon, Karmenta’s director, didn’t return a message seeking comment Wednesday. A letter sent earlier this year by Karmenta to residents and family members affected by the closure didn’t provide a reason.

“This has been a difficult decision as Karmenta Center has remained a center-point of senior care and employment for the community of Madison, WI for several decades,” said the letter, sent in February by John Noffsinger, chief operating officer.

Karmenta, which had a higher-than-average proportion of residents on Medicaid, the state-federal health program for the poor and disabled, lost $1.4 million from Medicaid from July 2017 to June 2018, according to a report by LeadingAge and the Wisconsin Health Care Association, which also represents nursing homes. Statewide, nursing homes lost $325 million from Medicaid that year, the report said.

Karmenta also received numerous citations from regulators in recent years.

51 citations

In 2016, when the average nursing home in Wisconsin and in the U.S. had eight citations, Karmenta received 51, according to the federal Centers for Medicare and Medicaid Services.

Two of the 51 citations were immediate jeopardy violations, the most serious kind. They involved poor treatment of bed sores and not informing residents, their doctors or their loved ones about situations affecting residents.

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In September 2017, the federal Medicare agency fined Karmenta $48,600 for improper treatment of bed sores that year.

In March 2018, the agency said payments for new admissions at Karmenta would be denied starting the following month, also because of concerns about bed sores.

This February, Karmenta told the state Department of Health Services it planned to close and discharge its remaining 26 residents. The last residents left May 1, and the facility closed May 2, health department spokeswoman Jennifer Miller said.

Dane County has 17 other nursing homes, including 187-bed SSM Health St. Mary’s Health Care Center on Madison’s Southwest Side and 120-bed, county-run Badger Prairie Health Care Center in Verona.

Attic Angel Community on Madison’s West Side closed its 44-bed nursing home in January after converting it to assisted living, a move the provider announced in 2017.

Appeal for funds

LeadingAge Wisconsin and the Wisconsin Health Care Association are calling for $83 million in additional state funding to boost Medicaid payments and help facilities hire staff, about four times the amount of a 2.5% increase proposed in Democratic Gov. Tony Evers’ budget, Sauer said.

The budget’s 2.5% increase could depend on expanding Medicaid, which would bring in more federal money. Leaders of the Republican-controlled Legislature have said they don’t support Medicaid expansion.

State officials have previously said reports by the nursing home groups overstate losses from Medicaid and don’t fully account for the facilities’ administrative costs.

But Sauer said more funding is needed because the state’s aging population will continue to need nursing homes.

“For us to sustain those nursing home operations, we need to pay a fair rate that’s more reflective of the cost of care,” he said.

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