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Company that runs 13 Upstate nursing homes beset by financial woes

Anderson Independent-Mail - 12/30/2017

Dec. 30--Orianna Health Systems, a Tennessee-based company that operates 13 nursing homes in Anderson, Pickens and Greenville counties, is facing financial problems.

Orianna, which manages more Upstate nursing homes than any other company, has fallen behind on lease payments for its facilities to Omega Health Investors, a Maryland-based healthcare real estate investment trust.

"We are in active discussions with Orianna regarding the transition of some or all of their remaining portfolio to new operators," said Taylor Pickett, Omega's CEO, in an Oct. 30 earnings statement.

Since 2014, Pickett said, the occupancy rate at Orianna's facilities has declined from 92 percent to 89 percent and expenses have grown by 6 percent while revenues increased only 2 percent.

"We believe that for some of the Orianna facilities new operators may be able to improve occupancy and reduce expenses; however, based on current facility performance, we anticipate that the current annual contractual rent of $46 million will likely be reduced to a range of $32 million to $38 million once the transition process is complete." Pickett said. "The transition timing is expected to take approximately six months."

As recently as July, Orianna was operating 48 skilled nursing facilities with 5,000 total beds in 11 states, according to the company's website. The latest version of the website says the company is now managing 43 skilled nursing facilities with a total of 4,500 beds in seven states. The company's website no longer includes previously listed facilities in Idaho, Oregon, Utah and Washington.

Orianna's former president and CEO, Craig Robinson, and former Chief Operating Officer Jennifer Botter are no longer listed on the company's website.

"Orianna is privately owned and does not comment on its financial situation or strategic plans," said Mikki Meer, the company's current chief operating officer, in an email responding to questions from the Indepedendent Mail.

"Orianna, like its industry peers, is facing a challenging regulatory and reimbursement environment, but remains committed to providing quality care to all its residents," Meer wrote. "The Orianna team looks forward to caring for the needs of the Upstate community for many years to come."

The Independent Mail took a close look at the company and its Upstate facilities during an eight-month investigation into Upstate nursing homes. A series of stories, "A Question of Care," was published earlier this year outlining the results of this investigation.

More: A question of care

As part of an investigation into nursing home care in the Upstate, the Independent Mail reviewed data from 88 inspections, 31 lawsuits and 65 police reports since 2011 involving the facilities now run by Orianna. This review found:

* Nine of Orianna's homes agreed to pay $4.46 million to settle lawsuits involving the deaths of 20 residents. That total includes three settlements adding up to $752,500 that were approved after last year's name changes.

* Inspectors found at least 525 deficiencies at the company's Upstate nursing homes, according to the Centers for Medicare & Medicaid Services. The deficiencies included instances of neglect, possible cases of abuse that were not investigated and medication errors, as well as failures to eliminate hazards, properly prepare meals and treat residents with dignity. The most dangerous deficiencies resulted in 26 fines totaling nearly $495,000.

* The company's nursing homes were responsible for 47 percent of the inspection-related deficiencies and 49 percent of fines at Upstate nursing homes. Orianna's facilities account for 38 percent of the overall nursing home beds in the region.

Last year, Greenville Health System sold one of the Upstate's mostly highly regarded nursing homes, The Cottages at Brushy Creek in Greer, to Orianna for $10.1 million. The facility now is known as Brushy Creek Rehabilitation and Healthcare Center.

The Centers for Medicare & Medicaid Services' ratings for Brushy Creek Rehabilitation and Healthcare Center declined after an inspection in late November 2016 that was the first inspection conducted since Orianna took over the facility.

The nursing's home overall rating, staffing rating and quality measures rating went from much above average to above average. Its health rating was lowered from above average to average.

Six deficiencies were documented during the inspection, twice the number found in the last inspection that took place when Brushy Creek was still owned by Greenville Health System.

The deficiencies in the December 2016 inspection involved a lack of steps to address the safety of a resident who fell seven times, and a medication problem. The nursing home also failed to provide hospice services for a resident, follow dietary instructions for another resident and assure foods were kept at appropriate temperatures prior to serving.

Meer addressed the inspection at Brushy Creek in a March 20 email.

"The six deficiencies noted were of a low scope and severity with no harm resulting to any residents," she wrote.

Meer described Brushy Creek as a "high performing 4 Star facility" and she said Orianna "has every expectation that it will return to a 5 Star rating in the near future as the survey cycle allows."

Between April and August, 31 deficiencies were found during inspections at seven of Orianna's Upstate nursing homes, including two that were documented during an August survey at Brushy Creek, according to the latest data from the Centers for Medicare & Medicaid Services.

No deficiencies were found during inspections at two of Orianna's Upstate nursing homes during that period, Linley Park Rehabilitation and Healthcare Center in Anderson and River Falls Rehabilitation and Healthcare Center in Marietta.

Linley Park and RIver Falls currently have overall ratings of much above average from the Centers for Medicare & Medicare Services, the highest rating that the agency can give a nursing home.

Follow Kirk Brown on Twitter @KirkBrown_AIM and email him at kirk.brown@independentmail.com

Where are they now? In the final days of 2017 we're bringing you up to date on some of the stories you were most interested in over the past year.

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