Salisbury nursing home loses public funding due to poor care. Some residents must move.

The federal government is terminating a troubled Salisbury nursing home from the Medicare program — a step that means many patients must move to other facilities.

The Citadel Salisbury, a for-profit home that has repeatedly run afoul of federal health and safety requirements, will no longer receive Medicare payments for its services, the federal Centers for Medicare and Medicaid Services announced in a press release.

“Involuntary termination of a provider agreement is generally a last resort after all other attempts to remedy the deficiencies at a facility have been exhausted,” the CMS press release states. “In this instance, the CMS has found that The Citadel Salisbury is out of compliance with CMS basic health and safety requirements.”

It was not immediately clear how many of the nursing home’s residents will need to be relocated.

A recently published inspection report by the N.C. Department of Health and Human Services includes more than two dozen violations at the facility.

One resident was hurt by a caregiver trying to move him. When he cried out, she put her hand over his mouth to muffle the sound. Another resident said no one helped after she complained to staff about a resident who kept offering her money for sexual favors.

A third had to be hospitalized for infections to surgical wounds after nurses failed to change his bandages for a full week.

One Citadel nurse aide said staffing was so “horrible” that she couldn’t help residents out of bed or give them showers some days. A nursing director reported that staffing was so thin that she sometimes worked 22 hours straight - and still “things fell through the crack and she could not keep up.”

“Left Alone,” a recent investigation by The Charlotte Observer, documented how a shortage of caregivers inside North Carolina nursing homes is putting thousands of vulnerable residents at risk.

Unlike most states, North Carolina has set no minimum staffing ratios for nursing homes.

A data analysis by Observer reporters also found that for-profit owners tend to operate with significantly slimmer staffing and more deficiencies than nonprofits.

The Citadel Salisbury will stop participating in the Medicare program on May 19, CMS said.

“The facility has been notified that Medicare will cease to pay for services furnished to Medicare and Medicaid beneficiaries admitted after May 19, 2022, although payment may continue for up to 30 calendar days for patients admitted on or before May 19, 2022,” the agency said.

CMS urged patients and their family members to consult the “Nursing Home Compare” site for information about other nursing homes where they might want to seek care.

The Citadel Salisbury is owned by Portopiccolo, a New Jersey investment company that bought about three dozen nursing homes in North Carolina over the past six years. The large majority of its facilities here earned just one or two stars for staffing and overall performance on the federal government’s five-star rating system.

In a federal class action lawsuit pending against the Citadel Salisbury, families of two residents allege that “systematic understaffing” led to residents frequently not receiving medications, showers and medical attention. Some days at the home, just three nurse aides were on duty to care for the more than 70 residents, according to the lawsuit, filed by the Wallace and Graham law firm last year.

In a court filing, Portopiccolo called the lawsuit’s claim of understaffing “meritless,” saying the nursing home mistakenly under-reported the hours worked by agency nurses.

A spokesperson for Portopiccolo did not immediately respond to a request for comment.

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