McGirr Rehabilitation and Nursing Care Center in Bellows Falls. (Zachary P. Stephens/Reformer)
McGirr Rehabilitation and Nursing Care Center in Bellows Falls. (Zachary P. Stephens/Reformer)
Saturday January 5, 2013

BELLOWS FALLS -- The Atkinson Street rehabilitation center shut down by the state faces more than $200,000 in fines and taxes eight months after closing its doors.

Margaret Perry operated the McGirr Rehabilitation and Nursing Care Center, Inc. at 33 Atkinson St. for decades until it was forced to close following two deficiencies handed down from state surveyors and a failure to comply with Medicaid and Medicare regulations. Perry, who also owns the child care center at 35 Atkinson St. and an apartment building at 26 South St., said the majority of what she owes came as a complete surprise to her.

She said all nursing homes file cost reports to Medicare every year, and she and her accountant assumed it was due at the regular time. It turned out, however, it was due at an earlier date because of the facility's closure. Perry said she received a letter from the Centers for Medicare & Medicaid Services that said her business owes a $150,000 fee for not filing on time. Perry said they mailed in the Medicare cost report two weeks ago and hope the issue will be resolved.

A call made to CMS was not returned.

The nursing care center also faces a fee of $35,000 because Perry did not mail in her building license to the state when the facility closed on April 28, meaning the business was technically still operating after the state shut it down. She said she did not know to mail in the license and did so as soon as she found out.

"We're hoping we can reduce that (fee)," she said, adding that it is just not reasonable. She said the fees could bankrupt her business.

Perry also owes the state a provider tax of about $34,000 and still has some final unpaid bills. Perry said she is trying to deal with them one day at a time.

Perry decided to sell the building and was recently granted a boundary line adjustment by the Rockingham Planning Commission. She did not want to mention the asking price but said she has some people interested.

Perry maintains that the whole problem started after McGirr took in a 33-year-old woman with a "long and complex physical and psychological history."

The patient eventually made some serious allegations against a fellow patient. Nursing homes are required to report the allegations to the Division of Licensing and Protection, a part of the Department of Disabilities, Aging and Independent Living, which in turn is within the Agency of Human Services.

Camille George, deputy commissioner at DAIL, said Monday she had no immediate comment and needed to do more research on the matter.

In a telephone interview several months ago, Perry said facilities have to do their own investigation while the state conducts an inspection, referred to as a survey, any time an allegation is made. Surveys, Perry said, can occur on weekends, holidays and at night so they are not expected.

She said the state wasn't satisfied with McGirr's investigation and sent a standard list of deficiencies 10 days after conducting its own. The facility then had 10 days to send back a plan of correction, stating what it would do to fix the problems.

Documents obtained by the Reformer state all deficiencies found are given a letter classifying their severity -- ratings A, B and C mean the deficiencies are still in substantial compliance while D, E or F ratings pose no actual harm, with potential for more than minimal harm to residents. Ratings of G, H or I constitute harm that does not rise to the level of immediate jeopardy to a resident's health or safety -- which is what J, K and L ratings are used for. Perry said weeks ago that everything from food to activities to cleanliness are evaluated in surveys.

Though the state eventually concluded that the allegations were unfounded, it had problems with McGirr's investigation, its conclusion and what the actions the facility took. Then, during a February follow-up survey, two J tags were discovered. The surveyors, according to court documents, then came back in March to reveal that though the J tags were fixed perfectly and all previous violations had been cured, they discovered new J tags that constituted immediate jeopardy.

She said McGirr had received tags before but they could always be easily rectified. She is now angry about her treatment from the state, which she described as "particularly heinous."

"I think there was a real lack of communication between McGirr and the state. ... Knowing (the patient's) history, there should have been more communication between the DAIL and McGirr. I realize in hindsight how little communication there was," she said, though she admitted she knows the DAIL is not meant to be a consultant. "You think you're done and then, whoops -- there's this and there's that."

At the time of its closure, McGirr was a 9,000-square-foot facility that employed 32 people. Perry said it had been in her family since 1966.

She said she has since become the director of the child care center next door and rents out three apartments to eight people.

Domenic Poli can be reached at dpoli@reformer.com, or 802-254-2311, ext. 277.