Elisabeth Strillacci

SALISBURY — After losing its Medicare and Medicaid funding because of ongoing and unresolved issues, the Citadel Salisbury, run by Accordius Health, quietly closed its doors on Friday, June 17, apparently without ever telling employees it was happening.

Facilities are required by federal law to meet particular health and safety standards in order to be certified by the Centers for Medicare & Medicaid (CMS) as a provider.

Since August 2020, the business was, for the second time, enrolled in the Special Focus Facility program under CMS. The program is intended to help “nursing homes which have a history of serious compliance and quality issues” to improve the quality of care offered to residents. Staff from CMS uncovered “instances of substandard quality of care and actual harm to residents,” according to a CMS spokesperson. The Citadel was previously enrolled in the same program from June 18, 2014, until Feb. 4, 2015.

“The Citadel Salisbury has continued to be out of substantial compliance after multiple on-site health and safety surveys (Feb. 19, 2021; Sept. 2, 2021; and March 4, 2022) documented a failure to comply with several federal requirements,” said the spokesperson. “Despite multiple opportunities to address its non-compliance, The Citadel Salisbury has not demonstrated that it can ensure the health, safety and well-being of its residents. The facility has had a cyclic pattern of immediate jeopardy, substandard quality of care and actual harm to residents.”

An involuntary termination letter was send to the Citadel on May 4, stating their Medicare and Medicaid provider agreement would end May 19.

The action foreshadowed an uncertain future for the complex, which, at one time was the site of the largest nursing home COVID-19 outbreak in the state. Local law firm Wallace & Graham has filed multiple suits against the facility’s owners alleging neglect and understaffing.

Linda Borders, who spent nine years with the agency, first when it was Genesis, then staying on when Citadel bought the facility just prior to the onset of COVID, said sometime in May, she got a phone call from a friend telling her the Citadel was closing.

“Nobody ever talked to us,” she said. “No one came from corporate, no one met with any of us about the closing, about other jobs, about a last day — nothing.”

At the end of May, Borders said residents began to be moved, but still, no information was forthcoming. Sometime during early June, independent companies providing CNA services on a contract basis began removing their employees, but even they did not seem to have verified information on what was happening.

“They asked us if it was true the Citadel was closing,” she said. “We didn’t know. But we had heard, through the grapevine, that June 17 was the last day.” In its letter of notice of termination, CMS outlined that Medicare and Medicaid payments for patients would be extended only until June 18.

Borders had already dropped back to part time because she was so stressed about the demands from a woefully understaffed workplace, she said. “There were seven of us who were permanent employees, and 87 residents. There were not enough of us to provide the level of care that should have been provided.”

By the time June 17 rolled around, Borders said only the seven permanent staff remained, along with two residents. That morning, Borders said, the last two residents were removed, and that afternoon, the remaining staff received a single text message: “The doors are now closed.”

There were no pink slips, no notice of any kind before or after that text, she said. She expects a last paycheck next week. If it does not arrive, she’ll be contacting an attorney.

Involuntary termination is generally the last resort after all other attempts to remedy noncompliance of deficiencies have been exhausted.

CMS did hold discussions with both the North Carolina Department of Health and Human Services and local officials about the availability of beds and services for residents impacted by this situation to ensure that the community’s health care needs could be met.

The company can appeal the decision, but calls to Accordius Health to talk about future plans were not returned as of deadline.

As for Borders, she said she cared for two former residents, Mr. Rankins and Mr. Troutman, and she had become “very fond of them both. They told me about their families and their dogs and all about their lives, and I don’t know where either one of them ended up, or if they are OK. If anyone knows, I’d love to just know they are alright.”