On Thursday, June 4, the Department of Social and Health Services (DSHS) revoked the license of the Mercer Island Care and Rehabilitation Center, arguing that the center constituted an immediate jeopardy to resident health and safety. The emergency closure was based on “a significant history of uncorrected violations,” reads DSHS’ Statement of Deficiencies.

The news didn’t come as much of a surprise, said Betsy Zuber,  mental health counselor and geriatric specialist for Mercer Island Youth and Family Services. Both she and the police department had responded to complaints about the facility in the past. Zuber said even before she heard news of the facility’s closure, she often discouraged families from housing their loved ones there, advising them to check in regularly if they did.

“The state closed them down and I think that speaks for itself,” said police commander Leslie Burns. It’s not uncommon for the department to get calls from  dementia patients across the Island, some of which are unfounded or don’t generate police reports. But Burns said she knew this particular facility had its challenges.

The 100-bed facility is one of a number of for-profit facilities nationwide, managed by Videll Healthcare. Nursing homes in Boston and Minneapolis have also been cited for financial trouble, including trash build-up, discontinued services and stoppage of food deliveries. MI Care and Rehab has 74 patients, all of whom will be moved to alternate facilities in the next three weeks.

Nursing homes that accept Medicare patients are graded on a five star scale (www.medicare.gov/nursinghomecompare). Most of the Island’s facilities receive high ratings. Covenant Shores, for instance, has an overall rating of five stars. But MI Care and Rehab consistently rated below average. Though results do not reflect DSHS’ recent ruling, public records show that the  facility had a long history of complaints. It received four stars for staffing, two for quality measures and just one on its health inspection.

A March 4 health inspection revealed that two of three residents sampled had pressure ulcers, or bedsores, injuries to the skin and surrounding tissue that are often the result of long periods of inactivity. One of the two, who was admitted with back pain but no skin breakdown at the time was not transferred to a pressure reducing mattress despite complaints of numbness around his tailbone and a request for a new bed. In an interview with the acting director of nursing on the same date, she acknowledged his care plan hadn’t been updated following the discovery of his ulcer.

Similarly, a second patient was found lying in his own stool with a partially open dressing on his left buttock and his feet not elevated, despite a medical note that he was at risk for bedsores on his heels.

Bags of dirty linens and hazardous waste were found on a back porch, unlabeled during a February 5 investigation. That same date, 31 voice messages from as far back as December 2013 were retrieved on the office phone including calls from family members, debt collectors, pharmacies and hospitals. Patients’ families and vendors often complained that it was difficult to get a hold of staff there, even in times of emergency.

On February 25, just three weeks later, an anonymous staff member reported that no food had been delivered because of an unpaid bill, leaving all 79 residents without a meal. When interviewed further, staff said there were no fresh fruits or vegetables in the facility.

“[Staff] stated they had some potatoes but had used the last onion the day before,” reads the health inspection.

They regularly reported not being able to meet menu requirements, instead serving smaller portions, frozen leftovers and otherwise adjusting meal plans. Questioned about the shortage, an administrator said it was the first time she’d heard about it and that she assumed the dietary manager would have enough back up in case of an emergency. On several occasions staff members said they had to charge supplies to their own credit cards.

Water, sewer, trash pick-up, electricity, even phone services were at threat of being discontinued. The center had bills of as much as $12,420 owed to one linen vendor, balances of $21,537 for Puget Sound Energy and $16,311 owed to the city’s Water and Sewer services at one point. The financial troubles appear to be an issue throughout Videll Healthcare. In a phone call made May 12, Videll owed a combined balance of $280,000 to Medline. Because of the accumulated debt, the company would not fill MI Care and Rehab’s full order, including basic necessities like zinc oxide for wound treatment and insulin syringes.

Further interviews conducted by DSHS clarified that all bills were processed through the center’s corporate offices and that the facility operated on a tight margin because Medicare and Medicaid were slow to pay.

But DSHS had delivered several warnings. If amendments are not made by June 22, the center’s Medicare and Medicaid contracts will be terminated. MI Care and Rehab has the right to request an administrative hearing and an informal dispute resolution meeting to contest the revocation of its license and emergency closure. A representative of Videll could not be reached for comment.

Zuber noted that an unexpected move like this, for disabled patients or elderly, is especially devastating.

With the closure of MI Care and Rehab, the city now has nine options for senior housing with varying degrees of care and beds available. Covenant Shores and Aljoya offer skilled nursing, assisted living and independent apartments. Sunrise Senior Living and Island House operate as retirement homes and assisted living facilities. Twilight, Nov, Mercer Island Premier and Seasons of Life are adult family homes, residential long-term care facilities that house up to six residents. Finally there is Ellsworth, section 8 housing for seniors 62 and older.

“We have reached out to them to see if we can be of help,” said Bruce Erickson, executive director of Covenant Shores. “We’re actually very full right now. So I don’t know whether we would be able to take someone…But we will be helpful and supportive in any way we can. That’s a tremendous challenge for them to try to get 74 people into other facilities.”