Lawsuits against Prestige Healthcare chain
Lawsuits are also piling up against the Arbors nursing home chain. The facilities are operated by Prestige Healthcare, a Louisville management company. Since 2024, at least 11 plaintiffs have filed lawsuits accusing Arbors facilities of negligence or medical errors that caused patients’ deaths, according to court records analyzed by Signal Statewide.
Victims of neglect contend that facilities are shortstaffed at the lowest possible levels, leaving residents vulnerable to all sorts of ignored issues as nurses are stretched thin. The case of Sam Frank Ray is a tragic yet typical example of the low quality of care provided by the Arbors chain.
In 2024, Ray was forced to sit still through 33 eight hour shifts as he developed a serious pressure ulcer that exposed his tailbone. Staff at Arbors of Sylvania in Toledo, Ohio failed to reposition him and take him to the toilet, instead directing him to use adult diapers and await being changed. Ray developed an infection likely worsened by the open ulcer.
He soon died at the hands of the nursing home his family had trusted to care for him. His family had no idea about his condition until the infection had become too serious to ignore but too deadly to treat.
“It’s a catastrophic situation at that point. And he passes away,” said Michael Hill, the lawyer representing the family. “It’s one of those things where he should have never gotten a bedsore to begin with.”
In an Oregon Arbors facility, a woman named Lucy Garcia also died from an infected pressure injury. Her lawsuit stated, “The open bedsore was exposed to Lucy’s own feces and urine from Arbors at Oregon leaving her in soiled adult diapers, and the wound was infected with bacteria causing sepsis.”
Around a year after Garcia’s death, Oregon state regulators flagged the facility for bedsore issues, and inspectors in other states have found many treatment concerns throughout the Arbors chain.
Administrators at several Arbors facilities named in inspection reports deferred comment to Prestige Healthcare. Bill Gray, a company spokesperson, declined to comment on a list of written questions. Attorneys representing the company in court also didn’t respond to written questions. Unfortunately, accountability is rare for nursing home operators due to the divided control of nursing homes. Arbors facilities are often held by unique operating companies, related entities that own the land the nursing homes sit on, and Prestige Healthcare.
Furthermore, a spokesperson for the Ohio Department of Health said the agency doesn’t consider that facilities are a member of a chain or larger system. Instead, violations are considered on an individual basis.
The Ohio Department of Health recommends that a facility be fined, but the federal Centers for Medicare and Medicaid Services (CMS) sets the amounts of the fine. The final figure typically reflects a 35% reduction in exchange for facilities agreeing not to contest the penalty. Over the most recent three-year period, CMS has fined Arbors facilities on 18 occasions for a total of more than $648,000, according to agency data as of mid-June.
Compared to facility revenue, the fines are small change. Data provided by the Ohio Department of Medicaid shows Medicaid has paid Arbors facilities a total of $233 million in revenue over the past three calendar years. Of course, that doesn’t include payments from private insurers.
In addition, not every violation is punished with a fine. While CMS inspections state that poor care at three Arbors facilities – Milford, Stow and Minerva – contributed to patients’ deaths, only one facility paid a fine – the Arbors at Milford, where staff physicians weren’t informed of a patient’s worsening diabetes attacks.
Stow’s fine was suspended when the facility blamed medication non-compliance for the patient’s death.
For Minerva, there are no records for a fine at all despite their failure to warn doctors of a patient’s worsening health.
According to Will Eadie, a Northeast Ohio attorney who has filed “a fair number” of lawsuits against Arbors facilities, short staffing is often a primary factor that contributes to poor nursing home care.
“Staffing is kind of the root of most nursing home problems,” Eadie said. “You’re really talking about nurses and aides who might want to do well, but they are burned out, overworked, or there’s a bad culture of it being OK to not have adequate care.”
Nursing home companies are deeply concerned with profits, and staffing is often a facility’s biggest overhead expenditure. Thus, reducing labor hours is something nursing home executives are all too happy to do.
Understanding who is responsible for the frequent neglect and abuse that happens at Arbors facilities is difficult. Company paperwork points to a mazelike structure. For example, Arbors at Delaware LLC’s land was purchased by a property holding company, and its agent is listed as Delaware Opco LLC.
Much of the maze points to Prestige Healthcare though, the “corporate” office to whom many administrators deferred in declining to comment.
The confusing legal architecture is intentional, according to Michael Hill, a lawyer who has sued the company. Every entity is either there to limit tax liability or insulate the owners from the financial risks of a lawsuit, he said.
The Arbors chain is not unique for its structure though, as nursing homes operators around the country are infamous for creating a web of shell companies. Often times, this helps them move and hide profits.
A recent white paper from the National Bureau of Economic Research has accused nursing home industry operators of “tunneling profits” to related entities to understate their earnings. If those “hidden profits” were instead spent on staff, it would translate to a 36% increase in staffing hours per resident-day.
In fighting nursing home abuse, getting to the bottom of abuse often means going after the people at the very top. In the case of the Arbors chain, that company appears to be Prestige Healthcare.