PROVINCETOWN — This past spring, a Provincetown resident who the Independent has agreed not to name to protect the person’s privacy checked into the Seashore Point nursing home for rehabilitation after breaking a leg. Three family members described what happened to their loved one there as “horrific.”

During a two-and-a-half-month stay, the patient had to be taken to Cape Cod Hospital for multiple infected wounds. When the family decided to remove the patient from the facility, their loved one was on the verge of collapse and had to be rushed to the hospital again. Doctors diagnosed respiratory failure, Covid, a urinary tract infection, sepsis, and a drug-resistant Staphylococcus aureus infection (MRSA).

The three family members, one of whom is a doctor, said the infection was life-threatening.

If left at Seashore Point any longer, the patient “would have died,” said one family member.

“It was horrific because you just knew it wasn’t right, and it was right before your eyes,” said another. “And you couldn’t do anything about it.”

According to another former patient, a former employee, a complaint investigation report, a state inspection report, and federal staffing data, this family’s experience of substandard care at Seashore Point’s rehabilitation facility was not an anomaly.

Since a for-profit company, Pointe Group Care, bought the nursing home at Seashore Point in 2019 from the nonprofit Deaconess Abundant Life Communities, public records show the quality of care has been in steep decline.

According to public data, the nursing home at Seashore Point, now formally called AdviniaCare at Provincetown, has failed to meet state-mandated nursing-hour minimums 552 times — about 55 percent of all days — since the requirements went into effect on April 1, 2021.

The most recent year reported, 2023, was the facility’s worst on record. The nursing home did not meet the state minimum of 3.58 care hours per resident per day on 215 of 365 days that year, according to data analyzed by the Independent and by a certified public accountant who analyzes data for state nursing home investigations.

The 41-bed nursing home, located on the first floor of the Seashore Point complex at 100 Alden St., is the only skilled nursing facility on the Outer Cape. It provides short-term stays for rehabilitation as well as long-term care for patients suffering from serious cognitive impairments, such as dementia, who need around-the-clock attention.

The federal Centers for Medicare and Medicaid Services (CMS) “Nursing Home Compare” tool gives the AdviniaCare at Provincetown facility a two-star rating out of five. The Mass. Dept. of Health and Human Services (DHHS) also rates it below the state average.

Inside the Home

Pointe Group Care denied the Independent’s request for a tour of the nursing home. State inspection reports, a former resident, and a former staffer all report serious problems there, however.

On Feb. 7 of this year, CMS and DHHS completed a complaint investigation following an incident in early January. According to their report, a certified nursing aid (CNA) attempted to assist a resident into a “Hoyer lift,” a mechanized swing used to move patients in and out of beds and wheelchairs.

The lift usually requires two staff members to operate. The CNA, however, transferred the resident into the lift and then into a reclining wheelchair alone, then left the patient in the reclining wheelchair unsecured and went to find another staffer for help.

When the CNA returned the reclining wheelchair had tipped backward, causing the resident’s head to hit the floor.

The resident required seven staples to treat a “deep gash” on the head, according to the report. Pointe Group Care was fined $11,333.

In a standard inspection by CMS and DHHS on Feb. 15, 2024, investigators found 11 deficiencies. Inspectors noted that one resident had fallen six times in nine days and observed another resident “at risk for developing pressure ulcers,” or bed sores.

In 2022, Anika Costa, a Provincetown native, stayed in the nursing home at Seashore Point for one week while recovering from a knee replacement. On her first night, Costa said, she used the button next to her bed to call a nurse for pain medication. No one came. Eventually, Costa lifted herself out of bed and into a wheelchair to find help.

When she reached the hall, she saw that three of the four beds in her corridor also had their call lights on. “That occurred more than once,” said Costa.

The family of the resident who went to the hospital with multiple infections reported similar issues. On multiple occasions, their relative called home to ask family members to phone Seashore Point’s front desk and let them know that they needed to go to the bathroom, said one family member.

Costa told the Independent that she also had to help herself to the bathroom because the staff either did not respond or were not able to take care of everyone. She said she witnessed unattended medicine carts, overflowing dirty laundry, and the doors of the nursing station left unlocked.

Costa also reported that she heard from nurses and family members of residents who said they were buying and bringing in their own care-giving supplies. Costa said shampoo, wet wipes, and cloth bed pads were especially in demand.

Kristin Hatch was director of social work at the nursing home when it was being run by Deaconess and then worked there part-time after the Pointe Group bought the property. She confirmed that there were times when staff bought their own supplies for patients.

Hatch told the Independent that there were very good nurses at Seashore Point during the years she worked there. “Everyone who works at Seashore Point cares about the residents,” she said.

But she was not surprised to hear that the facility had been consistently failing to meet staffing minimums, and she said she believed care quality had dropped.

“I am positive that it is not because of the staff,” Hatch added. “It’s a management issue.”

Pointe Group Care runs 14 nursing homes, 11 of them in Massachusetts.

“The administrator for Seashore Point was also the administrator in Salem and almost everything in between,” said Hatch. “So how many days a week is she actually there?”

A doctor visited the facility only once per week when she worked there, Hatch said. The social worker position has not been filled since she left two years ago. An employee at Seashore Point told the Independent that the nursing home administrator and social worker positions have been combined.

Hatch quit working for AdviniaCare because of declining quality, she said. When the Independent first contacted her with questions about Seashore Point, her immediate reply was, “It’s about time.”

Connected Companies

The nursing home and independent-living condominiums that make up Seashore Point were built after Provincetown sold the town-owned Cape End Manor nursing home in 2006 to Deaconess, a nonprofit founded in 1889.

After 13 years of running it, Deaconess sold Seashore Point and its land to three men: Benjamin Berkowitz, David Berkowitz, and Yosef Meystel. Ben Berkowitz owns 36 percent, while David Berkowitz and Yosef Meystel have trusts in their names that each have 32-percent ownership.

Seashore Point is one of a number of nursing homes in which the trio have controlling stakes.

According to ownership data from CMS, Benjamin Berkowitz partially owns 15 nursing homes, most of which are in Massachusetts or Florida. David Berkowitz, through his trust, has an ownership stake in at least 68 homes from Florida to Illinois to Massachusetts. Meystel has a portfolio of at least 70 homes.

Pointe Group Care, the company behind the AdviniaCare brand, was registered as a limited liability corporation in Illinois by Benjamin Berkowitz in March 2016. Since then, Berkowitz and his associates have bought and managed 14 nursing homes under the name “AdviniaCare” in Massachusetts and Florida.

According to CMS nursing home performance measures, 28 percent of AdviniaCare homes have an abuse icon, meaning the facility has a deficiency that has harmed a resident in the last year or potentially could have harmed a resident within each of the last two years.

AdviniaCare facilities average 1.6 “stars” on the agency’s five-star scale and have been fined over $1 million by the government for care deficiencies, according to the latest CMS reports.

AdviniaCare also operates AdviniaCare Pleasant Bay in Brewster, which has a history of quality issues and has accrued $169,000 in fines since 2020. The most recent standard inspection by DHHS found 29 deficiencies at Pleasant Bay.

The worst-rated nursing home in the group is AdviniaCare Newburyport, which has been fined more than $228,000 and been cited for 67 deficiencies in just five years.

Official Response

In a statement, Nury Carreno, the regional director of operations for AdviniaCare, said, “AdviniaCare Seashore Pointe provides high quality care to its short-term rehabilitation patients and long-term residents. As the only nursing home on the Outer Cape, it plays a critical role for older Cape residents. It is well staffed, with a four-star staffing rating on Medicare.com. Unlike many nursing homes, it is fully staffed by employees and does not currently use any outside staffing agencies. It has a consistently high patient census with a low rate of hospital readmission. To use one or two examples of residents with complications or an employee error to make a sweeping statement about this center, as the Provincetown Independent seems intent on doing, would be unfair.”

The four-star rating referenced in Carreno’s statement is from the CMS “care compare” tool, which experts say is not always reliable.

“CMS care compare is not a great gauge of quality,” said Sam Brooks, director of public policy at the National Consumer Voice for Quality Long-Term Care, an advocacy organization focused on improving nursing home care.

“It’s a relative measure based on how a facility performs in comparison to other nursing homes,” Brooks said. “If you look at the actual staffing numbers, this facility is likely staffing well below what they should be.

“The cornerstone of quality care is staffing,” Brooks said. “You see that not in star ratings but in clinical outcomes.”