Psych patients living at Lincoln Park nursing home

Hundreds of former New York state psychiatric patients are living in a Lincoln Park nursing home, which has collected close to $100 million in Medicaid payments from that state over the past six years.

Lincoln Park Care Center officials say they carved a niche by specializing in patients with behavioral issues, even though they are not licensed as a psychiatric facility.

"People like to send patients here because we have a unique program," Mimi Feliciano, Lincoln Park's CEO and owner, said of the behavioral facility. "There's a need, and we've tried to embrace it."

Lincoln Park Care Center houses 547 patients with behavioral issues, 354 from New York, many of them former state psychiatric hospital patients and some with criminal histories. Feliciano acknowledged that housing such a large population at a nursing home is unusual, saying her facility dominates that particular market.

The behavioral building has a larger population than Greystone Park Psychiatric Hospital, New Jersey's state hospital in Parsippany, which has 450 patient beds.

Nationwide, more psychiatric patients are being sent to private nursing homes.

Some mental health advocates say many of those patients would be better off in private apartments or halfway houses as long as states provide mental health services for them. That's the gist of a federal lawsuit filed against New York state health officials over sending patients to private nursing homes, including Lincoln Park and a similar facility in Andover.

The number of psychiatric patients in nursing homes has increased by 41 percent nationwide since 2002, partly because of a shortage of psychiatric beds, according to a recent Associated Press report. The percentage of younger mentally ill people among the nation's 1.4 million nursing home patients jumped from 6 percent to 9 percent over that time.

New Jersey state health officials said Lincoln Park and Andover nursing homes -- run by members of the same family -- operate within the law. And the parent of a former patient praised the Lincoln Park facility in a recent interview.

However, there have been some issues:

• State health officials said the Lincoln Park Care Center failed to report an assault to them last year when, according to a police report, a female nurse was beaten into unconsciousness by a male patient. State officials said the nursing home was required by licensing regulations to report the incident to state health officials.

"This matter is currently under review, and the nursing home may be subject to further enforcement," said Marilyn Riley, a spokeswoman for the state Department of Health and Senior Services.

Feliciano said she didn't believe the assault needed to be reported to the state. No criminal charges were filed.

• New Jersey officials say housing New York patients in private nursing homes has cost New Jersey taxpayers money, according to documents obtained by the Daily Record. New Jersey provides the patients with guardian services, including legal and financial services.

Edward Tetelman, New Jersey's acting public guardian, sent a letter last year to New York officials asking them to pay a long outstanding bill of $282,337 for those services, which are required by New Jersey law, provided to 30 Andover patients over the years.

New York officials responded by saying they don't require such services, and won't pay for them.

• Riley said a state investigation last year, shortly after the assault, found Lincoln Park to be inadequately staffed. As a result, additional nurses and aides were hired, Feliciano said.

• The federal lawsuit against New York state health officials was filed by advocacy groups, including that state's own Mental Hygiene Legal Service.

The suit describes Lincoln Park and Andover as "de facto psychiatric institutions" where patients are kept in secure areas and are not free to leave even though they are not legally committed. The suit claims that interviews with patients show many of them don't need nursing care and would be better off living in apartments.

Federal law bars nursing homes from admitting patients who don't need the level of care they provide.

New Jersey Assistant Health Commissioner Bill Conroy said state officials became aware six years ago that New York was sending former psychiatric patients to nursing homes, and determined at the time that admissions to Lincoln Park and Andover did not violate federal law.

Feliciano said patients are allowed to leave whenever they want, but it would be against medical advice. She also said she's confident patients at her facility have been appropriately placed.

"Somebody qualified them," Feliciano she said. "We don't make those decisions. ... The determination of appropriateness is out of our hands."

That's because placement decisions have not been made by her staff, she said, but by Medicaid officials, mostly in New York. New York health officials said that they no longer send patients to out-of-state nursing homes in such large numbers.

"Placements to those facilities have become very rare," Jill Daniels, a spokeswoman for the New York state Office of Mental Health, said, without specifying the reason.

However, 670 New York Medicaid patients remain in Andover and Lincoln Park.

Feliciano said her facility began specializing in behavioral issues in the 1990s, filling a need by accepting patients discharged from New York state psychiatric hospitals. Lincoln Park has educational programs to help patients return to the community, she said. Most of its patients are from New York but they also come from New Jersey, some from Greystone.

She said her patients receive more psychiatric monitoring than they would at traditional nursing homes, with more frequent visits from psychiatrists.

Feliciano also runs a traditional nursing home for the elderly in a separate building with 159 beds next door. She is building a third facility to specialize in short-term physical rehabilitation. That 60,000-square-foot building will have 60 private rooms and luxury amenities such as balconies, an indoor Japanese garden and a spa.

The exits to the behavioral building are monitored by staff members, the same as at other nursing homes where patients with dementia need to be watched, Feliciano said. Law enforcement authorities were called when a man got away in February. Police found him walking along Route 23 where he told them he wanted to go home to New York, according to a police report. He was brought back to the nursing home.

That man has a criminal history that includes second-degree assault in New York, according to court records. He ended up in a New York state hospital after charges of disorderly conduct and resisting arrest in 2002 led to a psychiatric evaluation, according to court records.

Sean Canning, Lincoln Park's police chief, said police are called to the nursing home about three times a year to find missing patients. None of those patients has refused to be returned to the nursing home, he said.

"Our main concern is getting a person out of the elements," Canning said. "The overriding issue is the protection of life."

Dennis Feld, an attorney representing the New York State Mental Hygiene Legal Service, said he interviewed patients at Lincoln Park and elsewhere before filing the federal lawsuit. The suit alleges that patients receive little or no training to prepare them for a return to the community, and that few ever get discharged.

On a recent tour of the facility, Feliciano showed off a large classroom where patients practice shopping and other skills needed for discharge. She said her facility discharges 20 patients a year, adding that most of the others require long-term care and have medical conditions that make them unfit to be returned to communities.

"There are very few people here who belong in community housing," she said.

A Bronx man recently said that his son received better care at Lincoln Park than he had at a New York state hospital.

"I was very happy with the facility," said Lou Mangini, 82, of the Bronx, whose son, Louis Jr., was a patient at Lincoln Park for years until he died more than a year ago. "He had more activities than he had at (Bronx Psychiatric Center). He could go to the day room. There was a social atmosphere. It was very pleasant."

He said his son required nursing care because he was in a wheelchair after years of medication and inactivity caused his muscles to atrophy.

i used to work there when i was a kid

They could send them to the former Hilltop Care Center and let them rebuild the place!