On Tuesday, Scott Schuett will come before the Virginia Board of Long-Term Care Administrators at a public hearing to determine whether he will keep his license to administer assisted living facilities (ALFs) in the state.
The board suspended his license in September after the Department of Social Services, responsible for their oversight, reported multiple ongoing problems at his six facilities, in particular at Ashwood Assisted Living in Hampton, Madison Retirement Center in Williamsburg and Oakwood Assisted Living in Suffolk. "Those are the ones I'm taking the most heat on," Schuett said.
Since then, Rena Gaddy Thomas and Donna Norvell, administrators at Ashwood and Madison, respectively, have had their administrators' licenses revoked. Another facility, Governor's Inn in Newport News, closed at the end of November. Schuett anticipates that Madison will also close, which would leave four homes under the umbrella company, ProPlusCare, which he formed in 2010. In November, Schuett stepped aside as its president and named Thomas as his successor. He and Thomas were married briefly in 2011, she said.
In an interview Friday, Schuett said he was resigned to the likelihood that he will lose his license and claimed it wouldn't affect his ability to run the remaining homes as long as he has licensed administrators on site. Thomas likewise said she could oversee them. Lynne Williams, director of the Division of Licensing Programs for Social Services, confirmed that the administrative role is separate from ownership.
Schuett didn't deny the problems at his facilities, citing hundreds of pages of violations found by inspectors. He stated readily that sometimes medications had not been available and that a persistent bed bug infestation has not been solved.
However, he also feels targeted, blaming others and the system, and pointing to other operators' facilities where the conditions are "deplorable."
How he got started
Schuett, 42, got into the business in 2003 in reaction to the care his grandfather received as a terminal Alzheimer's patient, he said. However, asked if he would have been happy for his grandfather to live in any of his facilities, Schuett didn't hesitate — for even a second — to say an emphatic "No."
A Michigan native, Schuett went to the University of Detroit law school and moved to Norfolk as a military lawyer with the JAG Corps, he said. After five years, he left the service in 2001, the same year his grandfather died, and worked in real estate. Two years later, he bought his first assisted living facility in Chesapeake. Thomas worked there from 1999, and though Schuett claimed to have trained her, she said that she actually trained with Irvin Land, passed all the necessary tests with good grades and gained her administrator's license in 2009. She had no problems until she moved to Ashwood in February 2012, where she inherited 39 pages of violations from the previous administrator, Angela Burrell, who was investigated more than once and received probation, according to Thomas, who looked up her record online.
In 2009, everything changed
For half a dozen years, everything went smoothly for Schuett as he acquired a couple more private-pay facilities and expanded his operation.
He pointed to 2009 as the watershed year when his businesses started to unravel. "Everything kind of turned upside down," he said. He referenced new regulations imposed by the state, requiring enhanced education for administrators and the regulation of medication aides. "You could be a Nobel Peace Prize winner in assisted living and not qualify to be an administrator. A qualification doesn't necessarily mean you'll be a good administrator," he said, stating his own experience as a lawyer. He cited Thomas as someone who came up through the ranks and was "a good administrator in a difficult situation."
From the start, his homes took in the elderly and those with dementia, residents he characterized as needing intensive care, "not the grey-haired lady who fails to take her meds." Then, he went a step further and took over Resthaven Manor, now called Ashwood Assisted Living, in Hampton, with a population of 99 percent public-pay residents. This was Schuett's first encounter with the auxiliary grant system that, used with Social Security income, provides homes with about $1,100 a month for each resident.
When he took over, the conditions were terrible. "Roaches were rampant. There was no heat, no hot water, they were eating out of vending machines," he said. Schuett spent $100,000 to upgrade the facility and brought in a food-service company.
By 2011, neighbors were complaining regularly to the city about residents' behavior in the community. "This isn't a prison. They're free to come and go." Schuett countered, but he characterized the facility as "a mental hospital" with 90 percent of residents with bipolar disorder, schizophrenia, or other mental illness. "What we do is more or less room and board — plus medications," he said. There's a 9 p.m. curfew and staff conduct checks on residents every two hours.
It was also in 2011 that Patrick Harvey, the Department of Social Services inspector who had examined all his facilities for eight years, was reassigned, according to Schuett. "It strikes me as odd that I could operate for eight years and have nominal issues, nothing huge. I prided myself on taking care of things quickly. All of a sudden it mushrooms into this nuclear cloud," said Schuett, who considered Harvey a mentor.
Thomas also referenced Harvey, but said that he continued to inspect Schuett's properties through March 2012, a one-year discrepancy from Schuett's statement. "He was the first person I called. I didn't breathe unless I called my state inspector," she said. In February 2012, Harvey was part of the panel that had Thomas sign off on the 39 pages of violations from her predecessor at Ashwood; this eventually led to the revocation of her license in October, when she hadn't made sufficient progress in remedying the situation. "I shouldn't have signed those," said Thomas, 36. "I don't feel like I was treated fairly. It feels personal."
Harvey, whom both Thomas and Schuett considered a trusted advocate, declined to comment for the story. Other inspectors at the Department of Social Services also did not return phone calls.
Likewise, others whom Schuett suggested would speak on his behalf, including a former neighbor and the family of a resident at Madison, either declined comment or did not return phone calls.
Is the system at fault?
He blames the system for his woes. "Deinstitutionalization was the single worst idea anyone could have had. We don't have the resources and support. They're getting younger and more mentally ill," said Schuett, who claims to be the largest auxiliary grant provider in the state.
His sense of responsibility to residents is what has kept him in the business, he said. "I've had many people tell me to get out of it — my lawyers, my parents. There's nowhere else for these people to go. The demand outdoes the supply 20 to 1." He routinely turns away prospective residents, as many as 50 percent of those who apply, whose problems are too severe.
Thomas doesn't blame Schuett. She pointed to a lack of continuity in Social Services' oversight. "Everyone has a different answer," she said. "They interpret standards in their own words." She'd like to see an end to finger-pointing and better team work between the Department of Social Services, community service boards and ALFs to address residents' problems.
Schuett described his assisted living facilities as important resources for the region's cities; he's not alone in this. Demetrios Peratsakis, executive director of the Western Tidewater Community Services Board, says they provide viable alternative housing for those who've struggled with other arrangements. A couple of months ago, he approached Schuett to set up a partnership between Oakwood and the CSB to provide coordinated clinical care for residents.
The establishment of a behavioral health medical home, where all the residents' needs for primary care, crisis management and mental health care are coordinated through one agency, "can substantially improve the quality of care for residents," said Peratsakis. He's hoping the comprehensive approach to wellness and preventive care will serve as a model for other community service boards to partner with ALFs.
Peratsakis characterized many of Schuett's problems as generic to the business, but suggested they were compounded by a learning curve and problems of his own making.
What would he change?
Schuett agreed. "You have to enforce the standards, but you have to understand the population," he said, noting that he has to meet the same standards as homes charging private-pay residents $6,000 a month.
"I'm trying. I've made some mistakes," he conceded, acknowledging that his business grew too quickly, without the necessary infrastructure, and that he should have had better trained staff. He hadn't anticipated the degree of mental illness in residents, he said, and felt he should have been more demanding of the local community services board.
"It took on a life of its own. Go to these other facilities and tell me they're any different," he said.
Want to go?
The public hearing by the Virginia Board of Long-Term Care Administrators is at 10 a.m. Tuesday, Dec. 11, at Department of Health Professions, Perimeter Center, 9960 Mayland Drive, Suite 200, Board Room #3, Henrico County.Copyright © 2015, CT Now