For the last six years, Jeannette Crowe has called the Hughes Health and Rehabilitation Center home. The 84-year-old with multiple sclerosis expected to die at the five-star facility, surrounded by the staff that has become like family.
But all that changed last month, when Sam Flaxman — the grandson of the man who bought the West Hartford building in 1961 and turned it into a 170-bed long-term care home — walked into a meeting with the 81 residents still living at Hughes to make a stunning announcement: The nursing home was closing.
“One day they come to you and say, ‘We’re going to close.’ And it’s like, ‘What are you talking about?’ It’s a slap in the face,” Crowe said during a recent interview in her room.
“You’ve got a beautiful, five-star place here. Why would you want to close? It’s a good home for people,” Crowe said. “Why are they taking it away from us? I’d do anything to stop it.”
Flaxman, 27, did everything he could to avoid that meeting after the family business was thrust into his care when his grandmother died in January. The former tennis pro, who now works for a professional pickleball league, tried to close a sale of the property that his grandmother had been working on, but it fell through.
Faced with a debt of $10,000 to $30,000 a month and a physical plant that needed at least $10 million in upgrades, Flaxman made the painful decision to close Hughes, in whose hallways he had walked hand-in-hand with his grandfather as a child.
Over the last few weeks, as he waited for the state Department of Social Services to approve his application to close Hughes, he and his staff have been helping the residents still there find new homes.
The building’s closure is in part a consequence of a statewide shift to home and community-based services, Flaxman has said, and in part due to declining occupancy and swelling costs.
State officials have called for a “right-sizing” of the nursing home industry by directing money away from nursing homes and toward home care programs, with plans to shed as many as 1,000 nursing home beds over the next few years, even as the older population grows.
[RELATED: Connecticut’s nursing homes are facing an uncertain future]
But Flaxman has a warning: The state’s shifting of funding away from long term care facilities into home health health care options is a process Flaxman and others say will lead to more nursing homes closing, and he’s not convinced demand will drop as much as some predict.
“The state is very open about how they’re looking to do multi-generational housing, and I think they expect more than like 50% of the residents who are leaving these nursing homes are going to go live with their family or live in a home-based community service,” he said.
“But I don’t think it’s true, and a lot of these folks are still going to other nursing homes and long-term care facilities, and at the end of the day, it’s going to catch up with the state.”
More closures to come?
The closing of such a well-respected facility has caught the attention of nursing home advocates and the state’s long-term care ombudsman, who worry that Connecticut’s new equity payment system and shift of Medicaid funding away from nursing homes and into home care could cause more smaller, family-owned nursing homes to close their doors.
[RELATED: CT’s aging population is growing, but support systems are struggling]
Long-Term Care Ombudsman Mairead Painter said she has told her team that over the next 18 months they can expect more nursing homes to close, though it is difficult to watch facilities like Hughes disappear.
“Just not ones like this one,” Painter said. “The small neighborhood nursing home is what we want to see more of, not less of, because that’s where you get good care. I would rather see the big business chains get forced out, not the smaller mom-and-pop ones.”
For nursing home advocates, the expected closure is a warning that the state might want to slow down the process.
Mag Morelli, president of LeadingAge Connecticut, an organization that represents nonprofit nursing facilities, said it highlights the need for a better partnership between the state and nursing homes.
“We’ve been concerned about this for years, that if there is no plan, we’re going to start to lose nursing homes we treasure,” Morelli said. “The concept of a very good, high-quality home needing to close because of census concerns is something we want to avoid. We want to be able to maintain homes that communities want to keep.”
Matthew Barrett, president and CEO of the Connecticut Association of Health Care Facilities, said Hughes, a facility with low occupancy but high care ratings, should signal to policymakers that occupancy isn’t the only measure of a nursing home’s value.
“We say you shouldn’t over-rely on facility-based care. But if you have a policy that over-relies on home and community-based care for this ever-exploding population, when there’s a known dearth of caregivers, then it’s going to fail,” Barrett said. “The consequences of that can be dramatic and harmful, including a five-star nursing facility moving to close and residents essentially being evicted from their long standing home.”
‘I wanted to die here‘
When CT Mirror reporters visited Hughes recently, many rooms were piled high with boxes as relatives were helping their loved ones pack up their belongings — the shock and anger of the announcement replaced for some residents by the fear of having to move to a new place so late in their lives.
“Nobody expected this to happen. We cried our hearts out when we first heard that they were closing,” Rosemarie Dembowski said. The 84-year-old had been at Hughes for about a year, recovering from heart surgery.
“I think a lot of us were in denial that it wasn’t really going to close,” Debrowski said. “I told my daughter I wanted to die here.”
When the shock wore off, Dembowski and her family immediately started looking for a new home. She is moving to a nursing facility in Avon before the end of April.
“I didn’t want to be the last one left here all by myself,” Dembowski said. “It’s sad enough having to leave and start over at my age.”
As she sat in her single room at Hughes, one with a mural of a lighthouse painted on the wall that she says reminds her of Cape Cod, Dembowski was apprehensive about moving. Her lunch — grilled cheese, pasta salad and hot tea — had just been delivered, and she wanted to finish and get to an afternoon bingo game.
She will not get a single room at the new facility, and although she has already met her new roommate, it’s an adjustment that worries her.
Painter said transfer trauma is a very real problem for elderly residents, who already have gone through leaving their original home to live in a long-term care facility and now must uproot their lives again.
“The transfer trauma is awful. They lose the connection with their peers and the staff that they know and trust,” Painter said.
Painter said some residents have asked her to send a letter to DSS officials asking them not to close Hughes, but that’s not likely to happen.
A family’s legacy
The Department of Social Services approved Flaxman’s request to close Hughes on Friday, nearly 30 days after it was filed.
“The closure of a skilled nursing facility is never easy, especially for the residents. DSS’ priority is to work with the Long Term Care Ombudsman to ensure that all residents can be placed in suitable housing and that Hughes continues to follow all state regulations and meet residents’ needs while this process moves forward,” DSS Commissioner Andrea Barton Reeves said in a press release.
Reeves said that Hughes Health & Rehabilitation is required to communicate a closure plan to its patients and their families and work with relevant state agencies during the closing process to guarantee a continuum of care. Hughes cannot close the facility and must continue to provide services and care for its residents until all residents have secured and moved to new housing.
There weren’t many options for DSS, other than closing Hughes, that wouldn’t have been expensive for the state. If they had refused Flaxman’s request, the state would have had to put the home in receivership and run it until a buyer could be found — or force it to stay open.
The state has never forced a facility to remain open, according to DSS spokesman Jalmar De Dios.
“We don’t have the ability to be the proprietor of a nursing home. We would have to look for somebody to step in and manage the facility, which we have never done,” De Dios said. “And essentially, it all boils down to — this is a private business. The state cannot go in and force a business to stay open.”
De Dios acknowledged a nursing home closure can be difficult for residents.
“We do take into consideration the residents who are in the home,” De Dios said. “But there is an excess of beds in the state. So what we ask nursing homes to do is find the nearest bed available for those residents.”
For Flaxman, informing the residents that Hughes was closing was hard enough, but to have to tell the staff — some of whom started working at Hughes when his grandfather Eugene Flaxman ran it — was even more difficult. Flaxman said there are dozens of employees who have worked at Hughes for 20 to 30 years and “expected to retire from there.”
“The staff is the reason this was a five-star facility. I mean, who cares about my family’s legacy at the end of the day,” Flaxman said. “It’s the staff that have been there and put their hearts and lives into it. At the end of the day, that is the saddest thing about Hughes closing.”
When his grandmother died in January, Flaxman took a leave of absence from his job as pro player director of the Professional Pickleball Association to come back and deal with the family’s business. He consults with his younger brother Ross and a few cousins, but he has made the difficult decisions himself.
During an hour-long interview, Flaxman repeatedly said, “This is not where my grandfather and father wanted us to be.” He said he was “sick to [his] stomach” about having to tell residents it was closing and said the whole effort to sell the facility was frustrating and disheartening.
He was careful not to criticize his grandmother, who lived in Palm Beach, Fla., and was more of an absentee owner than his grandfather had been.
“This has been a family legacy and a family business for so long, and it just hasn’t been the same really since COVID,” Flaxman said. “At the same time, it didn’t receive the same love as when my father and my grandfather were here.”
Flaxman said he realized quickly why his grandmother had been trying to sell Hughes. The occupancy rate had hovered at 50% for a few years, while other costs, from food to electricity, had increased. Meanwhile, the building needed $10 million to $12 million in upgrades.
“If you don’t put money back into the business to improve the physical plant, and you don’t increase your labor wages to compete with current market rates, and then to try and do it now, especially when the business has been losing money, it’s just not going to work,” Flaxman said.
The original Hughes nursing home on Highland Street in West Hartford was the family home of Henry C. Judd, a prominent Hartford businessman. The original 22,000-square-foot home was built in 1900.
It was a 17-bed convalescent home until 1961, when Eugene Flaxman, a podiatrist, bought it. By 1966, Flaxman expanded the footprint to seven times the size of the original home and rechristened it the Hughes Health and Rehabilitation Center. It would eventually grow into a 170-bed facility. He ran the facility until his health declined. He died in June 2018.
By then, Brian Flaxman, Sam’s father, had been working at the facility for years, starting out in the cafeteria, while he obtained his nursing license and ultimately became a vice president. He was expected to take over the nursing home after Eugene Flaxman died, but he died nearly a year later in 2019. He was 54.
“I always asked my dad, ‘Would it be smart to join the family business?’ My father was in the last nursing class at Boston University, and he started at Hughes in the cafeteria and worked his way up,” Sam Flaxman said. “But he was like, ‘Go do something that you love and that you are passionate about — don’t do something because your family does it.’”
So Sam Flaxman became a tennis pro, at one point teaching at the exclusive Breakers in Palm Beach, Fla., before later getting hired as the pro player director for the professional pickleball tour.
Hughes was left to his grandmother, Sandra Flaxman, who became more of an absentee owner. The family touch was no longer as visible at Hughes after Brian Flaxman died.
Crash and burn
After his grandmother’s death in January, Sam Flaxman tried to complete the sale that she was in the middle of negotiating, but the deal fell through for a variety of reasons, including the enormous amount of upgrades the building needed to better accommodate residents.
“My grandmother put the business up for sale because she knew the only way it was going to survive was if it wasn’t under our management because of how much money it was bleeding,” Flaxman said.
Inside Hughes, residents were told the facility was for sale and that once that happened, everything would be OK.
Linda Brescia, who had lived at Hughes for three years, believed it until the day Flaxman called the special meeting.
“I knew the building needed lots of work, but I never thought it would crash and burn,” Brescia said.
Flaxman said he is usually a good public speaker, but that day he struggled to get words out.
“I felt sick to my stomach. It was heartbreaking,” Flaxman said. “I was shaking up there, because certain actions that were done before I ever got here put us in this situation, and there was only so much I could do.”
Like many others at the meeting, Brescia, 77, was stunned by the announcement. She was a nurse and knew both Eugene and Brian Flaxman years ago.
“They were without a doubt the best people in the world and dedicated their lives to helping people,” Brescia said. “This was a five-star place because they were five-star people.”
Brescia didn’t hide her anger at Sam Flaxman.
“I sit here and wonder, what the hell would make [Flaxman] think [he] could run a nursing home?” Brescia said. “He never contributed anything to this place, probably hadn’t even been in this place for five seconds his whole life.”
As she spoke, Brescia’s grandson was packing up her belongings. The next day, she was leaving Hughes and headed to the Avery Heights nursing home in Hartford.
“I’m sad about leaving some of the friends I’ve made here the past few years, including the staff,” Brescia said. “I thought when I moved here it would be my final resting place, but it’s not going to turn out that way.”