Nursing home abuse plagues Ennis owned facilities

ENNIS – City of Ennis Mayor Kameron Raburn did not respond to questions regarding a situation he apparently inherited, and did not create.

Rayburn took the role of mayor in Ennis in May, and was on the commission prior to his mayoral seat since 2022.

However, Raburn and the other six city commissioners are part of a piece of city business most residents would probably be shocked to learn.

Ennis owns the operating license for 23 nursing facilities across Texas.

There are more questions than answers, and I have been holding this article for several weeks with no response. 

I did some investigating otherwise and found www.nursinghomedatabase.com/owner/city-of-ennis where I learned that as of Oct. 1, it was reported Ennis’ average rating on the 23 homes was an overall 2 out of 5 scale. 

The website indicated there were 721 deficiencies, four homes with abuse flags, and fines that total $1,547,762.

Looking at the list of homes at this website, it noted Ennis has the operating licenses for two facilities in Texarkana and one facility in each of the other cities listed that include McKinney, Bridgeport, Port Arthur, Rockwall, Decatur, Corsicana, Garland, Killeen, Irving, Socorro, Lufkin, Odessa, Gainesville, Pittsburg, Rockdale, Royce City, Katy, Waco, Granbury, Lubbock and Mineola. 

Names of these facilities can be found at the website listed above with individual ratings of each facility, which range mainly in the one and two star range, but two facilities had five stars.

It was also not possible to speak with the former City Manager Marty Nelson, who resigned in early August for reasons that were never revealed. 

He had been the city manager in Ennis since 2020, and likely knew about this operating license situation.

At npiprofile.com/npi/1306440409, it specifies “the City Of Ennis is a provider established in Granbury, Texas operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1306440409 assigned on November 2020. The practitioner’s primary taxonomy code is 314000000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Stephen Barnes (Finance Director).”

Also found at projects.propublica.org/nursing-homes/homes/h-676335 was a note the City Of Ennis’ Dba for this QIPP program is Broadmoor Medical Lodge. 

A report taken from this website from September 2024 noted City Of Ennis Dba Broadmoor Medical Lodge had 22 deficiencies and one infection-related deficiency, with a list of the complaint dates and full reports at this website.

There were a number of questions I asked city staff that have not yet been answered regarding these operating licenses. 

The most pertinent questions being:

• What liability falls on the city of Ennis and the taxpayers if the facilities are sued for negligence? 

• Does this cost the city money? How did the city get into this type of program? How does QIPP benefit residents? 

• And, is the city receiving income from these licenses? 

While one might wonder if other cities are involved in this type of operating license situation, I could only uncover one other city in Texas: West, north of Waco.

However, it appears he inherited the situation too since I was told by staff that the operating licenses for these facilities began in 2018.

It was in 2018 the City of Ennis was approached regarding a state directed program called the Quality Incentive Payment Program. 

This program was designed to encourage nursing facilities to improve patient care through payment for meeting quality metrics that are adopted by the state annually. 

I was told to visit pfd.hhs.texas.gov/long-term-services-supports/nursing-facility/quality-incentive-payment-program-qipp for details on how the program works.

My main takeaway was, “During the 83rd Legislative Session, the Texas Legislature outlined its goals for adding managed care to nursing facilities. 

“The Texas Health and Human Services Commission was directed to encourage transformative efforts in the delivery of nursing facility services, including “efforts to promote a resident-centered care culture through facility design and services provided.”

A discussion among the Ennis City Commissioners did take place on several occasions recently regarding this item. 

These discussions, however, were never during open session meetings to allow residents to be aware, only in Executive Sessions on July 16 and Aug. 6. 

It was noted action had been taken following the July 16 executive session discussion, but it was only to ‘take action as directed in executive session’ so that action has remained a secret from residents.

There was no action taken on this this item at the Aug. 6 executive session. 

On May 21, there was also an agenda item during the commissioner’s meeting, item H2, to approve the loan required for participation in year eight of this program. 

The item was a Resolution approving the entering into loan agreements with Prosperity Bank in an amount not to exceed $17,000,000 for QIPP Year 8. 

Further detail read. “The City Commission has previously authorized the participation in the Quality Incentive Payment Program (QIPP) and this program requires funding for QIPP Year 8. 

“This Resolution authorizes staff to enter into loan agreements with Prosperity Bank in an amount not to exceed $17,000,000. 

“The loans will be paid back by the Federal Government and it’s estimated that program participation will generate approximately $4.2 Million in income during QIPP Year 8.”

Mayor Pro-tem Jake Holland, no longer an Ennis Commissioner, moved to approve the loan and it was seconded by Ward 2 Commissioner Bruce Jones, who does still sit on the commission.