iCare Health Network is the Leading Provider and Operator of Long Term Care for the Justice Involved and Difficult to Place Population
Since 2013, iCare Health Network has operated the first long term care nursing center for the justice involved population and individuals that are otherwise challenging to transition and place in an appropriate site of care.
Now, in 2021, when budget and policy experts search for a provider and operator with experience, accomplishments and successes in working with a justice-involved population in a Medicare/Medicaid certified and state licensed Long Term Care Facility, iCare Health Network stands out as the gold standard.
60 West’s mission is to provide enrichment to the lives of our patients through specialized care, dignity and acceptance.
The mission is achieved through an inclusive, compassionate and stigma-free approach to caring for an aging population of residents that are difficult to place.
Timeline and Background for the 60 West project
In 2012, the State of Connecticut issued a Request for Proposal (Titled “Nursing Home For Individuals In State Care Who Are Difficult To Place”). The procurement notice summary read:
“The Connecticut Department of Mental Health and Addiction Services (DMHAS) is issuing this RFP in collaboration with the Departments of Correction (DOC) and Social Services (DSS) to identify nursing home level of care for clients under state care who are difficult to place. These individuals may be transitioning from a correctional facility, have criminal justice involvement and/or be transitioning from a higher level of care provided by the Department of Mental Health and Addiction Services. The Departments are seeking proposals from vendors who are presently providing skilled nursing care and are interested in reorganizing their present business model to afford this population accessibility to long term nursing home care.”
iCare Health Network submitted a response which resulted in a engagement with the State of Connecticut to establish nursing home care for individuals in state care.
After being the selected bidder and contracting with the State of Connecticut, iCare opened “60 West”, a 95 bed, Medicaid and Medicare certified, skilled nursing center operated by an iCare entity known as SecureCare Options in 2013, in Rocky Hill, CT. iCare continues to manage and operate this nursing facility.
Referral Review and Resident Profile
60 West is committed to providing skilled nursing care and services for physically, mentally and cognitively impaired individuals who are difficult to place in a standard nursing home or long-term care setting.
The basic resident profile was individuals that were: (1) difficult to place at a site of appropriate care as a result of their judicial, social or other history; and (2) they met federal requirements for long term care in a nursing home setting; and, (3) would be transitioning from a correctional facility, have criminal justice involvement and/or be individuals transitioning from a higher level of care provided by the Department of Mental Health and Addiction Services (DMHAS).
Referrals for admission originate from the community, inpatient psychiatric facilities, state correctional institutions and other sites of state-operated care and must meet nursing home level of care and the federal Preadmission Screening and Resident Review (PASRR) process. They are then directed to the Assessment Clinician for review.
In addition to the PASRR process, in the preponderance of cases each individual considered for admission will receive an in-person, comprehensive assessment and interview, including a risk review. Potential admissions are approved by a utilization management committee comprised of Mental Health and Addiction Services, Corrections and 60 West staff.
As part of, or in addition to, the federal requirements for long term care, each potential resident is thoroughly evaluated for the presence of a significant cognitive, physical or other impairment, disorder or disability that meet the federal guidelines and establish their appropriateness for a long term care setting. These impairments also serve to mitigate risk and determine a resident-specific, patient specific plan of care.
As noted, candidates for admission often have a degenerative medical condition, such as dementia, Parkinson’s, MS, Huntington’s disease, a terminal or hospice-level type diagnosis requiring skilled nursing, level of care services and is the most appropriate, least restrictive setting for that person. 60 West has two units – a secured cognitive impairment unit and a long term care unit. There is no secure behavioral unit per se, although referrals received may have psychiatric history or diagnosis.
- 24 hour Skilled Nursing Care
- 24 hour Assistance with Activities of Daily Living
- On-site Physician Services
- Mental Health Services
- Secured, Dementia Care
- Hospice and Palliative Care
- Rehabilitative Services - Physical Therapy, Occupational Therapy, Speech Therapy
- Social Work
- Therapeutic Recreation
- Pastoral Services
- Dietary and Meal Services
Vital Stats for 60 West
- Overall 5-Star Rating - One of only nine nursing homes in CT with 5-Star Ratings in all four categories (98th percentile – 320 out of 15,600 nationally).
- Over 100 resident admissions from correctional facilities since opening.
- Over 200 total admissions from a state facility since opening.
- Coordinated care and supervision for residents needing SNF level of care under the Psychiatric Security Review Board (PSRB) who were found not guilty of a crime by reason of mental disease or defect.
- Care and supervision for residents who are listed on the Connecticut Sex Offender Registry.
- Acquired Brain Injury - Traumatic Brain Injury Program.
- US News and World Report – Best Nursing Homes – 2018-2019 and 2019-2020 in the Long Term Care category.
- Zero Employee-Related Lost Time Injuries since opening in 2013
- 2020 American Health Care Association (AHCA) ‘Silver Quality Award’ Recipient
- Mission Statement: “Provide Enrichment Through Specialized Care, Dignity and Acceptance.”
Keys to Success in Long Term Care for the Justice Involved Population
Policies, procedures and interventions compliant with state and federal nursing facility regulations, including 2017 revisions to CMS Guidelines addressing justice-involved residents.
- Development of innovative and unique programming in a person-centered facility environment and culture guided by the social and cultural backgrounds and interests of the individuals who contribute to the community’s composition.
- Procedures to assess and treat PTSD and undiagnosed traumatic reactions and symptoms of residents.
- “Stigma-free” campaign and initiative in which all employees pledged to adopt a broadened philosophy of caregiving, including a commitment to welcome and respect those of differing cultures and backgrounds.
- Extensive pre-admission screening (CCR 2505-10 8.400) and risk mitigation strategies and protocols.
- Knowledge, skills and experience in legal, government and community relations, clinical operations and healthcare regulations.
- Recruitment, screening, hiring and training of the staff as building blocks for the development and maintenance of an environment and person-centered programming that promotes resident quality of life.
- A physical environment designed with a focus on safety and comfort, with removal or mitigation of potentially dangerous, hazardous or antagonistic spaces, equipment or systems prior to occupancy with particular attention to creating an atmosphere or milieu conducive to healing.
- Specialized visitation policy and procedures, screening and access control supervision have proven effective in providing a safe environment, while ensuring resident rights to visitation are protected.
- Extensive experience with justice-involved nursing facility residents with court-ordered restrictions or conditions of parole or probation.
- Facility policies, practices and care planning that assist residents with their legal responsibilities through awareness of the resident’s restrictions, education on consequences, and counseling regarding a resident’s choices and actions.
- Training in Safety-Care™, a certified behavioral management training curriculum that places great emphasis on safe and effective de-escalation and management of potentially harmful resident care situations.“
Resources, Links and News
Each line is a clickable link.
- “For Aging Inmates, Care Outside Prison Walls” by Christine Vestal, the PEW Charitable Trusts, 8/12/2014
- 60 West Project Timeline
- UCONN Center on Aging Study – “A Community-Based Skilled Nursing Facility for Difficult-to-Place Patients”
- AHCA Silver Award New Release
- iCare Behavioral, Cognitive, SUD Brochure
- iCare Mental Disorders Brochure
- iCare Health Network Clinical Capabilities Grid
- Governing Magazine Article: States Look so Nursing Homes to Lower Prison Healthcare Costs
- Hartford Courant - Rocky Hill’s 60 West nursing home named one of best by U.S. News and World Report
- 60 West - Facility News, Discussion and Updates
- Admission Criteria for the Justice Involved Population
- PASRR Level of Care Criteria Worksheet
iCare Health Network’s Qualifications for Special Population Care
- Care of Justice-Involved and Difficult to Place Individuals (both in Connecticut and Massachusetts)
- Seven (7) Secured Behavioral Health Programs
- Six (6) Secured Memory Care Programs
- iRecovery Substance Use Disorder (SUD) Program
- Ancillary company providing onsite SUD counseling services
- Huntington’s Disease Program (part of Movement Disorder Program) – Unique to only one nursing facility in CT.
- HIV/AIDS Program – One of only two programs in CT nursing facilities.
- Veterans Program
- Advanced CHF and COPD Programs
- On average, over 90% of residents payor State Medicaid
- Both unionized and non-unionized workforce (around 1900 employees)
- Eleven (11) American Health Care Association (AHCA) Bronze Quality Award Recipients
- Six (6) American Health Care Association (AHCA) Silver Quality Award Recipients
If you represent a State agency or other public or justice-involved organization or entity and you are interested in learning more about 60 West, iCare Health Network and/or skilled nursing programs for individuals that are difficult to place or in state care, please contact:
David Skoczulek, Vice President of Business Development, at (860) 250-3075 or email at MOC.NHERACI@OFNI.