Skilled Nursing Provider Athena Settles DOJ Probe Over Opioid Denials as Feds Promise More Crackdowns

The federal government this week announced a settlement with a regional skilled nursing chain that officials accused of discriminating against residents with opioid use disorder.

Athena Health Care Systems will adopt a non-discrimination policy regarding patients dealing with opioid addiction, develop training programs, and pay a $10,000 civil penalty to the government as part of the agreement, according to a statement from the U.S. Attorney’s Office for the District of Massachusetts.

The Farmington, Conn.-based Athena, which operates 16 facilities in Massachusetts — among more than 50 across New England — received a pair of Americans with Disabilities Act complaints for allegedly declining to accept residents who were being treated with buprenorphine, a drug intended to treat opiate addiction.

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“We commend Athena for cooperating with our investigation and working with us to modify its policies for compliance with the ADA,” U.S. attorney Andrew Lelling said in a statement announcing the deal. “We encourage other entities to proactively do the same.”

The residents’ need for skilled nursing care was unrelated to their opioid use disorder, the government noted, but they would still need to receive regular doses of buprenorphine in order to continue their addiction treatment.

“The opioid epidemic is a battle in which victory is measured by the number of lives saved,” Lelling said. “Medically assisted treatment is a powerful tool for helping people in recovery to avoid relapse. To that end, my office will continue to identify and eliminate illegal barriers to treatment.”

Athena thanked the federal government for acknowledging its efforts to comply with the ADA in the formal settlement statement, and emphasized its full cooperation with the DOJ’s investigation.

“Athena and its managed centers share in the struggle with individuals and families facing opioid addiction and other substance use disorders, and will continue to provide much-needed care and services,” Athena spokesperson Tim Brown said in a statement provided to SNN. “We look forward to continuing our mission of providing quality care and great customer service to our patients and their families.”

The Athena settlement marks the second such investigation into opioid-related nursing home denials by the federal government — both of which came out of the Massachusetts U.S. attorney’s office.

Charlwell House, a 124-bed skilled nursing facility in Norwood, Mass., paid $5,000 and developed similar anti-discrimination programs in May 2018 to settle allegations that it had inappropriately barred residents who used the drug Suboxone to treat their opioid use disorder.

“Overdoses killed more than 2,000 individuals in Massachusetts last year alone,” Lelling said in a statement at the time. “As Massachusetts faces this overdose epidemic, now more than ever, individuals in recovery must not face discriminatory barriers to treatment.”

Addiction treatment — and behavioral health issues more generally — have remained an area of improvement for the nursing home space, as operators struggle to adapt to a health care landscape with a significantly higher incidence of opioid use disorder than in the past.

“The facilities have no real guidance on how to take care of the population,” Helen Magliozzi, director of regulatory affairs for the Massachusetts Senior Care Association, told the Boston Globe.

Magliozzi could not provide the Globe with precise statistics about the number of Bay State nursing homes that accept residents with addiction issues, though she noted that several operators have begun working to develop a standard framework for treating such patients; the state’s Department of Public Health also established a program specifically designed to improve opioid treatment in long-term care this past July.

Part of the issue, according to the Globe, is a lack of connections to licensed medical providers that can prescribe addiction-treatment medication, as well as concerns that visitors can provide residents with illegal drugs. In addition, Magliozzi told the publication, people dealing with opioid use disorder are generally younger than the typical nursing home resident, with distinct needs from their older counterparts.

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