BOSTON (SHNS) – Three weeks into the job, Secretary of Veterans’ Services Jon Santiago told his former legislative colleagues Tuesday that he views the challenge of implementing reforms at his department similar to leading a business startup or turnaround, and highlighted how things have changed at the state’s troubled veterans’ homes.
“Really, the goals come down to one thing: it’s how do we rebuild trust in the veteran community,” Santiago, whose department serves the roughly 380,000 veterans in Massachusetts and their families, told the Joint Committee on Ways and Means at a budget hearing in Fitchburg. “This is effectively a startup in a turnaround in some respects. The governor has invested a significant amount of financial and human resources to do just that. Now, I’m here with our superintendent from Holyoke and the superintendent in Chelsea, who are committed to changing the culture, rebranding the institution, to best serve our veterans.”
The Department of Veterans’ Services that Santiago leads became a Cabinet-level executive office this month under a 2022 law that responded to governance and operational shortcomings that proved fatal during the pandemic, particularly at the state-run soldiers’ homes in Holyoke and Chelsea.
That law also required that the top official at each veterans’ home be a licensed nursing home administrator, a qualification that the head of the Holyoke facility reportedly lacked during the COVID-19 outbreak that killed dozens of veterans there in 2020.
On a number of fronts, Santiago said, “we’re beefing up our professionalism and I hope that will translate to better care and I’m confident that it will.” He introduced Veterans’ Home in Holyoke Superintendent Michael Lazo and Assistant Secretary of Veterans’ Homes and Housing Robert Engell, who is serving as interim superintendent at the Veterans’ Home in Chelsea. Both men, Santiago said, are licensed as nursing home administrators.
Healey’s fiscal year 2024 budget proposes a budget of $185.6 million for the new secretariat, up about 6.5 percent from the $174.25 million in total funding that the department got in the FY23 budget.
The governor’s budget includes $49 million for the Chelsea Soldiers’ Home, a slight decrease that the administration said reflects the absence of $1.7 million in one-time costs budgeted in fiscal 2023 while covering inflationary and staffing cost increases. It also recommends $30 million for the Holyoke Soldiers’ Home, a slight increase over the current budget.
With support in the governor’s budget for “robust staffing” and “substantial progress in clinical and infection control protocols,” Lazo said that “2023 will be a turning point for the veterans’ home.”
Lazo told lawmakers that the Holyoke facility met 466 of the 472 standards (98.7 percent) reviewed in a January survey by the U.S. Department of Veterans Affairs. He said one finding was of a clinical nature and that a corrective action plan was submitted to the VA last week.
“The VA will review and will return an accreditation decision over the coming weeks,” he said. “I’m very confident the home will receive accreditation.”
Lazo said that the Veterans’ Home in Holyoke has filled the “critical positions” of recreation director and budget director, and remains focused on recruiting and hiring direct care staff including nurses, certified nursing assistants, and licensed practical nurses. He said Holyoke also uses contracted agency staff to maintain staffing levels.
“As a result of increased staffing, our hours-per-patient-day consistently remains above the CMS five star rating standard of 4.408 hours for the skilled nursing facility. Our January 2023 average hours-per-patient-day was 7.5,” Lazo said. “We look to build our team and remain focused on continuously recruiting qualified clinical staff.”
Rep. Mathew Muratore, himself a licensed nursing home administrator, applauded Lazo for the Holyoke home’s staffing situation.
“I’m not sure how you’re doing it, but that’s unheard of to see or hear staffing levels like that. But I’ll tell you, that equates to good care. So I’m sure that’s going on. I applaud you for everything you’re doing,” Muratore said. “It’s unfortunate the media doesn’t pick up on the good things that happen in the soldiers’ home. But I applaud you for what you’re doing.”
The Holyoke home is planning to have a consultant conduct a staffing assessment to get a sense of the staffing needs for the new facility being planned for later this decade. Lazo said that the “modern design of this new facility will require additional clinical and non-clinical staff to maintain the 234-bed facility at appropriate levels.”
Both veterans’ homes are in the process of being replaced, but those projects are funded through the capital improvement plan and federal funding rather than the state budget.
The Holyoke replacement project is in the design phase and is projected to wrap by 2027. The state has already received $160 million in conditional federal funding for the project and expects a reimbursement rate of up to 65 percent for the rest of the project.
Chelsea’s 136-bed long-term care Quigley Building will be phased out in May and replaced by a new Community Living Center, a $200 million project reimbursed at 65 percent by the federal government.
Engell, who has been leading the Chelsea home since Healey fired Superintendent Eric Johnson when he came under fire for mismanagement in January, told the committee that the staff in Chelsea is actively planning to make a smooth move into the new center this spring.
“The thoughtful building design will provide an uplifting and pleasant environment for our residents. It is designed to capture daylight and provides panoramic views of downtown Boston and the harbor. Not only a model for dignified long-term care and veteran care, our new veterans’ home will be a state-of-the-art resilient and sustainable building that meets current and future needs for our veterans in Massachusetts,” he said. “The existing Quigley hospital building will be taken down when the new home becomes operational, facilitating the final development of a full seven-acre site into an accessible landscape while restoring and enhancing Powder Horn Hill as a public amenity.”
Engell said that the Chelsea home is also undertaking “aggressive hiring efforts” that so far this year have resulted in more than 30 new hires. The home is also working on becoming certified by the Centers for Medicare and Medicaid Services and licensed by the Department of Public Health as a nursing home.