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Livingston County nursing home reports medication error, $10,000 fine; officials dispute large Medicaid overpayment findings
Summary
Livingston County’s Center for Nursing & Rehabilitation (CNR) reported a harm-level medication error that led to a $10,000 fine and a one‑star CMS rating drop; officials approved a supplemental staffing contract and described ongoing appeals of OMIG and Performant audit findings totaling more than $1 million in alleged overpayments.
The Livingston County Center for Nursing & Rehabilitation reported a harm-level medication error from October 2025 that resulted in a $10,000 fine and a one-star reduction in its overall Centers for Medicare & Medicaid Services rating, county staff told the Human Services Committee on March 3.
Samontra Spencer, who presented the item, said the medication error involved a supplemental staffing nurse who was removed from the facility roster immediately after the incident. The committee was also asked to approve a supplemental staffing contract with Fusion Medical Staffing, LLC, covering 4/1/2026–3/31/2027; the contract was approved by the committee.
CNR reported strong occupancy — 260 residents in-house for 98.0% occupancy as of Feb. 23, 2026 — and total cash reserves of $2,458,237.32. At the same meeting, Chief Financial Officer Judy Seier summarized audit and payment issues that the facility is contesting.
County staff said the Office of Medicaid Inspector General (OMIG) has an estimated overpayment of $1,022,840 covering Jan. 1, 2018–Dec. 31, 2021; the facility intends to appeal roughly $318,000 of the total. Separately, a Performant audit of Medicaid claims paid for long-term care services from March 1, 2020 through Dec. 31, 2024 reported 420 overpayment claims; the facility is disputing $953,550.02 of the Performant total and agreed to $1,911.19 on 24 claims, according to the materials presented to the committee.
Spencer told the committee the CNR has submitted a Plan of Correction to the New York State Department of Health (DOH) on Feb. 20, 2026, following the recertification survey exit (Jan. 28, 2026) that resulted in 11 citations (2 physical plant; 9 health). The county identified the medication error and removal of the supplemental nurse as immediate corrective actions.
The committee heard that facility initiatives include completion of wanderguard system upgrades with two change orders pending, recruitment for a deputy director and a CFO candidate expected to start on March 16, and a six-week certified nurse aide training class that began Feb. 25 with 16 students enrolled. County staff said they are working with partners to start an LPN program in July 2027.
The committee did not vote on the appeals or audits themselves; it approved the staffing contract and received the operational and financial updates. The county’s materials note that some audit items will be appealed and that final audit reports remain pending.
