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Neville Center at Fresh Pond, the nursing home where more residents have died of Covid-19 than at any other long-term care facility in the city, has deep ties to the city of Cambridge and two major public agencies: the Cambridge Health Alliance and the Cambridge Housing Authority. Yet both agencies disclaim any responsibility for the operation of the nursing home, and the city has not responded to questions about it.

City Manager Louis A. DePasquale sits on the nursing home’s board as the city’s representative; Alliance general counsel Andrew Fuqua is the president; and housing authority chief financial officer John Filip is its treasurer, according to state corporation records.

Asked this week what they knew of or how they responded to the situation at Neville Center, where 27 residents had died as of Tuesday, the head of the housing authority and a spokesman for the Alliance both said their organizations did not exercise “direct oversight” over the 112-bed nursing home. A spokesman for the city did not reply to two email messages.

The Alliance spokesman, David Cecere, also said federal law requires Fuqua to keep his Alliance and Neville “roles separate because the two entities are referral sources for each other.”

After attempts at comment through their agencies and city offices, Filip, Fuqua and DePasquale – who is also on the Cambridge Health Alliance board – were sent emails directly Saturday. There was no response.

The head of the company that manages the nursing home, Steven Raso of Landmark Management Solutions, has also not replied to emails or phone messages. The nursing home paid Landmark $994,816 in 2016, according to the most recent report filed with the Massachusetts Attorney General’s unit that oversees nonprofits.

Ties go back to 1927

In retrospect, the ties between the nursing home and the public entities aren’t surprising, though they have never been mentioned in weeks of reports about local agencies’ response to the pandemic: Neville Center was formerly Neville Manor, the city nursing home established in 1927 as the City Home for the Aged and Infirm.

In 1999 and into the early 2000s, the Neville Manor site at Fresh Pond was redeveloped as a new nursing home and a separate assisted living facility. The two long-term care entities are Neville Center, the nursing home, and Neville Place, the assisted living facility.

The city and Cambridge Housing Authority helped finance the project with the aid of state bonds, federal low-income housing tax credits and loans from affordable housing agencies. In return, 75 percent of nursing home residents must be covered by Medicare or MassHealth, and 57 units in the assisted living center must be reserved for low- or moderate-income residents. A Cambridge Health Alliance-affiliated trust that owns the land under the nursing home and assisted living buildings charges $1 a year for a 99-year ground lease.

Opacity for nursing homes

It’s difficult to find out what goes on inside nursing homes at any time, and the pandemic has been no exception. Cambridge, which arranged universal testing for the coronavirus at all seven Cambridge long-term care entities in April, is reporting the aggregate number of residents who have tested positive and total deaths, but nothing about individual facilities.

The state now discloses a range of the number of staff and residents infected at each assisted living and nursing home, and only recently began reporting the number of residents who have died at individual nursing homes.

Tantalizing glimpses of additional details appear in weekly reports by Chief Public Health Officer Claude Jacob to the City Council. At a special meeting Thursday, Jacob said that testing showed a 70 percent infection rate at one long-term care facility – which remains unnamed. Jacob has said the overall proportion of positive tests has declined, but hasn’t said why.

Five-star facility

Neville Center gets an overall rating of five stars from Medicare, which the federal agency defines as much above average. In the most recent state inspection of the nursing home last August, it was cited for not scheduling a yearly check of one resident’s pacemaker; leaving another resident alone with prescribed medications instead of a nurse watching the person take the drugs; and failing to develop a “water management plan” to protect against potential Legionnaire’s disease.

Neville Center was fined $7,803 in 2018 after police found one resident, confused and with facial cuts, one and a half miles from the nursing home at 2:50 a.m. on a December night in 2017. A nurse claimed the resident had fallen out of bed and been sent to the hospital in an ambulance. The nursing home couldn’t produce any record of the ambulance trip, and five ambulance companies called by the inspector said they had no record of transporting a resident from Neville Center that night.

The state Department of Public Health says more than 30 residents and staff at the nursing home have tested positive for Covid-19 – the same infection level as at Cambridge Rehabilitation and Nursing Center, Sancta Maria Nursing Facility and Cadbury Commons Assisted Living. Seventeen residents have died at each of the two nursing homes besides Neville Center: Cambridge Rehabilitation and Sancta Maria.

The company that manages Neville Place Assisted Living and The Cambridge Homes, another assisted living site, has said no residents have been infected and only a small number of employees – fewer than 10. Youville House assisted living has 10 to 30 cases among residents and/or staff, the state says; phone messages left with a Youville manager have not been returned.

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