State agency cites 386 violations in decision to deny Brius more nursing homes

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California Department of Public Health’s severity and scope matrix for long-term care facilities.

In July of 2016, the state of California blocked Brius’ CEO, Shlomo Rechnitz, from acquiring the operating licenses to five nursing homes due to the company’s poor track record.

As part of its review process, the California Department of Public Health (CDPH) assessed Brius’ compliance history over the past three years (June 22, 2013 – June 22, 2016) and found 386 serious violations of federal and state law during that time.

The Health Department’s examination  revealed 265 federal regulatory violations that had a severity and scope of “Level 2, F” or worse; 108 citations for state licensing violations; and 13 penalties for failing to comply with minimum nurse staffing requirements. The CDPH cited this as support for its recent decision to turn down Rechnitz’ applications to operate more nursing homes.

According to the CDPH, the scope and severity of a federal deficiency is based on how flagrant the violation was, and how widespread the problem was in terms of the affected residents. Here, for example, a “Level 1, A”, the least severe deficiency, would indicate no actual harm with potential for minimal harm for an isolated few nursing home residents, while a “Level 4, L”, the most severe violation, would indicate immediate jeopardy is widespread for nursing home residents. Below is the CDPH’s tally of Brius’ 256 deficiencies over the past three years followed by links to its denial letters.

Deficiency Level

Scope & Severity Level Description

Number of Deficiencies

Level 2, F No actual harm with potential for more than minimal harm that is not immediate but is widespread.


Level 3, G

Actual harm that is not immediate jeopardy and is isolated.


Level 3, H Scope is pattern present, severity level of actual harm that is not immediate jeopardy.


Level 4, J Immediate jeopardy to resident health or safety and is isolated.


Level 4, K Immediate jeopardy to resident health or safety that is a pattern.


Level 4, L Immediate jeopardy to resident health and safety and is widespread.



According to the CDPH, the most severe citation the Department can issue is a class “AA.” Just below this are class “A,” and “B” citations. Below is a  count of Health Department  citations at Brius facilities from June 22, 2013 to June 22, 2016.

Citation Level

Citation Level Description

Number of Citations


A direct proximate cause of death of a patient of a long-term health care facility.


A Imminent danger of death of serious harm to patients, or a substantial probability of death or serious physical harm to patients.


B Has a direct or immediate relationship to patient health, safety, or security. Can include emotional and financial elements.



Lastly, the denial letter also points out that Brius was hit with 13 penalties for failure to comply with the required minimum nurse staffing requirements  (3.2 Nursing Hours Per Patient Day) in facilities it owned, managed, or operated, either directly or indirectly.