PHOENIX (3TV/CBS 5) -- The nursing facility where a patient was raped and became pregnant in Phoenix is shutting down the intermediate care unit of their building. 

Hacienda HealthCare released a letter to their employees Thursday saying in part, "After careful consideration, the Board of Directors have come to understand that it is simply not sustainable for us to continue to operate our ICF-ID. Thus, we will begin to transition clients and eventually cease operation."

The Arizona Department of Economic Security, the state agency that ordered Hacienda HealthCare to hire a third-party manager, is not on board with their decision to shut down the ICF unit.

“This is very disturbing news. We want to find a path forward that is in the best interests of the patients — and this approach is not it.

We encourage Hacienda to work with the State to find a path forward. State agencies are exhausting all efforts to bring this to a conclusion that is beneficial to the patients, some of whom have been at this facility nearly their entire lives. They are the ones who should come first, without question. This approach simply does not meet that test.”

[SPECIAL SECTION: Hacienda HealthCare pregnancy investigation]

The ICF is where the victim in the rape case, which was first made public by Arizona’s Family in January, was being treated. Phoenix police have since arrested a nurse in connection with the sexual assault.

[ORIGINAL STORY: Woman in vegetative state gives birth at Hacienda HealthCare in Phoenix]

There are at least 36 patients currently in the ICF, said a spokesman with Hacienda HealthCare.

Earlier this week, Gov. Doug Ducey called on the Arizona Attorney General’s Office to investigate and bring charges against Hacienda HealthCare.

[RELATED: Gov. Ducey calls on state attorney general to prosecute Hacienda HealthCare]

Hacienda HealthCare released the following statement Thursday about the closure.

"The Hacienda Healthcare Board of Directors, after a great deal of careful consideration, has come to understand that it is simply not sustainable to continue to operate our Intermediate Care Facility for the Intellectually Disabled. Thus, pursuant to a vote of the Hacienda Board of Directors on February 1, 2019, we will begin to transition clients and eventually cease to operate the ICF-ID unit.

"Immediately following the February 1st vote, we notified the State of Arizona of the Board’s decision. Since then, we have been working with the proper state agencies to develop a plan to help the State transition our ICF-ID patients to other facilities. We will continue to work with these agencies in the weeks and months ahead to ensure an appropriate and safe transition moving forward. The care of our patients remains our top priority and we will do everything in our power to ensure a smooth transition for them and their families."

Read the entire letter sent to Hacienda HealthCare employees below.

"In the more than half-century history of Hacienda HealthCare. our organization has never faced a challenge as difficult as what our clients and our team have faced over the past five weeks. Each of you have responded admirably. You have worked long hours and gone the extra mile in every way possible for our clients, their families, your co-workers and for Hacienda

"As you know, in the aftermath of the unconscionable and unprecedented alleged actions of one of our employees, we have had to make a complex set of changes to virtually every aspect of how Hacienda does business, following directives from multiple state agencies. Each of you is to be commended for your hard work and your willingness to help Hacienda's new leadership team implement these changes instantly and comprehensively. It has not been easy. Each of you have given your all to ensure that every single Hacienda client is safe and cared for as effectively as possible Every state directive has been taken seriously.

"As part of these changes. AHCCCS has required Hacienda to hire a third-party manager to oversee operations in the Intermediate Care Facility for the Intellectually Disabled (ICF) and the Skilled Nursing Facility (SNF). Hacienda's new leadership put in place this new team ASAP, again making sure to do what the State asked. Unfortunately, a long term work agreement could not be met.

"After careful consideration, the Board of Directors have come to understand that it is simply not sustainable for us to continue to operate our ICF-ID. Thus, we will begin to transition clients and eventually cease operation.

"For however long this difficult transition takes, our obligations to our staff, patients, and their families will be heightened even beyond what we have experienced of late. It is imperative to us that we continue to serve each of you in the best way possible

"This transition will be a team effort, one that will not take place overnight and may be many months. We will work with the State closely during this time to ensure every patient's safety, security and care as we will lead up to what eventually will be a sad goodbye to many beloved patients.

"We understand that this is a difficult day for many Hacienda team members. Your management team shares that sorrow. We will do everything in our power to help every employee impacted by this change to secure employment within our other programs where possible, or within the community. We will be offering retention incentives as well as a severance package to employees that help us see this transition through. As an organization, we will do everything possible to get through the challenge together, effectively and with an undiminished commitment to those we serve.

"Again. Thank you for everything you have done and will continue to do for our clients and this community."

Arizona's Healthcare Cost Containment System (AHCCCS) also responded to Hacienda's plan to close the unit Friday morning with a letter to the facility: 

"The State is in receipt of Hacienda’s letter dated February 6, 2019 and its notice sent yesterday to the Arizona Department of Health Services (ADHS), regarding its plans to cease operations of the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID). As has already been communicated, the State’s paramount priority is and has been the health and safety of the residents of the ICF-IID. It is for this reason the State has concerns over the confirmation in your communications that the facility will be closing with little detail or clarity in your plan to move forward. As the health and safety of these residents could be adversely impacted by transitioning them to another facility, every effort should be made to ensure that such a transition is not necessary; at this time the State does not have confidence that Hacienda has provided a plan that meets this test.
Additionally, you agreed, in writing, that you would employ a third party within the timeline provided by the State and subsequently communicated your compliance with this directive. Your February 6th letter confirms your understanding of this requirement. Unfortunately, Hacienda’s agreement with the third party was rescinded, resulting in the State’s request for a new plan. Your February 6th response falls well short of meeting this request.
The response neither provides clarity nor demonstrates intent to comply with contract provisions or prior directives to reasonably assure the health and safety of the residents of the ICF-IID – something the State finds deeply concerning. Your recent correspondence and statements to the media make it clear that rather than complying with the prior agreement to bring in a third party and without a definite plan to address challenges Hacienda faced with the third party it chose, such as costs, the Board of Directors decided to close the facility citing the facility’s lack of financial viability.
To avoid any potential misunderstanding, and to assist the State in ensuring that the residents of the ICF-IID are protected, the State requests Hacienda to definitively answer the following questions and provide the following information in writing no later than 4:00 p.m., Friday, February 8, 2019:
• Was the vote of the Hacienda Board of Directors to formally and unconditionally close the ICF-IID? If the vote was conditional, please provide the conditions. Please provide the State with a copy of the Board resolution.
• How does this decision comply with paragraph 5 of Hacienda’s contract with DES (ADES 18-00007493) which states: “5. Contract Changes. The Contractor shall not terminate the operations of the ICF/IID institution without the prior written consent of the Department during the term of this Contract.”?
• Does Hacienda intend the letter of February 6, 2019, to serve as its notice to DES/DDD that it is terminating its contract with DES (ADES 18-00007493)? If not, please provide a specific date by which that notice of termination will be sent.
• With respect to the ICF-IID, Hacienda notified the Arizona Department of Health Services of its plan to close the facility; however it did not indicate its intent to relinquish its Medicare/Medicaid certification as required by 42 C.F.R. 438.75, nor was the notice sufficient. Please provide a specific date by which that notice will be sent.
To be clear, it was never the State’s desire to see the ICF-IID shut down. As stated in our prior communications, the State’s primary objective is to ensure that the residents are living in a safe environment and are provided appropriate care by qualified individuals in a manner that is safe and that fully addresses the residents’ needs and the choices of the residents and their families. To be clear, the State does not consent at this time to the ICF-IID ceasing operations.
As the State has continued to have employees on site to monitor this facility, the State is anxious to facilitate a solution that ensures the ongoing safety of residents while moving forward and is offering Hacienda two options: (1) come into compliance with the directive in the January 16, 2019 letter from the State or (2) enter into an agreement with the ADHS to voluntarily permit ADHS to exercise licensing authority over the ICF-IID pending legislative action regarding licensure. For more information regarding the second option, Hacienda may contact ADHS directly.
As mentioned above, the State expects your written response on or before 4:00 p.m., Friday, February 8, 2019."


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