Three weeks after regulators put Blossom Philadelphia on notice by revoking its license to run group homes for intellectually disabled adults, family members and advocates say not much has changed at the Chestnut Hill agency.
Last week, there were no staff present when a client returned home after Blossom's day program, clients continued missing their medications, and the houses were still running out of food, a mother said Tuesday evening at a parent support group in Mount Airy. She declined to be identified because she fears reprisals.
Mary Citko, who works for the Pennsylvania Department of Human Services unit that oversees Blossom, told families at the meeting that she visited five Blossom homes last week and saw some of the same issues, including problems from previous inspections that still had not been fixed, even after the license revocation on Oct. 24.
"It really frustrated me," Citko told the support group, which met at an NHS Human Services office.
The absence of urgent action by Blossom, which filed an appeal Tuesday, means the agency is unlikely to improve long term, said Audrey Coccia, co-executive director of Vision for Equality, a nonprofit that sponsors the group.
"I think you should make an example out of Blossom," Coccia told Citko, who is a manager at DHS's Office of Developmental Programs, but who will not decide on Blossom's future. "If this is the way you do business, it's time to go out of business," Coccia said.
That was surely not the kind of change Paula Czyzewski, Blossom's chief executive since 2014, had in mind when she hired a consultant in 2015 to help foster culture change. Czyzewski praised the results in a case study: "We're much more willing to try things, and see where it takes us."
Under Czyzewski, who declined an interview request, change came in spades to the 71-year-old nonprofit. Czyzewski oversaw complete turnover in senior management. She also changed the organization's name this year to Blossom Philadelphia, from United Cerebral Palsy Association of Philadelphia.
But Czyzewski, who was paid $185,726 in 2015, didn't stop there.
Effective July 10, Czyzewski hired a staffing firm to supply direct-care workers for Blossom's 32 community homes, laying off 179 of Blossom's employees.
One longtime observer of intellectual disabilities services in Philadelphia said Blossom, which had $24.6 million in revenue in fiscal 2016, needed to modernize.
"I had some hopes for her coming in that she might bring new vitality and dynamism to it, but this is more like total upheaval," not the right approach, said Kathy Sykes, former director of intellectual disability services in Philadelphia.
Outsourcing staff was a terrible idea, Sykes said. Blossom said it did so to relieve supervisors of scheduling headaches, but Czyzewski also told family members that the residences were losing money and might have to close.
The change led to an ever-changing set of caregivers at Blossom, which houses 89 adults.
"It's a revolving door. I don't even bother learning their names anymore because they're not going to be around long enough for it to matter," said Earni Young, who has a 48-year-old family member in one of Blossom's houses.
Not long after the license revocation, Blossom told families it would try to hire back some of the staffers it laid off.
"We are currently developing how this will be implemented and understand that this transition will take time," Blossom spokesman John Moeller Jr. said.
But only about 30 of the direct-care staffers — mainly those who had not worked there long enough to get unemployment benefits — took jobs with Integrity Workforce Solutions LLC, a long-term staffing firm in Haverford, that was supposed to offer jobs to all 179 of Blossom's residential staff, albeit at sharply lower pay and no benefits, a former worker said.
The lack of regular staff makes it hard for family members to advocate for their loved ones.
"With the turnover in staff, you just can't get anything done. As soon as you start talking to someone it's someone new, even with the higher-ups at Blossom I've been talking to," said Diane Sessions, whose 41-year-old sister has lived at Blossom since 2001.
Sessions described her sister as a social butterfly, who enjoyed Blossom's day program and outings. "In the last two years, though, she has been bedridden due to wounds, which are the result of sitting in urine and feces," Sessions said.
Physical harm is not all that upsets family members.
A supervisor recently went winter-clothes shopping for Young's relative and bought skinny jeans — for a woman who can't straighten her legs and can only use one hand.
"This is the kind of thing that as a family member drives you to drink because it tells you when they look at the client, they see a blur," Young said. "They don't see an individual. They see a blur."
Family members and advocates are not convinced that regulators are doing enough to protect residents. They are meeting with Blossom officials every other week to monitor progress, a city official said.
"What I want is for somebody to be sitting on them 24/7 to make sure they do right. I don't want it to go back to what we've had to deal with," Young said.