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MEMPHIS, Tenn. — Small signs that read “grand re-opening” and “now hiring” line the front of the building at Signature Healthcare at Saint Francis.

The East Memphis nursing home has been at the center of turmoil for months.

In February, state surveyors uncovered major problems at the nursing home which led to the facility temporarily losing reimbursements from the Centers for Medicare and Medicaid Services.

After the funding loss, patients moved out.

Eventually, CMS fined the facility $1,225,900.00.

Brian Lee runs a national, nursing home advocacy group called Families for Better Care and he previously served as a long term care ombudsman in Florida.

“$1.2 million is the largest fine I think I’ve ever seen,” he told WREG.

Lee has been following the situation at Signature Healthcare at Saint Francis and WREG’s reporting of the issues.

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Lee said a seven figure fine confirms horrific conditions at the nursing home.

However, he said the nursing home is sort of being “let off the hook,” considering the alternative, of losing its funding for good, would have likely shut the doors.

“That’s really dodging the bullet considering what would have happened in response to the tragedy that occurred for those residents,” added Lee.

Signature Healthcare spokesperson Bed Adkins told WREG in April there would be a fine in lieu of a denial for all patients on Medicare and Medicaid.

“There will be a monetary fine and they will also temporarily halt payment for new admissions,” Adkins explained during that previous phone interview.

The amount of the fine, nor the most recent surveys were available at the time.

Records showed Signature Healthcare at Saint Francis has been cited with 65 deficiencies since 2011.

It’s a one-star rated facility at Nursing Home Compare.

A survey from late 2014 revealed a patient was rushed to the hospital after not getting the proper pain management.

A family member confirmed she later died.

WREG obtained a copy of the nearly 400 page document that reveals what surveyors found after spending almost two weeks at the nursing home in February.

The nursing home was cited with 35 deficiencies, many of them severe.

There were medication errors, problems with staff not conducting skin checks on patients at high risk for wounds, and in some cases, patients went months without even seeing a doctor.

There were also dirty bathrooms, expired medications and patients were left sitting in their own urine.

“The big question is, what is the quality of care going to be like moving forward,” said Lee.

The On Your Side Investigators requested an on camera interview with the nursing home administrator.

Adkins sent an emailed statement.

He said Signature paid its fine, and has worked closely with regulators to correct issues.

“In fact, Signature HealthCARE at St. Francis has gone beyond the state’s recommendations to ensure high-quality care for all our residents,” he said.

Adkins also said the nursing home has a number of new staff members including a new administrator, director of nursing and medical director.

He added that all employees have gone through special training focused on “enhancing person-centered care and abuse prevention.”

Lee said no matter what, it’s critical for all families and patients to make sure their voices are heard.

“If you don’t complain, problems don’t get fixed,” he explained.

CMS officials confirmed Signature paid the bulk of the fine months ago related to the worst deficiencies.

The balance was paid earlier in August.

Families with additional questions can contact the Regional Long Term Care Ombudsman at 901-529-4565 extension 215.