The Pennsylvania Office of Attorney General, through its Medicaid fraud control neglect team, is investigating Blossom Philadelphia, a Chestnut Hill nonprofit that in October lost its license to operate residences for 89 adults with developmental and intellectual disabilities, a spokesman for the office confirmed Friday.

When the Pennsylvania Department of Human Services revoked Blossom's license to operate group homes in October, the agency said Blossom had displayed "gross incompetence." Four new providers have taken over services at 32 former Blossom houses, most of which are in Northwest Philadelphia.

Family members of Blossom residents said the neglect at the Blossom houses took many forms, including lack of food, failure to give residents their medicine or get them to medical appointments, lack of social outings, the absence of basic hygiene, and, for at least one resident, the refusal to change diapers, causing severe bed sores.

On New Year's Eve, before the transfer, a Blossom resident died after being given pizza to eat even though he was on a doctor-ordered diet of pureed food only. That death is being investigated by state and local disability services officials. A second individual died shortly after the transfer to a new provider, a spokeswoman for the state human services department confirmed Thursday, but she declined to provide details until the investigation was completed.

In the year ended June 30, 2016, Blossom received $18.2 million of its $19.4 million in revenue from government agencies, with much of that money coming through Medicaid waivers for particular individuals. Those waivers are supposed to pay for services that in some cases residents were not receiving, family members said.

Blossom's chief executive, Paula Czyzewski, became chief executive of Blossom in 2014 and totally revamped senior management leading to a notable decline in the quality of services starting in 2016, families said. Czyzewski's most fateful move, however, was the decision last year to lay off 179 caregivers and hire Integrity Workforce Solutions, of Haverford, to staff the houses. That led to constant turnover and rapid deterioration in care, family members and other observers said.

On Thursday, Czyzewski told Blossom's headquarters staff that she is taking a leave of absence under the federal Family & Medical Leave Act without specifying why.