Nursing Home Profits: "Astonishing"

According to a recent Wall Street Journal Market Watch press release, the nursing home industry is doing just fine, thank you very much. This is true despite the fact Medicare reimbursements were reduced back in 2011.

Families for Better Care, Inc. is a citizen advocacy organization dedicated to quality resident care in nursing homes and other long-term care settings. Executive Director Brian Lee served as Florida’s State Long-Term Care Ombudsman for most of the past decade. According to Mr. Lee: “The industry’s analysts framed the Medicare adjustment as an eventual doomsday for the nation’s nursing home market. But the industry’s own reports show quite the opposite, revealing surging revenues, strong profits, and expansion through acquisitions. The industry is wallowing in strong profits while failing to consistently provide quality care.”

The release goes on to note: "A recent study by the University of California-San Francisco shows a steady decline in nursing hours for Medicare-licensed facilities and an unacceptably high level of deficiencies."

Do not let the nursing home industry fool you by crying poverty due to funding cutbacks. The numbers don't lie. In 2011, one company, Adcare Health Systems posted record annual revenues of $151.4 million, which is an increase of 198% over the previous year. Another company, Kindred Health Care, reported an increase in consolidated revenues of 27% to $5.5 billion compared to $4.4 billion in previous year. If that's "hard times" ...don't we all wish our times were that hard?

Staffing cutbacks effect nursing home residents every day. No matter what the industry says, those cutbacks are not because of a lack of funding. They are nothing more than a business decision...a decision that puts profits over people.

More Evidence Nursing Homes Do Not Pay Staff Enough - Homes Want Exemption From Health Care Law's Requirements

In an article in today's New York Times, Robert Pear describes the efforts the nursing home industry is undertaking to escape from the requirements of the new Affordable Care Act. The first sentence in Mr. Pear's article says it all: "It is an oddity of American health care: Many nursing homes and home care agencies do not provide health insurance to their workers, or they pay wages so low that employees cannot afford the coverage that is offered."

Why is it important that nursing home workers have access to affordable health care? According to Ms. Charlene A. Harrington, a professor at the School of Nursing at the University of California, San Francisco: "If employees have health insurance, they are more likely to be treated for illnesses, less likely to pass on infections to nursing home residents and more likely to get early treatment for occupational injuries.” Unfortunately: "Among workers who provide hands-on care to nursing home residents, one in four has no health insurance."

Shouldn't the people responsible for caring for nursing home residents be paid a living wage and, thus, be able to afford health insurance? Shouldn't these same people have access to affordable healthcare? Aren't nursing home residents safer if staff can afford to see a physician when they are ill or injured? The answer to all of these questions is: "Yes."

If you think nursing homes should have to abide by the new Affordable Health Care Act by offering staff affordable health care beginning in 2014, as the law requires, do not remain silent. Contact your congressperson. Let them know your thoughts. Nursing home residents would be safer if all staff had access to affordable healthcare.

Civil Justice System Is An Effective Force In Uncovering Nursing Home Abuse

We have all heard about "tort reform" and limits on the amount of damages juries can award for "pain and suffering." In essence, advocates of "tort reform" do not believe juries are capable of making decisions, based on the evidence presented at trial, concerning the award of non-economic or human damages. For example, in Idaho, there is a "cap" on non-economic damages set by statute. As a practicing trial attorney, I believe any such artificial limit on damages is, simply put, wrong-headed. It is an invasion of the province of the jury and, in fact, shows total disdain for the process and the commonsense of our jurors.

As reported by the Kansas City Star, a recent study by the American Association for Justice, an organization to which I belong, demonstrates how the civil justice system reveals neglect and abuse of nursing home residents.The report, entitled: "Standing up For Seniors: How the Civil Justice System Protects Elderly Americans," can be found here.

The civil justice system is able, to a certain extent, to ensure the owners and operators of nursing homes are held accountable. The reason is say, "to a certain extent" is because of the artificial limits placed on a jury's ability to award full and appropriate monetary damages to those who suffer abuse and neglect in the nursing home and assisted living settings. I certainly trust our citizens to make reasoned and proper decisions when it comes to the award of money damages for non-economic (pain and suffering or, as I refer to them "human losses"). You have to wonder, why don't Idaho's legislators have the same faith in juries? 

Cuts In Home Care Make It Even More Important To Adequately Research Nursing Homes

In an article in today's New York Times, reporter John Leland, describes the cuts states are making to close budget gaps and the effect those changes are having on the elderly. Some of the cuts described by Mr. Leland include meal deliveries, housekeeping assistance and aid for family caregivers. 

As Mr. Leland correctly points out at the beginning of his article, such cuts are "penny wise and pound foolish" (my words not Mr. Leland's) because the programs being cut have demonstrated they actually save states money by keeping the elderly at home and not in expensive nursing home and assisted living facilities. Interestingly, Bruce Goldberg, the director of the Oregon Department of Human Services, inadvertently demonstrated the very problem with attempting to balance Oregon's budget on the backs of its elderly and infirm population. According to the article, Mr. Goldberg said: "[T] he agency did not have an estimate for how many of the people losing home care would end up in assisted living facilities or in nursing homes -- or, if they did, how the state would pay for them."

Is it right for Oregon and other states to balance their budgets in such an irresponsible manner? I will leave that for you to decide (although, perhaps, the way I phrased the question reveals my answer). More importantly, to the extent those loosing the financial assistance for home care need to take adequate steps ahead of time to properly research nursing home and assisted living facilities in order to ensure when the time comes, they are placed in a safe, nurturing and caring facility. A facility that is able to adequately care for their needs. 

A new wave of nursing home and assisted living facility residents are being created by state budget cuts. The question remains, will the facilities be able to handle the deluge of new residents? Only time will tell. 

Health Care Reform May Result In More People Going To Nursing Homes

In today's New York Times, an editorial by Harold Pollack, of the University of Chicago's School of Social Service Administration, recognizes one of the costs of expanded health care now being considered by Congress. According to Mr. Pollack,  although approximately 30 million Americans stand to gain health care coverage under the bills now being considered by Congress, that expanded coverage comes with a price.

That price, Mr. Pollack informs us, is a decrees in Medicare spending on home health care services. These are the very services which allow Medicare recipients to remain at home and out of nursing homes or assisted living facilities. Mr. Pollack's editorial contains short views of a number of other experts concerning the Senate bill.

Is it better for us or our loved ones to be cared for at home rather than be forced, by financial realities, to enter a nursing home or assisted living facility? Of course. Is it better for 30 million Americans to be provided with health care coverage which they otherwise would not have? Of course. There, as they say, is the rub.

No matter the final outcome of the health care debate, with the aging of the American population, one thing is certain. More people will likely be entering into nursing homes and assisted living facilities. Those individuals and their families must be sure the facility provides the services necessary to provide adequate care. Those facilities also must be held to the highest standards in the care of residents.