According to a bombshell article from the New York Times, nursing homes across the country are resorting to dangerous, sometimes illegal tactics to get rid of some of their sickest and poorest patients. Many of them are long-term residents on Medicaid. Officials say nursing homes are discharging patients to hospitals for psychiatric problems and disruptive behavior and then refusing to let them back into the facility once they have been treated.
This has led to a disturbing trend across the country. If these residents aren’t welcome at nursing homes, many of which are owned by for-profit companies, where will they go?
Let’s find out.
Recent reporting shows that some nursing home residents are being evicted or discharged for the slightest infractions. In one New York facility, a resident was removed after throwing a bingo chip. In Georgia, a woman paralyzed from the waist down complained to staff that no one had changed her diaper. In a California facility, a resident threw a piece of tableware.
In all of these cases, the nursing home in question cited these incidents as reasons to send these residents to a local hospital for a psychiatric evaluation. However, once they were evaluated, the facility refused to let them return.
According to recent court documents, government-funded watchdogs in 16 states, and more than 60 lawyers, nursing home employees, and doctors, local hospitals will usually discharge these patients in a matter of hours, giving them the all-clear to return to the nursing home; however, these facilities won’t allow it.
Mike Wasserman, a former chief executive of Rockport Healthcare Services, one of the largest chains of for-profit nursing homes in California, says this trend is nothing new. “Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those that need high levels of staffing. The pandemic has basically supercharged that.”
The Cost of Treating Long-Term Residents on Medicaid
All the patients mentioned above were long-term residents living off Medicaid, which notoriously pays less than Medicare. From a financial perspective, these residents may be seen as expensive or burdensome, especially when nursing homes are dealing with the cost of responding to the pandemic.
It’s important to note that 70% of the country’s nursing homes are considered for-profit, so they have a vested financial interest in keeping their costs low. The most lucrative patients for nursing homes tend to be short-term residents with private insurance or Medicare. Reports show that long-term residents on Medicaid may be more likely to get evicted if they suffer from chronic conditions that can be costly to treat, such as dementia.
Nursing home officials and whistleblowers say they have felt pressure during the pandemic to get rid of their facility’s patients like this. All the while, staff members are calling out sick or refusing to show up for work due to the spread of the coronavirus. This makes it all the more difficult to care for those who need additional medical and personal care services.
Caring for Those Most Vulnerable
Nursing homes have long admitted those with dementia, Alzheimer’s, and other psychological issues. Experts say that these angry outbursts are nothing new and that these facilities have a legal and moral obligation to look after these individuals.
According to federal law, nursing homes must follow strict guidelines when they intend to evict someone. They must give 30 days notice and come up with a plan to transfer the resident to a facility that can meet his or her needs. If a resident goes to a hospital, the facility must hold the bed for a week.
However, the New York Times says many facilities have been getting rid of low-income residents in waves since the summer, often discharging them to homeless shelters, motels, and other temporary living areas.
In March, Joan Rivers, who suffered from dementia and is on Medicaid, was discharged from the Rehabilitation Center of Santa Monica, CA after throwing her chair. Staff members said at the time she was scaring the other residents. She was soon transferred to a local hospital for a psychiatric evaluation. Within 24 hours, they discharged her, but the facility wouldn’t allow her to return.
After months of fighting with the facility, her daughter eventually got her into the Colonial Care Center nursing home in Long Beach, CA, where she eventually contracted COVID-19 and died on July 20th.
Alison Hirschel, senior legal counsel to the Michigan ombudsman program, warns these tactics can be a danger to residents and their communities. “We have been seeing these kinds of illegal discharges all the time because nursing homes seem to have figured out that they will rarely, if ever, be penalized. It’s devastating for residents and their families all the time, but especially horrible and dangerous during a pandemic.”
Caring for some individuals can be costly, but these for-profit facilities need to look after these residents instead of trying to foist them off on another facility or leaving them to their own devices. If you have noticed similar patterns at your facility or know someone who has been illegally evicted from a nursing home, visit Nursing Home Abuse Justice to report the incident and learn about your options.