Most nursing homes are for-profit institutions. Now, some residents requiring extra care or who do not have money are being removed from nursing homes on the slimmest of pretexts. Many of these involve sending them to psychiatric hospitals after minor outbursts. Once they are out of the facility, the nursing home does not allow them to return.
While for-profit nursing homes have long tried to get Medicaid residents out of their facilities, since Medicaid pays less than patients with private insurance or Medicare, the pandemic has accelerated this trend. Medicare patients with COVID-19 often need nursing home care, so there is even more of an incentive to replace residents on Medicaid with Alzheimer’s disease and other conditions requiring constant care with more profitable Medicare patients.
Ignoring Federal Law
Under federal law, nursing homes cannot evict residents without a 30-day notice, and must place them in safe locations. Should the resident go to a hospital, the nursing home must retain their bed for at least one week.
Because of visitor restrictions in nursing homes since the arrival of Covid-19, there is little oversight. Unscrupulous nursing home operators find it easier to flout federal law prohibiting these evictions when less scrutiny occurs.
Pressure to Get Rid of Expensive Patients
The coronavirus has devastated nursing homes nationwide, with both residents and staff succumbing to the disease. Chronically short-staffed nursing homes are now in even worse shape. Nursing home employees say they are under pressure to get rid of residents with dementia and other illnesses requiring a great deal of care.
One tactic to eliminate expensive patients is sending them for psychiatric evaluation under almost any pretext. The New York Times reports a resident throwing a bingo chip in a New York nursing home was sent for a psychiatric evaluation, as was a paralyzed Georgia woman who complained her diapers were not being changed. Neither resident was allowed to return after the assessment. In another case, a resident with dementia yelled at a nursing home employee and was labeled as psychotic.
Medicaid vs. Medicare
Medicaid provides longer stay nursing home coverage for poor residents. Medicare does not pay for long-term nursing home stays, but it does pay for those undergoing short-term rehabilitation at these facilities. Since Medicare reimburses nursing homes at a much higher rate than Medicaid, many of these businesses want to free up those lower-paying beds for Medicare patients.
Boardinghouses and Homeless Shelters
Where do these ousted residents end up when the nursing home refuses to allow them back in? Many end up in homeless shelters, unregulated boardinghouses, or simply on the street. Their families are often not notified. These individuals, already suffering, may die soon afterward from exposure and lack of care.
Nursing homes get away with dumping expensive residents for more profitable ones because serious penalties are so rare. A stroke victim with dementia was sent for a psychiatric evaluation after cursing at a nursing assistant in one California case. He was cleared to return to the nursing home, but they would not readmit him. His son appealed the decision to a state health care agency, which determined that the nursing home was required by law to take his father back.
The nursing home refused to do so, and the only authority the state had was to fine them $50 per day. Since the Medicare patient replacing the stroke victim paid much more, the fine was simply part of the cost of doing business. The man continues to languish in a hospital.
If you or a family member suffered a fall and was seriously injured or is being neglected in a nursing home, convalescent center or long-term living facility, call us today. All consultations are free, without obligation and confidential. We consider cases nationwide.
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