Nursing homes using hospitals as middlemen to bounce low-reimbursement, high-maintenance residents
Are nursing homes around the country craftily evicting poor and problematic occupants?
Yes, concludes a mostly anecdotal yet compelling New York Times investigation that shows a common tactic is sending off Medicaid-covered seniors with dementia following emergency “psychotic” episodes.
When psychiatric wards and hospitals quickly discharge the patients, the nursing homes refuse to take them back in.
The practice is illegal and obviously unethical, but it evidently preceded the pandemic and is widespread now.
Even when eviction may be warranted, the sample set of nursing homes in the analysis—whose authors sought information from ombudsmen in all 50 states—suggests the rules are commonly flouted.
“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,” Alison Hirschel, senior legal counsel to the Michigan ombudsman program, tells the Times. “It’s devastating for residents and their families all the time, but it’s especially horrible and dangerous during a pandemic.”
Reporters Jessica Silver-Greenberg and Rachel Abrams recount several troubling stories that put real lives to industry watchers’ observations.
One involves an 87-year-old woman with dementia who was sent off for psych care after an outburst. She was refused readmission when the hospital sent her home less than 24 hours later. A Medicaid recipient, she was taken in by another nursing home only to contract COVID there and die.
“Nursing homes have faced acute staff shortages as the coronavirus has left employees sick or afraid to go in to work,” Silver-Greenberg and Abrams report. “Workers said they faced increased pressure from their employers during the pandemic to get rid of the most expensive, least lucrative patients.”
They cite previous Times reportage showing a number of nursing homes illegally evicting low-profitability residents into homeless shelters and ramshackle motels.
“Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those [who] need high levels of staffing,” says a former chief executive of Rockport Healthcare Services, which manages California’s largest chain of for-profit nursing homes. “The pandemic has basically supercharged that.”
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.