Nursing Homes Attempt to Lure in More Medicare Patients to Increase Profit

A recent exposé by the New York Times revealed that as nursing homes revamp their facilities to include luxury living quarters, the disparity between the lavish amenities of short term accommodations, and the quality of care can be drastic.  Although nursing homes are attempting to lure in patients whose short stays will be funded by Medicare dollars, in lieu of Medicaid, many patients are being discharged from the facilities before they have been rehabilitated.  Or worse yet- they leave with more medical issues than they had upon admittance.

A recent exposé by the New York Times revealed that as nursing homes revamp their facilities to include luxury living quarters, the disparity between the lavish amenities of short term accommodations, and the quality of care can be drastic.  Although nursing homes are attempting to lure in patients whose short stays will be funded by Medicare dollars, in lieu of Medicaid, many patients are being discharged from the facilities before they have been rehabilitated.  Or worse yet- they leave with more medical issues than they had upon admittance.

Nursing homes are reaping 84% more in profits from short-term patients on the Social Security age based Medicare program than they do from lower income patients whose long-term stays are funded by need based Medicaid program.  Medicare does not provide for long term care funding, so many facilities are creating “luxurious” accommodations that may even include putting greens, restaurants, and private rooms with the hopes of luring in patients and increasing revenue.  Some nursing homes have decided to sustain themselves on Medicare funding alone because it is so profitable, thus excluding Medicaid patients.

Due to the time limits for nursing home stays for Medicare patients, many patients will be forced to leave the nursing home before they are fully rehabilitated or before they have adjusted to their medications.  More facilities are catering to short term care in order to receive the substantially higher Medicare payments.  The quality of care is being compromised by ushering patients out the door with quick (and often ineffective or negligent) treatment with less staff.

One family has decided to sue the nursing facility where their mother was rehabilitating after a fall.  While at the facility, she lost twenty pounds and developed a bed sore that exposed her bone.  As a result of the nursing home’s negligence, the patient’s health had deteriorated so badly that she was brought to a hospital where such succumbed to her condition a month later.

In another case, an 87 year old retired neonatologist who checked herself into a top rated facility to recover from an injured foot also developed bedsores so severe that she had to be brought to the emergency room.  She also claims that the staff did not take precautions to prevent bedsores by turning her over periodically; nor did the staff respond to her diaper change requests promptly or give her a full bath.  The patient is suing the facility for negligent care.

Those in the industry are optimistic that the playing field will even out and the quality of care will stand on equal footing with the quality of accommodations in the not too distant future.  While hospitals are required to pay penalties if too many patients are readmitted, they will likely cease sending patients to nursing homes that perform poorly.  In addition, new payment models are being implemented that reward low costs without sacrificing quality.

To read the full article:  http://www.nytimes.com/2015/04/15/business/as-nursing-homes-chase-lucrative-patients-quality-of-care-is-said-to-lag.html?partner=rss&emc=rss&_r=0

Author: Tanya Hobson-Williams

Appointed to the bench by the Board of Trustees in 2008, and elected in 2009, Tanya Hobson-Williams was the first African-American Female Justice in the Incorporated Village of Hempstead. Tanya Hobson–Williams obtained her B.A. in Government and Politics from St. John's University and her law degree from Benjamin N. Cardozo School of Law. Tanya Hobson-Williams has an active elder law practice assisting senior citizens in obtaining Medicaid for Home Care and Nursing Home Care. She routinely lectures at senior citizen centers, assisted living facilities, law schools and counsels families on a variety of topics of concerns to families caring for the elderly.

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