Don’t Let the Fancy Amenities Fool You: Nursing Home Neglect in the Race for Medicare Dollars is Rampant

April 22, 2015 | Crandall & Pera Law
Don’t Let the Fancy Amenities Fool You: Nursing Home Neglect in the Race for Medicare Dollars is Rampant

A recent New York Times article describes how, despite the promised luxurious amenities, many nursing facilities have a poor quality of care. There is a massive shift going on in the nursing home industry to appeal to short-term Medicare patients and turning away from catering to lower-paying Medicaid patients. However, in the rush to appeal to higher-paying Medicaid patients, it is the patients themselves who are losing out because many of these facilities do not offer the care that these patients need.

The crux of the problem

When elderly patients leave the hospital after an illness or injury, they often stay in nursing homes funded by Medicare to recuperate before going home. Medicare pays 84% more for short-term patients than these nursing facilities get for Medicaid patients, which makes competition intense to attract the Medicare patients.

But a 2014 report by the Department of Health and Human Services' Office of Inspector General found that 22% of Medicare residents experienced adverse events during their stay at a nursing home. (An adverse event is described as one that required a prolonged stay in the nursing facility, transfer to a hospital, permanent harm, life-sustaining intervention or death.) The report estimates that 21,777 Medicare residents experienced an adverse event, and 2.6% experienced more than one; some of those patients experienced three events during a single stay at a nursing facility.

Abuse and neglect of the elderly

The NYT article talks about the lofty promises of care that the Watermark at Logan Square nursing facility in Philadelphia made to Dr. Lois Johnson-Hammerman, who ended up being taken to the emergency room with a dangerously infected bedsore. She was promised hot baths and quality health care, but in reality she had difficulty getting the staff to bathe her, change her diaper and turn her every few hours to prevent bedsores.

In another sad example of neglect, Mary Dwyer, age 87, checked into the Harborview Healthcare Center after having fallen and dislocated her shoulder when she fell. The care Mrs. Dwyer received at the nursing facility was negligent, as described by her family. They did not feed her properly, they did not reposition her in bed frequently, and in just one month after she lost 20 lbs. and developed a bed sore down to the bone. She was sent to the hospital to get care for her injuries and died a month later. Her family won $13 million in a wrongful death action, which the nursing home is appealing.

Protecting your loved ones

If you must put a loved one into a nursing facility, here are a few tips from the National Institutes of Health to keep in mind:

  • Consider what is most important to you in a nursing facility-- the quality of nursing care, the food, the physical therapy, connection to your religious faith? Is it important that the facility be close so that family and friends can easily visit?

  • Ask your friends, relatives, and social workers what facilities they recommend. Use their suggestions to make a short list.

  • Call each place on your short list. Ask about how many resident they have, what the costs are, and if they meet the priorities you considered earlier.

  • Visit the facility. Meet the director and the nursing staff.

  • Ask questions. Look at the condition of the residents and notice if they seem well cared for and content. Does the place smell clean? Find out about the rate of turnover in the nursing staff, food service and social service departments. Finally, make a second, surprise visit at mealtime. Does the dining room look clean? Does the food look appetizing?

  • Carefully read the contracts before you make your final selections. Talk with the director to get answers for your questions so that you are clear before you sign and pay.

Taking the time to select the right facility is vital in protecting your loved ones. If you have a loved one in a nursing home, visit as often as you can – several times a week if possible – to see the kind of care they are receiving. Be a constant presence and make sure that the staff knows that you are keeping an eye on your family members’ care.

If you have a loved one who has experienced abuse or neglect in a nursing facility, you may be able to take legal action against the facility. Schedule a consultation with a nursing home neglect attorney who can answer your questions and advise you of your rights.

Contact Crandall & Pera Law today to discuss your nursing home negligence case. We’ll give you the answers you need and fight to protect your rights.