A for-profit business has to make money to stay afloat; there’s nothing surprising about that. But when that for-profit business is a nursing home and that nursing home short-changes its residents so that it can make more money, this is wrong.
According to Bloomberg.com, a recent report by federal healthcare inspectors attests that U.S. nursing homes overbill Medicare by $1.5 billion each year for treatments patients do not need or never get. The report doesn’t break down this amount into how much is overcharged by nonprofit versus for-profit facilities. A sampling of claims obtained from the inspector general’s office of the U.S. Department of Health and Human Services, however, revealed 30 percent of improper claims from for-profits and only 12 percent from nonprofits.
What Studies Show
At least half a dozen government and academic studies over the last three years link the increase in for-profit providers to an increase in fraud, waste, and patient harm.
One such study was conducted by Charlene Harrington, a professor at the University of California, San Francisco. Her findings revealed that the 10 largest for-profit nursing home chains
- employed 37 percent fewer registered nurses per patient-day and
- received 59 percent more deficiency reports from government inspectors
than did nonprofits. The results of this study were published in 2011 in the journal Health Services Research.
Jill Horwitz, who is a professor at the University of California, Los Angeles (UCLA) School of Law, said, “Research shows for-profits are more likely to pursue money in all kinds of ways than nonprofits are, even by pushing the legal envelope.”
Integrity or Income?
The Bloomberg article cited some examples of misplaced priorities:
- Two days before she died, an 80-year-old nursing home resident was put into a “standing frame” for physical therapy—even though she could not keep her eyes open or control her head.
- Two days before he died, a 92-year-old nursing home resident underwent two hours of physical, occupational, and speech therapy—although earlier that day he had been spitting up blood.
- In the seven months before she died, a nursing home resident fell three times, broke her hip twice, had two hip surgeries and an amputation, and suffered several urinary tract infections, bedsores, malnutrition, and pneumonia—apparently because the facility was understaffed.
- A 77-year-old nursing home resident was left unattended in the dining room with her dinner. The mentally impaired woman choked to death on her food.
- The president of a nursing home chain allegedly required managers at each site to report labor expenses daily. He praised the managers when labor costs decreased—even when state-mandated requirements for nursing staff minimums were not met.
Nursing homes, both nonprofit and for-profit, have an obligation to provide competent, safe care for their residents. If someone you love in a Kentucky nursing home has been abused or neglected, get in touch with the Kentucky nursing home abuse lawyers at Gray and White Law. Call us at 502-210-8942 or toll free at 888-450-4456 to set up a FREE, no-obligation consultation.