Nursing homes behaving badly

 All of us learned, at the beginning of the coronavirus outbreak, that a nursing home in Kirkland, Washington, was at the center of the outbreak. A couple of months later, we learned about the nursing home in New Jersey where 70 people died and 17 bodies were found sequestered there. In fact, 40 percent of the nation’s fatalities have been residents of nursing homes. They have much to answer for:

• While it looks like nursing aids may be responsible for much of the virus spread, I don’t blame them. The national average pay for aids is $13.38 an hour, mostly without benefits. Thirteen percent live below the poverty line and almost 36 percent rely on some form of public assistance. They are not paid if they contract COVID and go out sick. To make ends meet, many work multiple jobs at multiple facilities, going from one to another in a single day. 
• Nursing homes are a $100 billion business. Around 70 percent of them are for-profit and more than half are affiliated with corporate chains. Just five companies own more than 10 percent of the country’s 1.7 million licensed nursing-home beds. Private equity has bought up four of the ten largest for-profit nursing homes. It’s a growth industry! (Studies have shown that when nursing homes are bought by private-equity groups, frontline nursing staff are cut, and residents are more likely to be hospitalized.)
• Nursing homes complain of being in financial distress because of low Medicaid reimbursements. This is actually not true. Three-quarters of nursing homes have created networks of sub-companies called “related parties” that trade with one another, including real estate, insurance, management, consulting, medical supplies, hospice, therapy, private ambulances, and pharmacy services—even interior design firms. This arrangement allows companies to siphon profits out of their nursing homes through overpriced transactions with their sister companies. By 2015, nursing homes were spending $11 billion a year on contracts with related parties. Nevertheless, Life Care Center of Kirkland has received nearly $919,571 in federal pandemic relief (Life Care is one of the biggest chains).
• To increase billing, nursing homes provide unnecessary therapy. Example: a 92-year-old man who was dying of metastatic cancer was allegedly given 48 minutes of physical therapy, 47 minutes of occupational therapy, and 30 minutes of speech therapy two days before he died.
• The five-star rating system for nursing facilities is a fiction. “Quality measures,” such as the number of residents who get pressure ulcers, are self-reported and rarely audited.
•  American Health Care Association, which represents for-profit nursing homes, devotes around $4 million a year to political lobbying, which consists primarily of asking Washington for less “burdensome” regulations and more empowerment to the free market.

I usually try to keep my posts short but was unable to in this instance. Even so, the above is only told part of the story.

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