By now, we all know that nursing homes are ground zero for the COVID-19 global pandemic, not just because the elderly are at higher risk for dying from the infection, but also because the virus exposed pre-existing nursing home chain’s business practices of staff shortages and failures by facilities to follow infection control protocols.
For those who are unfamiliar with the nursing home business model, corporations make money by filling beds in facilities. The more care a resident needs, the more the government pays them. So, for example, the Medicare/Medicaid reimbursement rate for someone who is ambulatory and can feed herself is lower than for another resident who needs help getting out of bed, going to the bathroom, and eating.
When one of those ambulatory residents dies, facilities look to fill that person’s bed with someone else who needs more hands-on attention. Why? Because the facility is chasing the highest reimbursement senior residents. With any luck, they find one. As this is happening, the facility should increase staffing to compensate for the increased need for more labor. But in practice, that doesn’t happen. Nursing homes are continually trying to improve the census of so-called “high acuity residents” while keeping staffing constant at the bare minimums. That way, overhead expenses stay the same while their revenues go up, and they make more money. Oh, and by the way, the resulting understaffing leads directly to elder abuse and neglect.
Well, as they say, one man’s poison is another man’s cure, which has never been more true than now with the novel coronavirus. Because no one wants a patient who is infected with COVID-19, the federal government has started paying a premium, up to four times more, to those facilities willing to take them in. According to the Los Angeles Times, “A new Medicare reimbursement system that went into effect last fall pays nursing homes substantially more for new patients — including those released from a hospital — particularly for the first few weeks. Under those guidelines, COVID-19 patients can bring in upward of $800 per day, according to nursing home administrators and medical directors interviewed by The Times.”
If you do the math, $800 per day is $24,000 per month – per COVID-19 patient! That is a staggering amount of money, and for that amount, you might expect that a nursing home resident would have a private butler, maid, and chef. Unfortunately, it will be the nursing home corporate executives who will be hiring the private butlers, the maids, and the personal chefs. At the same time, their COVID-19 positive residents will likely receive sub-standard treatment in understaffed facilities. More than likely, those COVID-19 residents will quickly die, but that’s all right. Those beds will open up so the same facilities can fill them again with new COVID-19 patients. Better yet, the unsuspecting residents who weren’t previously at risk of contracting the illness will likely get infected. When they die, the nursing homes can fill those $200 per day beds with newly infected $800 per day residents. When will this insanity stop?!
It is time to hold skilled nursing facilities (SNFs) accountable and to stop rewarding the least qualified ones, those who are eager to get COVID-19 patients, over the ones who are vigilant in protecting residents from infectious diseases. Let’s follow the COVID-19 money trail and stop paying institutions that are systematically killing vulnerable senior citizens. They deserve better.
Attorney Wendy York of York Law Firm specializes in prosecuting elder abuse and wrongful death cases. For further information, please call 800-939-1832.