For-profit nursing homes have grown exponentially in the last two decades. So too have the instances of abuse, fraud and waste.
Our North Carolina nursing home abuse lawyers know the correlation is no coincidence, according to an investigative report by Bloomberg News, which exhaustively scoured through reams of government data to reach this conclusion.
The federal government data was pulled from research conducted by he inspector general's office for the U.S. Department of Health and Human Services. The government data did reveal that in the last five years, over-billing for Medicare and Medicaid had spiked to $1.5 billion annually and federal prosecutions for nursing home abuse and neglect had doubled. The report was silent on the rise of for-profit facilities.
Let's consider first that the care of our older loved ones, while a calling to some individuals, is actually a $3 trillion industry in this country. For the last 10 years, for-profit nursing homes and assisted living facilities have been getting an increasing slice of that pie - from 72 percent in 2002 to nearly 80 percent in 2010.
Consider too that for-profit nursing homes and assisted care centers operate the lion's share of the outpatient surgery centers in the U.S. - about 96 percent. In the last nine years, that area of health care has ballooned by a third, according to the Medicare Payment Advisory Commission.
Additionally, when compared to non-profits, for-profit hospices increased their numbers 10 times faster between 2004 and 2009. Those now account for more than half of all hospices. Dialysis clinics? Eighty-five percent are now for-profit, as are 84 percent of home health care agencies.
Why does it matter whether a center is for-profit or non-profit? There have been numerous studies indicating that for-profit centers are more likely than non-profit centers to go after the almighty dollar in ways that are not only questionable on an ethical and moral level, but a legal one as well. A law school professor at the University of California in Los Angeles, who has studied the matter extensively, was quoted as saying that when a facility is in the business of care, with money as the bottom line, the quality of the care inevitably becomes secondary.
While some might see Medicare fraud as something that only hits our pocketbooks, consider the recent case involving a South Carolina nursing home, owned by a for-profit chain. An 80-year-old woman wasn't able to to walk. In fact, she couldn't stand or even control her head or keep her eyes open. But as part of a "physical and occupational therapy session," she was forced for nearly 90 minutes to endure standing up in a standing frame. Two days later, she died.
The nursing home that allowed this has been sued by the federal government for overcharges and unnecessary treatment, but the incident begs the bigger question: Was the procedure a factor in her death?
That hasn't yet been made clear. What we do know is that just as criminal prosecutions regarding nursing home abuse and nursing home neglect have risen, so too have the number of civil cases.
One such recent case out of California involved a mega-nursing home chain that was sued for six wrongful deaths between 2005 and 2012. The allegations centered around the assertion that staff administrators were so money-hungry, they skimped on essentials: staff, medicine, food, etc. As a result, patients were left on their own for hours, denied meals and bathing and suffered from malnutrition and infection.