Admonitory tale regarding nursing home care and billings

Maybe your mom, dad, cherished grandparent or other loved one who is spending time in a nursing home just informed you that, while he or she feels just fine, the home has been administering intensive and hours-long therapy on a daily basis.

You might want to check in on that, Now.

And you might want to bring in a copy of a recent federal report that contains some truly hair-raising information and charges relating to care-delivery practices and policies of high numbers of homes across the country.

Here’s a nugget of information that virtually pulses with light in study findings that recently made their way into the national media courtesy of the U.S. Department of Health and Human Services.

To wit, and as noted in one of those stories focused upon questionable nursing home treatments and care: Some therapies are flatly “unrelated to the condition or characteristics of patients.”

Many of our readers — in all likelihood, millions of people across the country — undoubtedly grow a bit agitated when reading that. What it means in simplest terms is that in some instances a loved one’s best interests are being flatly sacrificed by greedy home administrators and employees in pursuit of maximum gain.

Sadly, many people are probably not surprised that, notwithstanding the existence of some facilities in California and nationally that are clearly focused on quality care, many outliers across the country are just as clearly fixated on profit.

There’s a clear takeaway from the DOHHS report, namely this: Due diligence doesn’t stop at the moment a care facility is selected for a loved one. Rather, it simply makes sense that family members routinely and carefully assess the treatment and services offered by a nursing home to a loved one.

Why arbitrated nursing home outcomes matter to the public

Should private arbitration that definitively — and legally — settles a nursing home dispute between a resident and facility matter to you if, as an adult reader, you have no personal connection to any such care provider?

Put another way: Should you care a whit whether the outcome concerning an allegation of nursing home negligence or neglect is settled through arbitration forced upon a facility resident or, alternatively, proceeds pursuant to a process that works its way through court?

According to a media article that examines nursing home arbitration versus litigation, you should care. And quite a bit. Here’s why.

For starters, the statistical likelihood that you might someday become a nursing home resident is increasing. According to the article noted above, the number of Americans 65 and older who will be receiving care in nursing facilities in 2050 will be more than double the amount that was similarly situated in 2010.

And that increase is becoming progressively realized at a time when homes are proactively searching for ways to lessen their liability in instances of negligent care that harm patients.

One such way they seek to minimize their risk, notes the above article, is by requiring would-be residents to agree to arbitration for any future dispute prior to being admitted.

As opposed to a court proceeding, that arbitration is often private, even secretive, with its terms never disclosed to the public. As such, the public is not privy to important information concerning infirm care delivery that might otherwise receive wide media coverage following a court outcome.

As a result, there can be a dulled impetus for a home — and other similarly acting entities — to improve. The cited article notes that, as opposed to a court outcome, there will lack “a detailed public record that can inform industry practice and help develop case law.”

That is why you should care. For a number of notable reasons, arbitration in the nursing home context favors care facilities. Conversely, court outcomes promote transparency and accountability that can help promote safety improvements in the nursing home industry.

California nursing home group suffers string of decertifications

A prominent California nursing home operator says that industry regulators are unfairly singling out his facilities and taking unnecessarily adverse actions against them.

That is not how government officials see it. In fact, they say that many of the multiple homes owned and operated by business entrepreneur Shlomo Rechnitz — described in one media account as “California’s most influential nursing home owner” — are rife with worrisome problems.

That concern has indeed brought a forceful response from officials, with a recent article focusing on nursing home neglect noting the “flurry of citations and fines [doled out] for alleged poor quality care.”

Rechnitz reportedly maintains control of about seven percent of all skilled nursing beds in facilities across the state, owning more than 80 homes. Collectively, his operations have come in for withering criticisms and strong sanctions; notably, three Rechnitz-operated facilities were recently decertified by federal authorities, which bans them from receiving funding from Medicare and Medi-Cal, respectively.

And now litigation has entered the picture, following the harrowing story concerning a former resident of the Rechnitz-owned Mission Grove Healthcare & Wellness Centre in Pasadena.

That facility is one of the decertified homes. Health officials failed it on four consecutive inspections last year, and slapped it with more than a score of citations earlier this year.

The lawsuit targeting Mission Grove was filed earlier this month by the family of an ex-resident with known mental health issues who took her life at the home.

The complaint centrally alleges that the quality of care at the facility has suffered in light of management’s undue focus on maximizing profits.

Source: The Sacramento Bee, “California’s largest nursing home owner sued,” Marjie Lundstrom, Aug. 12, 2015