A September 29, 2011 article from the New England Journal of Medicine discussed the importance of reducing the unnecessary hospitalizations of nursing home residents. More than 1.6 million Americans live in nursing homes, and hospitalizations are common in this population of people. Several studies have suggested that many of these hospitalizations are inappropriate, avoidable or related to conditions that could be treated outside the hospital setting. The article states that one of the possible reasons for unnecessary hospitalizations is that nursing homes have a financial incentive to hospitalize residents who have Medicaid coverage because after a three-day inpatient stay at the hospital, the resident may qualify for Medicare Part A payment for post-acute care in a nursing home at three to four times the daily rate paid by Medicaid. This means that the facility will increase its profit, if a resident is hospitalized for three days, and returns to the nursing home for care.
The Philadelphia, Pennsylvania nursing home abuse lawyers at Shrager, Spivey & Sachs have handle many nursing home cases. We often see evidence of “for-profit” nursing home chains under-staffing their facilities. Under-staffing results in the nursing home not having the necessary number of nurses and aides to protect the elderly residents, and/or a failure to provide the necessary treatments to maintain the residents health and well-being. The reason the nursing home under-staffs the facility is to increase their profit. The “for-profit” nursing home can actually financially benefit from under-staffing their nursing homes in two ways. First, the nursing home increases its profit by under-staffing the facility. Second, because the facility is under-staffed, the residents do not get properly assessed and evaluated and instead get sent to the hospital which can result in increased profits when the resident returns because the facility can obtain better billing rates from Medicare post-acute hospitalization. These issues are difficult and complicated for a family, who is mostly likely having their first experience with a loved one in a nursing home. However, families should be aware that numerous hospitalizations can be a good sign of under-staffing, neglect and abuse and the motive is often financial gain. Or in other words, the “for profit” nursing home is increasing its profitability at the expense of your loved one’s safety.