Elder Population Studies

February 9, 2019

Despite Record of Poor Care, New York Approves Nursing Home Owners

New York State routinely allows nursing home owners with a record of poor care and government fines to operate more long-term care facilities in the state, according to a report by The Buffalo News. Speaking to the upstate newspaper, Toby Edelman at the Center for Medicare Advocacy described the problem as a “disturbing but all-too-familiar pattern” and joins elder advocates in demanding the New York Health Department provide more transparency and stricter scrutiny when selecting nursing home owners. In response to the criticism, the New York Department of Health, the state agency responsible for regulating nursing homes, drafted legislation intended to allow stronger and more effective government oversight of the long-term care industry.

The evidence uncovered during The Buffalo News investigation paints the portrait of a government agency whose incompetence is endangering elderly New Yorkers. Of the 47 nursing homes in the newspaper’s geographical area, sixteen were purchased in the last decade by for-profit nursing home corporations, which have a documented record of provider lower-quality care to their residents.

In one instance, the Department of Health approved the takeover of a nursing home by a group of New York City investors fined almost $90,000 in the last two years. In another example cited by the newspaper, a nursing home corporation with poor ratings and federal and state fines totaling “at least $325,000” was approved to purchase another nursing home in the state. In both cases, the state agency amazingly concluded that it had received “no negative information” about the nursing home owners. The deputy health commissioner told the newspaper that the agency now vets potential nursing home owners more thoroughly.

February 5, 2019

Corporate Takeover of Nursing Home Industry Causing Bankruptcies, Closings, and Poor Care

by Gallivan & Gallivan

The nursing home industry continues to reshape itself as small, independent nursing homes focused on providing high-quality care are rapidly replaced with corporate conglomerates seeking to maximize the profits. Predictably, the harmful effects of the profit-seeking model have only amplified in the last year. According to industry analysts, the ownership structure of nursing home conglomerates – where multiple nursing homes are owned and operated by the same owners – combined with riskier financial decisions are causing a slew of bankruptcies and closings across the country. In addition to removing America’s senior citizens from their nursing home, investigations into for-profit care providers have raised serious concerns about the quality of care provided to financially stable nursing homes.

Last November, The Washington Post reported on HRC ManorCare, a massive nursing home chain owned by Carlyle Group, reportedly one of the “richest private-equity firms in the world.” Despite an owner flush with cash, the nursing home chain struggled financially for five years and eventually filed for bankruptcy. The five years of financial instability exposed HRC ManorCare’s 25,000 nursing home residents to increased health risks, according to the newspaper. The number of health code violations at the nursing home chain rose by 26 percent, which includes serious health violations for failing to prevent bedsores, medical errors, and failing to provide proper nutrition and hygienic care for residents. Serious health code violations – violations that either caused “actual harm” or put patients in “immediate jeopardy” – rose 29 percent between 2013 and 2017, the year HRC ManorCare filed for bankruptcy.

February 1, 2019

Federal Government Struggles to Collect Data on Elder Abuse

by Gallivan & Gallivan

Elder abuse is one of the most widespread and under-reported problems in the country. However, despite the prevalence of elder mistreatment, the federal government does not gather data or require reporting for the crime against America’s senior citizens. With the population of Americans over the age of 65 expected to double by 2050, elder care advocates are urging the federal government to stiffen enforcement and begin tracking elder abuse cases across the country.

Elder abuse encompasses a wide range of illegal behaviors, from sexual abuse and financial exploitation to outright neglect by family members, caretakers, or nursing homes. Unfortunately, the federal government has not provided states with a precise definition of what behaviors constitute “elder abuse” and therefore, the exact definition varies depending on the state. When the federal government attempted to gather data on the subject for the first time this year, federal bureaucrats described the data received from states as incomplete, according to USA Today.

December 29, 2018

Federal Government To Begin Cracking Down on Short-Staffed Nursing Homes

by Gallivan & Gallivan

The federal government announced this month that it will begin performing more surprise inspections at nursing homes in an effort to crack down on nursing homes with inadequate staffing. According to the government, these surprise inspections will be done on Saturdays and Sundays at nursing homes with records of insufficient nursing staff on the weekends. According to the federal Centers for Medicare and Medicaid Services (CMS), nursing staff levels are directly correlated with the quality of care received by the nursing home residents.

Over a decade after the federal government mandated CMS collect payroll data and publicize each nursing home’s results, the federal agency finally overhauled its information technology system and began publicizing the information this year. While staffing levels at nursing homes were previously determined by “spot-checking” during yearly inspections, the new method for calculating uses payroll data from the entire year. Consequentially, the new method employed by CMS provides a more accurate and complete picture of staff levels.

December 25, 2018

Criticism Grows Over New York Department of Health’s “Oversight” of Nursing Homes

by Gallivan & Gallivan

Only two weeks after putting a Buffalo nursing home under conservatorship, the New York Department of Health announced that Emerald North and Emerald South Nursing and Rehabilitation Center will be closing their doors. The closure follows a long line of missteps and scandals by the formerly for-profit nursing homes, according to The Buffalo News. In the last year, an elderly woman was beaten to death in the facility’s dementia unit and another nursing home resident died after falling from a third-story window. The two nursing homes, which are owned by the same for-profit organization, were fined over $100,000 in 2017 for not maintaining accurate records on whether patients wanted to be revived in the event of a medical emergency. Tragically, the nursing home’s gross misstep was only discovered after a revived patient was found to have a “do not resuscitate” order.

The nursing homes, which have below average ratings by Medicare, continued to operate with the blessing of the Department of Health for almost an entire year after these scandals. Last month, the Department of Health finally appointed Grand Healthcare System as the nursing homes new operator. At the time of the government agency’s appointment, nursing home residents and their families criticized the appointment of another for-profit nursing home system. Their concerns proved well-founded when Grand Healthcare System announced it would be shutting down both nursing homes and opening new facilities under a different name.

November 14, 2018

Another Study Confirms For-Profit Nursing Homes Provide Worse Care

by Gallivan & Gallivan

A study released by the University of Illinois at Chicago reports that for-profit nursing homes provide lower-quality care to their elderly residents. This study provides further confirmation that the for-profit nursing home industry, which is still growing across the country, is sacrificing adequate care for vulnerable senior citizens in the pursuit of ever-growing profits. Once again, elder care advocates are sounding the alarm about the substandard quality of care and the need for greater government oversight while President Trump’s administration continues to deregulate the industry.

The University of Illinois at Chicago study included more than 1,100 senior citizens living at five different Chicago hospitals between 2007 and 2011. The results showed a stark difference in the quality of life and health of elderly residents depending on whether their nursing home operated as a non-profit or as a profit-seeking business. Overall, residents at for-profit nursing homes were twice as likely to have health problems related to poor or neglectful care. Among other maladies, for-profit residents were more likely to suffer from severe dehydration, develop stage 3 and stage 4 pressure ulcers – the most serious and commonly preventable type of pressure ulcer, or bed sore. Further, the study concluded that broken catheters and dislodged feeding tubes were more common in for-profit nursing homes and their patients were less likely to receive satisfactory care for their chronic health conditions.

November 5, 2018

Citing Low Staff, Medicare Lowers Ratings for 1,400 Nursing Homes

by Gallivan & Gallivan

Medicare recently lowered the overall ratings of almost one-fourth of the country’s nursing homes due to insufficient staff levels. The move comes after Medicare adopted a new, objective measurement for staffing nursing homes. Previously, Medicare relied on unverifiable data submitted by the nursing homes. Medicare ratings, which can range between one and five stars, are provided for several categories of nursing home care, such as its rating of pressure ulcers or slip-and-falls, along with an overall rating for the nursing home. Medicare now gives the lowest rating, a single star, to 1,387 nursing homes across the country, according to The New York Times.

Medicare requires all nursing homes to have a licensed nurse working at all times and a registered nurse working at least eight hours every day. The payroll data submitted to Medicare by the nursing homes show that the registered nurse requirement produced the majority of compliance problems. Registered nurses, who have the highest level of training and education requirements, are typically able to provide medical services, such as diagnosing illnesses or prescribing medicine.

August 20, 2018

As For-Profit Nursing Homes Increase, Quality of Patient Care Decreases

by Gallivan & Gallivan

A rarity only a few decades ago, nursing homes operating for profit have exploded across the country. According to NPQ, for-profit nursing homes account for over 70 percent of all facilities across the country. According to elder care advocates, the rapid takeover of the nursing home system has harmed America’s vulnerable senior citizens. Instead of focusing on providing the best quality care for a reasonable price, for-profit nursing homes choose to maximize their income while limiting their costs and the resulting legal liability from their cost-cutting measures.

In general, the rise of for-profit nursing homes has coincided with the consolidation of the nursing home industry which means a senior citizen is more likely to choose a corporate nursing home chain than the once-ubiquitous retirement communities that operated solely for the best interest of their residents. Considering the deep pockets of a corporate chain, it would be reasonable to assume the potential for large settlements in the cases of mistreatment or elder abuse would incentivize these corporations to treat their residents with the utmost respect.

August 13, 2018

With Limited Guidance from Medicare, Nursing Homes Prepare for Natural Disasters

by Gallivan & Gallivan

After a spate of negative press coverage last year, Medicare has only issued limited guidance for the upcoming natural disaster season. After widespread lack of preparation in the wake of Hurricane Irma in Florida and Hurricane Harvey in Texas harmed America’s nursing homes, many patient advocates are worried about the nation’s nursing home residents. According to these advocates, the same systems and policies that led to widespread power outages and death last year have not been fixed yet.

Last September when Hurricane Irma struck Florida, residents of Rehabilitation Center at Hollywood Hills found themselves stuck at a nursing home without any air conditioning, power, or a backup generator – all violations of Medicare policies. Sadly, fourteen of the residents at this now-closed nursing home passed away during the 90-degree heat which overtook the nursing home for a week. In response to these flagrant violations, Medicare passed emergency planning regulations last November which required each facility to:

August 9, 2018

Medicare Lowers Ratings for Short-Staffed Nursing Homes

by Gallivan & Gallivan

In response to insufficient medical and nursing staff, Medicare has lowered ratings for 1 out of every 11 nursing homes across the country. The lowered ratings come after the government agency retooled the way it calculates the nursing staff at each nursing home. Under the new method, which requires nursing homes to submit payroll information every quarter, nursing staff numbers appeared grossly deficient at facilities across the country. After Medicare warned nursing homes in April about a possible reduction in their rating without an increase in nursing staff, the government agency followed through last week and reduced the star-rating for nearly 1,400 nursing homes across the country.

For the most part, the nursing homes with recently reduced ratings lacked a sufficient number of registered nurses, which are the “highest-trained caregivers” and responsible for managing other nurses. Under Medicare guidelines, a nursing home only needs to have a single registered nurse working eight hours per day. However, most nursing homes are not meeting these simple guidelines or could not provide payroll information proving the requirement was satisfied. According to Medicare officials, payroll information is not usually “taken seriously” by nursing homes and forcing the facilities to provide proof through their payroll system will hopefully force nursing homes to take their record keeping more seriously.