Are some nursing home residents still in jeopardy today, after countless scandals over the decades? Reports that many of them ARE, indeed, come from various sources. Among them are a critical newsletter article about California nursing homes, and a study report that says hospitals don’t give patients enough information to enable them to competently choose a good skilled nursing home:
Read MoreCalifornia – A Stunning “Status Report”
In a summer 2017 newsletter article, the California Advocates for Nursing Home Reform said:
“Although California spends nearly $5 billion in Medi-Cal funds per year on nursing home care, discrimination against Medi-Cal-eligible residents is systemic, and the care provided to nursing home residents is getting worse every year.
“Poor regulatory oversight, minimal monetary penalties, repeat violations without consequences, and the never-ending quest by the nursing home industry for more money – these are only a few of the reasons that care is so bad and that demand for nursing home care has decreased every year.
“Too many California nursing homes don’t want to keep residents once they’ve sucked all of the Medicare rehab funds from them – dumping (mainly Medi-Cal) residents into acute care hospitals as a matter of course and refusing to take them back regardless of administrative law decisions to the contrary.
“Meanwhile, California’s Department of Public Health – the agency charged with providing regulatory oversight of nursing homes – has put on blindfolds, refusing to acknowledge the grievous violations that harm and, often kill, nursing home residents….
“A constant litany of sexual, verbal and physical abuse, neglect, refusal to provide pain medication, refusal to answer call buttons, allowing residents to lay in their own feces and urine, bedsores, falls resulting in broken bones and deaths and hundreds of preventable acute care hospital admissions at cost of millions of dollars – this is the status of nursing homes in California in 2017.”
National – Inadequate Hospital Discharge Information
The Commonwealth Fund reported on August 8, 2017 that most hospital patients who require care from a nursing facility following their discharge receive no information about the quality of available facilities, according to interviews with patients and medical staff. With hospitals now held partly responsible for their patients’ care after discharge, Medicare will likely need to amend or clarify its rules to encourage hospitals to recommend higher-quality facilities to their patients, the report said.
The title of the report is: “Patients Are Not Given Quality-of-Care Data About Skilled Nursing Facilities When Discharged from Hospitals.”
I was amazed to find out that this problem, which my mother and I encountered in 2011, with severe consequences, continues today. Medicare rates nursing homes on a scale of one to five, with one being far below average, two being below average, and three, average. I found in a judgmental sample of my own that close to half of the nursing homes in two large chains operating in Pennsylvania were below average (rated one or two), so uninformed consumers are at high risk of ending up in a below average nursing home.
In the Commonwealth Fund study, a research team interviewed 138 staff members at 16 hospitals and 25 nursing facilities across eight U.S. markets. The team also interviewed 98 patients admitted to 14 of the nursing facilities in five of those markets.
Researchers found that hospitals are not providing patients who need care in skilled nursing facilities (SNF) with data that would allow them to select a high-quality provider. Hospitals should provide these data to help patients make a more informed choice, researchers said.
When researchers asked patients what information they had been given by hospital staff members to help them select a SNF, only four patients said that they had received any information about SNF quality or instructions about where to find such data. Instead, patients made comments such as this: “I got a two-page list of different facilities that I could go to. It basically was the name, the address, and a phone number.”
While federal statutes protect the right of Medicare patients to choose their own providers, nothing in the law prevents hospitals from helping patients make an informed choice, the researchers said. The report authors recommend adoption of proposed changes to Medicare’s conditions of participation to require hospitals to share data on facility quality with patients. Alternatively, the Centers for Medicare and Medicaid Services could clarify the limits on what hospitals may do to aid patient choice. Adopting a less strict approach to patient choice, the authors argue, would allow patients to make better, more-informed choices that would lead to improved outcomes for patients and hospitals alike.
The researchers who produced the report were Denise A. Tyler, Emily A. Gadbois, Renée R. Shield, Vincent Mor, and Ulrika Winblad, all affiliated with Brown University, and John P. McHugh, of Columbia University.