Billions Spent on Poor Nursing Home Care?

Today marks the official start of the “sequestration” cuts. Unless compromise is reached, over the course of the year, $85 billion will be cut from the federal budget. While the stated goal is to tackle the significant annual federal deficit, virtually all sides of the political spectrum admit that such dramatic cuts will have very serious effects on the economy as a whole. Many worry about the change causing a massive double dip recession, sending the economy plummeting back after a few years of steady rise.

The bottom line is that public coffers are stretched incredibly tight and now is a time when efficiency in spending is a priority. That is why reports like the one released yesterday by the U.S. Department of Health and Human Services can aggrieve residents to no end. The report, as summarized in a recent Star Tribune post, analyzed the spending of Medicaid funds at long-term care facilities that fell below federal safety requirements. The results are not pretty. Essentially, the inspector general found that over $5 billion was spent annually on poor, sometimes completely wasteful, even harmful nursing home care.

The Numbers
The investigation covered a range of areas, but essentially tried to match up quality standards, incidents of neglect, and Medicaid payments. For example, they found that altogether about 33% of Medicaid participants end up in substandard facilities. This is a huge number suggesting, as our Chicago neglect attorneys have often mentioned, that poor care is far more than just an isolated problem.

Beyond reminding us of the need to protect residents from bad conditions and situations that place them at risk, this inspector general investigation is a reminder that all of this poor care actually costs taxpayers billions.

For example, the report noted that a large number of residents received unnecessary therapy. Taxpayers footed the bill for the care, even though it did nothing to improve the wellbeing of the resident. The main benefit was to the nursing home owners and operators who were able to draw in more public funds to boost their own bottom line.

As a resident care matter, the investigation is a reminder that making a solid choice at the outset can save loved ones significant pain and suffering. One senior interviewed for the story explained how “once you’re in a nursing home, if things don’t go right, you’re really a prisoner. As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they’ll be fixed.”

Neglect, Waste, & the Law
As always, if you or someone you know has been harmed by neglect at a nursing home, please contact our office to see how we can help. Also, if you are a current or former employee of a nursing home and have knowledge of wasteful or fraudulent billing practices at the facility, please visit our office to see how whistleblower provisions in federal law might apply to your situation. The False Claims Act allows whistleblowers to receive a portion of recovered funds, and so there is significant incentive to ensure that public funds are properly spent at all times.

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