Column discussing Tennesse's legislation to protect deficient nursing homes
Mark N. Geller is a Memphis attorney with Nahon, Saharovich & Trotz PLC. He leads the firm's nursing home practice group. He wrote the following column which can be found here:
The federal government's Medicare program recently released a rating system that ranks the quality of care for residents in nursing homes. Among our nation's 50 states, Tennessee ranked third from the bottom in its percentage of nursing homes that received the report's highest five-star rating -- ahead of only Louisiana and Georgia.
According to this rating system, Tennessee also had the fourth-highest percentage of poor-performing nursing homes in the nation (those that received the lowest possible rating of one star), behind Louisiana, Georgia and Virginia.
On the surface, these results are bad enough for Tennessee's elderly population and their families. Unfortunately, though, the Medicare Nursing Home Compare report fails to capture the true extent of how poorly our fellow Tennesseans who live in nursing homes are being cared for right now.
In fairness to the nursing home community, four nursing homes within 50 miles of Memphis were given the highest ranking by Medicare's report, and they stand out among the best in the country. (To view the full report, go to medicare.gov.)
As an attorney who practices in the area of nursing home litigation, I witness almost daily the substandard level of care many elderly Tennesseans must endure. I have seen the wide range of poor nursing home care across this state; poor care that sometimes includes leaving people in their own excrement for long periods of time, which results in bed sores and even death. There are cases -- and they're not uncommon -- in which elderly nursing home residents have been left begging for food and water, but have been ignored. Or cases -- including one recently in Memphis -- where elderly residents have wandered out of their nursing facility unsupervised and were severely injured.
Even this bare recitation of facts pales next to actually hearing a family's story. Family members have spoken about how they begged and pleaded for care that never came. They have talked about the heartrending suffering their loved ones go through in their last days of life.
Despite these stories and the objective data ranking Tennessee among the worst in the nation for nursing home care, Tennessee legislators recently sponsored bills (HB2243 and SB2160) to reform lawsuits against the nursing home industry by putting a monetary value on human life.
The bills set the price of a human life at $300,000. If they become law, that would be the maximum amount of noneconomic damages that could be awarded to plaintiffs in lawsuits against a nursing home. In addition, if a jury concludes that the nursing home's actions were so wrong that they warrant the award of punitive damages, that amount would be limited as well, by a formula that uses calculations provided by the nursing home itself relating to its level of patient care.
These proposals, which are under review in legislative committees, are bad bills that are primarily focused on limiting the compensation that a family can recover if a jury finds that a nursing home acted improperly. They would protect nursing homes from liability. Nothing in them would protect nursing home residents.
There is no serious measure within these bills that sets out minimum standards for proper care of nursing home residents. The proposals fail to provide measures to protect the residents from negligent or improper care. They have no provisions to require nursing homes to maintain proper staffing levels or even treat their residents well.
Tennessee's low ranking in the nursing home industry is easy to understand. Typically, nursing homes are operated by multibillion-dollar, multistate corporations whose main purpose is to make as much money as possible for their shareholders. Of course, there's nothing wrong with making money. What is wrong is that many nursing home chains too often cut operational costs to increase profits. Such cuts are unconscionable when they are done at the expense of their stated business goals: the comfort and well-being of the elderly.
When a nursing home's budget is cut, the nursing home must function with less supplies, equipment and staff. Less staff means fewer people to provide care to the residents. Eventually, it reaches a point at which the staff, no matter how caring or qualified they may be, are simply unable to meet the needs of the residents.
Life is precious and should be treasured. Every human being deserves to be treated with dignity and respect.
Making money is perfectly acceptable so long as you are doing your job first. Here, the primary job should be to provide skilled and humane care to the residents of Tennessee's nursing homes and to make sure their needs are being met.
The state should legislate serious standards of care for nursing homes. And nursing home operators should be held accountable if they fail to live up to those standards.
