South Carolina Nursing Home Lawyer & Attorney : Poliakoff & Associates Law Firm : Elderly Care, Senior Care

Interesting article from the Courant.com about a deal to sell the bankrupt Haven Healthcare nursing-home chain.  Attorney General Richard Blumenthal said that Formation Capital, which owns Genesis HealthCare, notified the state that it was pulling out of an $85 million deal to take over 14 of Haven's homes in Connecticut and 10 in other New England states, without giving a reason.

Formation announced June 12 that it had signed a purchase agreement for the homes, but the company had two weeks to reconsider before the deal was to be finalized in bankruptcy court Thursday.

Many nursing homes across the country are owned by real-estate investment firms and managed by other entities — a form of ownership called a REIT, or a real-estate investment trust. By law, a REIT cannot operate a nursing home, but must hire a licensed provider to do so.

"The former management of Haven is history. We are all committed to a new day for these nursing homes, their residents and their dedicated employees," Blumenthal said.

Blumenthal and officials of the state Department of Social Services said they and the health department will be closely monitoring operations of the Haven homes while the future of the chain remains in limbo.   Occupancy in some Haven homes has fallen off dramatically since the chain declared bankruptcy seven months ago.

Haven — one of the largest chains in the state, with more than 1,800 beds — declared bankruptcy last November in the wake of a series in The Courant detailing its financial troubles and repeated citations for patient-care deficiencies. The company defaulted on millions of dollars in bills for supplies and utilities while its CEO used corporate assets to launch a Nashville recording company and make other personal purchases.

The Department of Social Services had offered Genesis sizable Medicaid rate increases and other incentives to take over the chain, but also had required that Genesis agree to provide detailed financial reports and meet certain staffing standards once it took over operations. 

Blumenthal said Thursday that a wide-ranging investigation of Haven's financial dealings will continue, regardless of the outcome of the sale of the chain.

• Print
• Comments
• Trackbacks

Below is an excerpt of an article I recently saw from The Choate News about how California nursing homes used an increase in reimbursements from the State for profit instead of providing adequate care.

Nursing Home Pocket Money Meant For Care
By Jordan Rau

SACRAMENTO, Calif. -- California’s nursing homes pocketed much of the $590 million that state lawmakers provided them to better tend to low-income people, while patient care declined by several key measures, according to a study to be released Tuesday.

A law boosting reimbursements from MediCal, the state’s health-care program for poor people, passed in 2004. By 2006, the first full year the higher rates were in place, average nursing-home revenues from MediCal had increased from $124 a day to $152 per day, according to the study by a team of researchers at the University of California, San Francisco -- but few of the promised improvements for patients or staff had come to pass.

Nursing attention for patients grew, on average, by 3 percent. But the study also found that 144 homes, or 16 percent, did not meet the state’s minimum staffing standard.

Average wages for nursing assistants increased from $10.61 an hour to $11.32, not quite enough to keep pace with inflation, the study said.   Turnover among nurses grew slightly worse, with nearly 7 in 10 leaving their jobs that year.

The amount nursing homes spent on direct patient care actually decreased by 3.6 percent, according to the study. Substantiated complaints of patient mistreatment increased by 38 percent. State and federal regulators cited homes for 6 percent more violations.

“They got so much money, they should have been able to do something,” said the study’s lead author, Charlene Harrington, a UCSF professor and nationally recognized authority on nursing homes.   “The fact that they let the nursing-assistant wages actually decline with inflation, I think there’s no excuse for that,” Harrington said. “They’re the bulk of the workers and they’re the lowest paid.”

The higher reimbursement rates were pushed through the Legislature in the final two weeks of its 2004 session by a powerful alliance between the nursing-home industry and Service Employees International Union, which represents many health-care workers.

At the time, several nursing-home advocates objected that the measure lacked sufficient safeguards to ensure that the money went to patient care.

Along with more money, the new law changed the way facilities were reimbursed from a flat fee for each patient to one based on how much the homes spent on workers, patients and the physical plant. Supporters pledged that the change would reward homes that hired more nurses and paid them better.

The average nursing home netted $248,047 in 2006, a 233 percent increase from 2004, the study said.   The study found some areas where nursing-home spending did increase substantially.

For example, administrators’ wages rose by 13 percent, and the pay for licensed nurses -- who have more training than assistants -- grew by 9 percent.

Nonprofit nursing homes raised their wages more than for-profit homes. Still, said Michael Connors of California Advocates for Nursing Home Reform, a patient watchdog group, “to a great degree, no one knows where the money went and how it was used. What’s clear is it hasn’t been used for beneficial effects on residents, which is appalling.”

• Print
• Comments
• Trackbacks

There is a great editorial by Tamara Hill in the Tennessean.  Here it is in its entirety.

Lawsuits are the only way some nursing homes will provide the services they're supposed to offer

By TAMARA L. HILL   Tennessee Voices

In response to a letter to the editor by Debra Fish ("Nursing homes are pot of gold to lawyers," March 5):

Taxpayer money does not line the pockets of attorneys who sue nursing homes for providing negligent care. If the facility is found to be negligent because a civil justice attorney brings its behavior to the attention of the courts and jury system and the facility pays a judgment or settlement, Medicaid and/or Medicare, whichever paid for the negligent care, is reimbursed ... meaning the taxpayers are reimbursed when a facility is found negligent, not that the taxpayers' burden is increased.

It has also been suggested that lawyers "pile on huge sums of money that bankrupt nursing homes and keep money from being spent on improving care for the residents" on top of judgments allowed by judges and juries. This simply is not true. A lawyer cannot force the nursing home to pay more than the judgment or settlement amount.

As a former nursing-home nurse working in administration, there were multiple instances in which I had to beg corporate for things needed to provide basic patient care ... soap, shampoo, gloves, bandages, dressings, towels, sheets, equipment and, of course, the staff to actually provide the care. I was often told that it wasn't in the budget.

Sometimes the ONLY way I could get what I needed for the residents was to say "OK, but if I can't get what I need for my staff to take care of them, then you are just buying a lawsuit." Then, suddenly, someone "found" money in the budget to get the things the patient needed. If there were caps, then it would become a cost-benefit risk analysis, weighing a known cost (about 75 percent of the cap) and the savings (benefit) by not providing the staff, supplies and care vs. the risk that someone would take the lawsuit with caps in place.

National HealthCare Corp. is using some of its money in two ways: One is to give bonuses to its corporate employees. Another is to pay lobbyists to convince your state legislators that it needs "liability reform" so that it can't be held responsible for its negligence.

The proposed bill seeks to put a cap on so-called non-economic damages suffered by nursing-home residents, such as pain and suffering, emotional distress, disfigurement and death. It also seeks to make the cases much more expensive to pursue and defend by placing nursing homes under the Medical Malpractice Act.

Finally, the bill seeks to give nursing homes the ultimate immunity by forcing residents to sign away their right to access to the courts as a condition of admission. How does this protect patients? I submit to you that it does not. It protects nursing-home profits.

--------------------------------------------------------------------------------

• Print
• Comments
• Trackbacks

 U.S. Medicare Monday proposed a $690 million increase in payments to nursing homes. The 3.3-percent increase would go to nursing facilities that provide skilled nursing and rehabilitation care to Medicare beneficiaries, according to the Centers for Medicare & Medicaid Services.

Under the new payment schedule, called the skilled nursing facility prospective payment system, the daily rate for room, board, medical care and other expenses would be increased. Current payments are based on a 1997 market basket, but the proposal would update rates using a 2004 market basket.

Hopefully, this increase will lead to more staff who are better trained.

• Print
• Comments
• Trackbacks