Study Finds For-Profit Nursing Homes and Other Healthcare Facilities Place Money Above Care

All too often in our world money trumps morals. One arena in which this problem is particularly pronounced is the nursing home industry. As a San Francisco elder law attorney, Greg Brod helps victims of nursing home neglect and other mistreatment. These abuses often coexist with Medicare overbilling, a problem discussed in a recent Bloomberg report carried by the San Francisco Chronicle.

Article Ties Overbilling and Profit Motives to Elder Neglect
Bloomberg’s research delved deeper into a November report in which federal health care inspectors concluded the nursing home industry overbills Medicare to the tune of $1.5 billion (yes, with a “b”) annually for treatments patients either don’t need or never actually receive. The further study focused on profit motives, noting that investigators deemed thirty percent of reviewed studied claims from for-profit facilities improper, compared to a significantly smaller (though still too high) twelve percent from non-profit homes. At least six other studies undertaken by government and academic bodies in the past three years reached similar conclusions, finding that the rise in the number of for-profit providers is leading to waste and fraud. Likewise, this profit-driven culture is fueling patient harm.

Between 2008 and 2012, federal prosecutors brought 120 civil and criminal claims against nursing homes and individuals in the industry, twice the number brought in the prior five year period. In some cases, the homes overbilled Medicare for unnecessary procedures that caused harm and suffering rather than providing actual treatment. In other cases, companies skimped on staffing leading to patient neglect that included leaving patients in soiled clothes for hours, denying them baths, and causing malnutrition and preventable infections. Between 2003 and 2008, the ten biggest nursing-home chains operated by for-profit facilities employed 37% fewer registered nurses per patient day than their non-profit counterparts. This figure is likely part of the reason that the for-profit homes received 59% more deficiency notices from the government than nonprofits did in that time frame.

The problem of for-profit companies placing profits over care extends beyond the senior care arena. For-profit groups manage 96% of outpatient surgery centers, a major growth sector in the health care field. For-profit hospice care companies have also been cited for overbilling and providing inappropriate services. Home health care and dialysis centers have also been moving to more for-profit management. Notably, hospitals are more resistant to the trend with 88% of hospital revenues in 2010 coming from government and non-profit operated facilities.

Fighting Nursing Home Neglect in California
A couple of quotations jumped out to our San Francisco nursing home law firm as we reviewed the article on the Bloomberg investigation. Staff members at one for-profit facility reported, “we have been encouraged to maximize reimbursement even when clinically inappropriate.” That nursing home settled a wrongful death and elder abuse lawsuit involving a woman who fell several times, allegedly because of profit-driven understaffing. In another case, the California attorney general brought a lawsuit against a for-profit nursing home. Discussing an understaffing issue, the jury foreman commented “You can’t make people lie in their own filth because you’re too focused on profits to hire enough nurses.”

Elder abuse and nursing home abuse must not be tolerated. Companies are taking advantage of a vulnerable population, risking health and safety in order to make more money. If you believe a nursing home or other facility has sacrificed care leading to injury or death of a Northern California nursing home resident, please call our office. As an experienced San Francisco nursing home neglect lawyer, Attorney Greg Brod can help you protect your loved one and seek justice in civil court.

(Photo by Craig Toron)