Nursing homes oust unprofitable patients with claims of psychosis
In a New York nursing home, a resident hurled a bingo chip. At a home in Georgia, a 46-year-old woman, paralyzed from the waist down, repeatedly complained that no one had changed her diaper. In a California facility, a patient threw tableware.
“Even before the pandemic, there was tremendous pressure to get rid of Medicaid patients, especially those that need high levels of staffing,” said Mike Wasserman, a former chief executive of Rockport Healthcare Services, which manages California’s largest chain of for-profit nursing homes. “The pandemic has basically supercharged that.” He said homes often take advantage of fits of anger to oust patients, claiming they need psychiatric care.
Invoking psychiatric problems is a popular tool. Nursing homes routinely admit patients with dementia, Alzheimer’s or similar illnesses, and angry outbursts are common. Federal law requires nursing homes to follow strict guidelines when they intend to evict someone: They must give 30 days’ notice and come up with a plan to transfer the resident to a facility that can meet his or her needs. If a resident goes to a hospital, the facility must hold the bed for a week.
Gloria Single was a resident of the Pioneer House nursing home in Sacramento. She had dementia and pulmonary disease and was on California’s version of Medicaid. Pioneer House was receiving about $400 a day for her care. John Supple, a lawyer for the Retirement Housing Foundation, which operates Pioneer House, said that its medical director had deemed the home unsuitable for Single’s medical needs and that Pioneer House had never received the medical records it needed to readmit her. Supple said Pioneer House had held Single’s bed for months and had not replaced her with a Medicare patient.
A state health inspector later determined that the discharge was illegal, according to a copy of the inspector’s report reviewed by the Times. In June, Connie Rodina got a phone call from the Richmond Healthcare and Rehabilitation Center in Richmond, Kansas. Her 63-year-old brother, Jon Fowler, who suffers from mental illness and dementia, had hit another resident. Rodina, her brother’s guardian, was told that she needed to pick him up immediately.
In some cases, nursing homes have ignored orders from regulators to take back patients they sent to emergency rooms or psychiatric hospitals.
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