The topic of nursing home evictions has been at the forefront of our minds, ever since NPR singled out Illinois and Maryland this past May as having the worst nursing home eviction rates. Nursing home eviction, commonly referred to as involuntary discharge, has grown tremendously in recent years, with many theorizing that nursing homes have begun to catch on that they can get away with dumping Medicare patients as soon as their nursing home benefits expire. Medicare reimburses nursing homes at a higher rate than Medicaid, making new Medicare patients such an attractive prospect that nursing homes are willing to buck the law and dump current residents that are recently transitioning from Medicare to Medicaid.
NPR recently profiled the case of Mrs. Gloria Single, an 83 year old woman suffering from Alzheimer's who was evicted in March from Pioneer House, the Sacramento, California nursing home in which she resided with her husband of 30 years. Pioneer House staff claim that Mrs. Single became aggressive with staff and threw plastic dishware. Even after a psychiatric evaluation at a local hospital determined there was no cause for concern, Gloria Single was evicted from the nursing home and sent to a hospital where she lived for 4 months before being placed in another facility. As hospitals are not intended to maintain a social or activity routine for patients, Mrs. Single lost her ability to walk during her stay and is now wheelchair bound. She also is heartbroken at having to spend her remaining years in a facility separate from her husband, who is 10 years her senior.
In an attempt to reunite his parents, Gloria Single's son took her case before the California Department of Health Care Services. Among other rules, nursing homes are required to give 30 days notice before evicting a resident, as well as to hold a bed for the duration of a resident's hospitalization. Pioneer House failed Mrs. Single on both counts.
Mrs. Single's son won the case, but was later told that they couldn't actually do anything to help. AARP, the California-based non-profit organization dedicated to ensuring positive aging, had been pushing the government to start investigating California's high number of evictions. They heard about Gloria Single's case and agreed to take on Pioneer House and its parent company, The Retirement Housing Foundation. Once word had spread that AARP was taking on nursing homes, the California Long-Term Care Ombudsman Association asked to join the lawsuit as a plaintiff. According to that organization, they receive so many complaints about involuntary discharge that their staff can't handle other concerns. They speculate that one of the causes of the recent uptick in California's illegal evictions could be the dwindling number of nursing home beds. According to their executive director, there are 2,300 fewer nursing home beds than there were just 6 years ago.
Regardless, NPR's independent evaluation found that only 7% of nursing homes who illegally dumped residents had been punished. The average fine was $1,000 or less, with the majority of those fines unpaid in full.
What good is regulation if no one follows it? It's time for empty threats and meaningless rules to be replaced by firm laws and strict punishments. Only then will nursing homes begin to see residents as people and not as a paycheck. Here's hoping that Gloria Single's case will set a positive precedent that changes the way the industry handles involuntary discharge.