The Consumer's Role in the Nursing Home/Healthcare Reform Battle

Health care reform is the big issue today- as it should be. But how will it affect our elderly in nursing homes? Nursing home owners say they are looking at $16 billion dollars in cuts from Medicare over the next 10 years. Is that so? The Washington, DC-based Center for Medicare Advocacy (http://www.medicareadvocacy.org/ ) reviews reports from the Government Accountability Office (GAO) and the Medicare Payment Advisory Commission (MedPAC) and advises that those reports show that Medicare overpays nursing homes billions of dollars a year. MedPAC found that the aggregate profit margins for freestanding nursing facilities exceeded 10 percent for seven years in a row. In 2007, their profit margin was 14.5 percent. Moreover, they didn’t add staff. So the Center for Medicare Advocacy believes that the nursing home operators are pocketing much of the profits, rather than reinvesting them. The reports also cannot account for money paid out to associated groups who own the property, manage the facility etc.

We read every day about Congress wrestling with health care reform. Hand in hand with Congress are the groups we refer to as lobbyist- there to make sure their particular industry is protected. One of those groups, of course, is the nursing home industry, which claims it is facing a $16 billion cut in direct support from Medicare over the next 10 years, as well as Medicaid cuts in many states.

The nursing home operators warn that further cutbacks in Medicare-which are part of the reform legislation– will drive many facilities out of business. Some homes are laying off employees now, and a few have recently closed. We are also seeing the nursing home reduce Registered Nurses with Licensed Practical Nurses in many areas. Meanwhile, the need for these institutions is increasing. As the number of people going into nursing homes increases so does the level of nursing care.

Are the nursing home owners trying to defeat healthcare reform because Medicare benefits reduction will affect care .or their bottom line? Is the advocacy center right that profits are really higher than reported? Nursing home owners have been known to put their own profits before people. There are cuts in Medicaid. We should all be concerned about the care our elderly will receive.

Knowing what is going on in your local nursing homes is probably the best each of us can do on an individual level. Check them out carefully before placing your loved one in a nursing home. The earlier you know what to look for to prevent nursing home neglect or abuse, the better for your loved one. Here are some cites that will give you information about getting good care: the National Coalition for Nursing Home Reform http://www.nccnhr.org/ , a governmental agency, the National Center Elder Abuse Http://ncea.aoa.gov , and Medicare web site http://www.medicare.gov/nursing/overview.asp.

There are warning signs that nursing home abuse or neglect may have occurred. It is not uncommon to hear reports of various forms of violence and irresponsible, inhumane treatment being inflicted upon residents, including: physical assault and battery ; sexual assault and battery; rape; deprivation of food and water; unreasonable or unwarranted physical or chemical restraint; withholding of needed medication ; overmedicating; suspicious injuries; appearance of untreated wounds, cuts, bruises, welts; reports by residents of being slapped, struck, pushed, shaken, beaten or likewise mistreated; improper confinement; serious injuries requiring emergency treatment or hospitalization; and incidents that result in broken bones, especially a fractured hip.