Elder Abuse in For-Profit Nursing Homes
As the number of for-profit nursing homes increases, so do the overall statistics regarding fraud and abuse reported by nursing home residents.
It would be unfair to assume that all nursing homes are the same; nothing could be farther from the truth. However, it is important to be aware of what problems do plague many of these institutions.
The Problems Plaguing Nursing Homes
One thing is certain: there are both good and bad nursing homes. Some of them only provide minimal care to patients, while others over-bill Medicare and Medicaid patients for services they may (or may not) provide. Unfortunately, some types of nursing homes are more prone to over-bill and provide minimal care than others.
The facilities most likely to file invalid claims with the government tend to be for-profit nursing homes. According to data from the U.S. Department of Health and Human Services, a staggering 30 percent of medicare claims filed by for-profit nursing homes were invalid, compared to only 12 percent of claims submitted by nonprofit nursing homes.
The Growing Problems Within the For-Profit Industry
Why is there an increase in the problems associated with fraud, waste and abuse in for-profit nursing homes? One possibility is an increase in the number of for-profit nursing homes. For example, in 2002, for-profit nursing homes accounted for 72 percent of all revenues within that sector of the industry, and in 2010 78 percent out of $105 billion was allocated to for-profit facilities, but this trend is not limited to just nursing homes.
For-profit outpatient surgery centers make up 96 percent of the total number that are in operation; this is a 33.3 percent increase over the past decade. Half of the hospices in the United States are also for-profit, as are over 80 percent of all dialysis clinics and home-health care agencies.
The Effects of Overbilling and Cost-Cutting Measures
While some may think overbilling doesn’t really hurt anyone, this is far from the truth. Overbilling can deplete the limited resources that are allocated for patient care which prevents the elderly (who depend on those services) from receiving the nursing service on which they depend.
Another factor to consider is the aggressive cost control measures used by for-profit nursing facilities. For instance, there were 37 percent fewer registered nurses employed by for-profit facilities compared to nonprofit and government-run facilities during the five year period of 2003-2008. They also received 59 percent more deficiency reports during inspections than those in the nonprofit category. This report was released in 2009, and according to the American Health Care Association, the nurse-patient ratio has improved, though they still have a long way to go before they are equal to nonprofits and government-run facilities.
If you or a loved one is concerned about the care being rendered in a nursing home, especially one in the for-profit category, call my office at (214) 651-6100 and discuss your situation with us for free. We’ll evaluate your potential case and explain your options for no cost.
Category: Lawyer's Advice
