A recent New York Times report reveals that government oversight of long-term care facilities is deeply troubled. Inspection of rehabilitation facilities is inadequate, and we, the public, had best not rely on reporting inspection results.
If your loved one needs more care than can be provided at home and trying to find a facility, be sure to do your due diligence. Visit the facility, talk to doctors, get references, and do everything you can to gather your data in deciding whether you would feel comfortable placing your elder there.
You may have seen the rating system provided by the Centers For Medicare and Medicaid Services (CMS). CMS awards stars to healthcare facilities on “Care Compare.”
The stars are intended to help you make informed decisions. The more stars, the better the facility is supposed to be. However, the website also advises that in addition “to reviewing the information here, you should talk to your doctor, social worker, or other health care providers when choosing a provider.”
That is for sure. The New York Times report, published on December 10, 2021, is titled “How Nursing Homes’ Worst Offenses Are Hidden From the Public.” The report documents how federal and state investigators failed to record some severe nursing-home infractions – including abuse, neglect, over-medication, and endangerment of residents. If violations were cited, and even if they were upheld in a secret appeals process where only unopposed nursing homes are permitted to make their case, the stars on the “Care Compare” site did not reflect the proven violations. Some facilities with serious violations retained their glowing reviews regardless.
The “Care Compare” star ratings are highly consequential to the nursing homes’ balance sheets. As the Times reports, there is a link between the number of stars awarded to a facility and the facilities’ profits. In other words, the public relies on the stars, but visitors to the site have no way of knowing whether the stars do reflect the state of affairs at the facility.
New legislation may help. The Nursing Home Improvement and Accountability Act was introduced in August 2021 by Senate Finance Committee Chair Ron Wyden (D-OR) and several other Democrats. Wyden’s bill aims to improve the quality of care and the oversight system for those facilities receiving government funds. The bill is in the first stage of the legislative process at writing.
Of course, given a choice, most people would rather stay at home if possible. That option, too, however, is plagued with problems. Government money available for in-home care is presently stretched very thin. Thousands of elders are on waiting lists to receive funds through various programs. Care workers are among the lowest-paid in the nation. The standard of care inevitably suffers.
The “Build Back Better” package, currently proposed by the Biden administration, has been slashed during negotiations in Congress. However, the current funds under discussion, $150 billion for elder care, would be a significant first step toward improving the outlook for so many who need support and health care at home.
Congress is also considering extending a tax-relief provision that is presently contained in the covid-stimulus package, the American Rescue Plan, which passed in March 2021. The ARP provision permits tax deductions of $4,000.00 in care expenses per dependent for low- and middle-income families.
Some help for home care has already arrived with the ARP tax relief, and more may become. But if your elder needs more-intensive care in a facility, caveat emptor – and contact your representatives in Congress. The nursing-home improvement bill has a long way to go before it becomes law.