The hard reality is that from eligibility to reimbursement rates, it is largely the fault of state and local governments that nursing home care is just barely adequate and rarely provides a decent quality of life.

By Steve Moran

I have to tell you this is one of my favorite stories I have ever written.

There is story after story about how terrible nursing homes are, about how residents are neglected and the tag line at the end of every article is twofold:

  • We need more regulations

  • Someone should sue the nursing homes

The stories often tug at the heart, and the emotional reaction is “yeah, go get those dirty rotten profit-mongering nursing home operators”.

Total BS

Most of those stories completely ignore the real culprit.

The Real Truth – The Real Fault

The hard reality is that from eligibility to reimbursement rates, it is largely the fault of state and local governments that nursing home care is just barely adequate and rarely provides a decent quality of life. They are strangling the life out of providers . . . which, one might argue is ok, except that what it really means is that providers only have the resources to provide the most minimal of acceptable care and . . .

It is hurting elders.

And the thing that no one talks about is that hundreds of thousand of frontline staff members are living below the poverty line, many of them forced to work more than one job just to make ends meet.

The Superman Award Goes to Evangelical Lutheran Good Samaritan

Evangelical Lutheran Good Samaritan Society gets the prize for taking on the state of Kansas. They have filed suit on behalf of 21 residents who live in their Kanas buildings because the state has refused to approve or deny benefits for those residents. This means the communities had two choices . . . 1) They could sue the state (the chosen course of action); or, 2) Evict the residents (a terrible option). 

It is crazy but will surprise no one, that some of these approvals go back to residents who were admitted in 2013. They are owed anywhere from $24,562 to $84,133 per resident. This suggests the state is holding onto somewhere between half a million and three quarters of a million dollars.

This ought to outrage elder advocates. It ought to outrage providers, it ought to outrage AHCA and LeadingAge. It ought to outrage families.

I find myself wondering just how long it would it would take to get some real reimbursement action if every nursing home organization in the country started fighting back with lawsuits when the government shirks it’s responsibility to the nation’s elderly and to those who do the heavy lifting work on the front line each and every day.

Ken Dychtwald was right that we should be asking both presidential candidates to address issues related to our aging population.   

Filing suit would force lawmakers to pay attention. It would grab the attention of the media. Most importantly it would lay the blame for less than ideal care where it belongs — at the feet of the government.