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Every 24 hours I receive links to news articles posted on the Internet pertaining to the nursing home industry. I have an average of 40 news articles to shift trough every day. That makes for a lot of reading and lots of tough decisions about what I should post about on this blog. Additionally, your e-mail messages provide me with more excellent topics to write about. At any given time I probably have at least two dozen news articles or topics to write about. If there were only enough hours in the day to devote to this blog and attend to the other things that demand my attention!
Easily the number one topic in the news these past few months – which is the time of the year that various state’s legislatures have been in session – has to do with the near hysterical responses of the nursing home industry about proposed cuts to state Medicaid funding. Nursing homes happen to be the largest recipients of Medicaid funds, so it is understandable that the industry would have strong emotions when it comes to their income stream being threatened. Strong emotions I can understand. But the near hysteria that has been coming from industry spokespersons is, at best, over the top and should be taken with a huge grain of salt.
If you’ve spent any serious amount of time reading this blog, then you know my position is that FOR-profit nursing homes have a clear history of MISspending their income (e.g., spending it on things OTHER than resident care), while NON-profit nursing homes not only spend their money where it truly belongs (e.g., spending it on nothing but those things that directly impact resident care).
So when the paid mouthpieces of the for-profit nursing homes get hysterical about proposed Medicaid spending cuts, I gotta’ ask what is their response REALLY all about? Their hysteria is cleraly influenced by….
- For-profit CEOs who might have to take a cut in pay (many make is excess of $1 Million per year, while nurse’s aides barely make above minimum wage). Maybe their Rolls Royce will be replaced by a BMW? What, no more heated indoor swimming pools in their multi-million dollar homes?
- Stockholders, since cuts to Medicaid reimbursement will likely reduce the growth of of profits and therefore mean smaller dividend checks.
- Nursing home administrators, who might have to take a pay cut? I certainly don’t feel sorry for them since the average base salary for administrators of for-profit nursing homes is believed to be in excess of $80,000. Will they have to trade-in their BMW for a Chevy or Ford?
- Corrupt politicians, since the for-profit nursing home industry might have to reduce the money it spends on buying their votes.
Less money to buy luxury homes built on multi-acres of land, smaller stock dividend checks and fewer dollars to influence legislators…maybe even less income to spend buying up more nursing homes. Make no mistake: these are the things that are REALLY “at risk” if Medicaid reimbursement is decreased. Moreover, these things are NOT in any way, shape or form related to providing nursing home resident care! Instead they are hallmarks of a greedy, whoring industry that has a clear track record of wasting your tax money – our tax money – to feed its out-of-control appetite.
Some of the hysterical remarks from the for-profit nursing home industry involve threaten to reduce staffing levels to compensate for reduced Medicaid reimbursement. The TRUTH is that for-profit nursing homes are staffed at a LOWER level than comparable non-profit facilities. So don’t believe the lie that the nursing home staffing levels have to be reduced. The only thing that should be “reduced” is the degree of greed that the industry has been getting away with for the past 20 years!
Kudos to Ohio Goveror John Kasich! During his recent State of the State speech he used very blunt language to confront the greedy nursing home industry (and this from a Republican!).
Kaisch pledged to rein in the powerful nursing home industry, whose lobbyists and campaign contributions have helped it preserve a big piece of his state’s Medicaid budget. “If your mom and dad want to stay home instead of going to a nursing home, we should help make that happen,” he said. “Taxpayers will save a bundle of money. This has been discussed for decades. It’s time to get this done.”
Amen, Governor Kaisch!
While I don’t know about the cost for nursing home care in your corner of the USA, here in Louisville, Kentucky, the average cost of a semi-private room is around $150.00 per day. This is the room rate and does not include the cost of medications or other incidentals.
For-profit nursing homes can’t seem to stop whining that need/deserve an increase in the amount that is paid to them by Medicare and Medicaid. In fact, many nursing home industry lobbyists tell our Kentucky legislators that they can’t possibly improve their staff-to-resident ratio without a significant increase in their daily rate. Really?!? Well I beg to disagree.
The last time I checked, the average salary for nursing home administrators in the United States was nearly $80,000 per year. The average annual salary for a nursing home Director of Nursing is nearly $70,000. Many COOs, CEOs and CFOs of for-profit nursing home chains command annual salaries of hundreds of thousands of dollars, while some earn more $1 million per year!
What do residents of for-profit nursing homes get for their money? Not much to boast about…
– Staff-to-resident ratios far below those of non-profit facilities.
– The average amount spent on nursing home meals: around $1.00 per meal. One Canadian-based nursing home chain, with facilities in both the USA and Canada, recently celebrated when they discovered a way to cut the cost of their average meal to less than 80 cents!
– Wheelchairs that lack working breaks and beds that can’t be adjusted like they were designed to be because they need repaired or replaced.
All of this proof that the money from Medicare and Medicaid is not going into resident care and yet …
– In Kentucky the nursing home industry spent more than $250,000 during a 10 year period to bribe (sorry, we should say “influence”) legislators so as to prevent nursing home reform legislation (including minimum staffing standards) to be enacted into law.
– An east coast nursing home owner pumped most of his profits into running a recording studio for a friend who is a popular country music artist.
– And then there’s the Indianapolis-based nursing home chain that can’t stop putting every available penny of profit into gobbling up even more nursing homes.
– Oh yeah, don’t forget about the many large nursing home chains that have to pay out a hefty dividend to their stockholders.
In my opinion, for-profit nursing homes don’t need one cent of increase in their daily rate. Instead what they need is a CONSCIOUS that will guide them to put all of their profit into improving resident care!
Before you think for one moment that for-profit nursing homes “need” increased reimbursement from Medicare and Medicaid to increase the staff-to-resident ratio, consider the overwhelming body of evidence that non-profit nursing homes (they also receive Medicare and Medicaid payments) have far better staffing ratios than the for-profit facilities.
It is time to stand up to corporate greed and their mismanagement of public (and private) funds and insist that the money intended for resident care go for that purpose and that purpose alone!
Earlier today (Sunday, 2/7/10) I received a hopeful message from “Janie” who lives in the Metro Louisville area. She shares the following thoughts about a positive experience she had involving the nursing home where her mother currently lives…
“There is a nursing home in Louisville that, in my opinion, is a model of excellent care. It is (located in Louisville, KY — name withheld). My mom has lived there nine months and had incredible care. I credit them with bringing her back to life which her previous nursing home could not begin to manage.
I hear the frustration in the Courier-Journal (2/7/10) article and in the messages on this NursingHomeReality website. I am writing to suggest looking into a nursing home that is working well and finding out what makes it so, may offer some insight as to how to move into the positive role homes can play and are needed to play – (the nursing home where my mother lives) is such a place! I know that (this facility) is owned by (a local family) who have had the home since it’s opening. That management and mission may have a lot to do with the level of care.
When mom did have to go to the hospital once from (Nursing Home X), the staff was on top of it early and she was back and getting better within 10 days…Once back, it wasn’t minutes before she was embraced for a lengthy hug by the nurse on duty. The needed oxygen tank and breathing treatment equipment was already in mom’s room – these were items she had never had to use prior. Something is going really right at this nursing home for my mom – just wanted to offer a model as a starting ground – to maybe figure out what makes it so.”
Indeed Janie is one of several persons who have shared very positive things with me about the nursing home in question over the past few years. I tried to arrange for admission for my mother to that same facility, but was turned down due to a decision made by management a few years ago to drop several Kentucky Medicaid-certified beds so the facility could increase the number of (Medicare and private pay) rehabilitation beds. Also this facility did not offer a dementia unit, so they felt they could not meet my mother’s needs. This isn’t to put down this nursing home, just to point out that while the nursing home in question is a great match for many persons, it may not be the right facility for others. This is of course true for all nursing homes.
I believe Janie touched on a key ingredient of excellent nursing home care: ownership that is local and not part of a large, multi-state corporation. It seems that whenever these large corporations get involved, that the quality of care suffers because of the corporation’s greed. When financial profits become more important than resident care, then the quality of resident care always suffers.
Because of the “corporate greed factor”, I have no doubt that minimum staffing requirements, as mandated by individual states, are needed now more than ever. There are fewer and fewer locally-owned nursing homes, like the facility mentioned by “Janie”, since the overwhelming trend in the industry is for big, greedy multi-state corporations to continue gobbling them up.
I would be in favor of legislation that either mandates that all nursing homes be owned by non-profit corporations or that for-profit nursing home corporations be limited as to how many facilities they can own. Perhaps this latter option would at least help reign in the greed factor, if not eliminate it completely.