Medicare boomers are in a bad place.
Nursing home residents trapped in wheelchairs with floodwaters rising to their waists — the photo of Hurricane Harvey everyone’s seen. But even where the weather’s fine, nursing home residents are in peril. An alert issued Monday by the Inspector General for the federal Department of Health and Human Services calls for urgent action. It cites incidents in 33 states where nursing home residents were rushed to emergency rooms because of rape, broken bones, and severe neglect. The IG warned families to “visit your loved ones often” and “report potential cases of abuse or neglect to your local police.”
One out of every three baby boomers will need a nursing home. Not necessarily for permanent living. Many will go for rehab after heart surgery or an orthopedic repair, never thinking the stay could turn deadly. Robert Pineda, a New Mexico accountant, had surgery on his injured knee, then went to a rehab near the hospital. Inadequate care led to a bed sore, which became infected, requiring several surgeries, landing him on dialysis and a ventilator. He was taken off life support one week before his 69th birthday.
Lana Chmielewski said her mother spent “11 days of hell” at James Square Health and Rehabilitation Centre in Syracuse, New York. She developed bed sores and an infection, forcing her back to the hospital, where she died after four days.
You can blame the indifference of hospital administrators and government officials for the frequency of these tragedies. When hospital patients are told they need to go to rehab, instead of straight home, the hospital hands them a list of facilities. Beware. Some facilities have five star ratings from Medicare, but others have only one or two stars, meaning substandard care. Hospital staff don’t tell you that. Laura Rees took her 88-year-old mother to the facility on the top of the list, clueless it had only one star. Three weeks later, according to the California judge who ruled in the case, Laura’s mother was left to “drown in what appeared to be her own excrement.”
What can families do? Complaining to the facility usually elicits “we’re short-staffed.” That’s what Lee Ann Johnson was told when she came to James Square each morning, always finding her husband drenched in urine. Conditions were so bad the New York State Attorney General raided James Square in June. But enforcement actions are rare. New York has 600 nursing homes, and 40% of them provide substandard care, according to Medicare ratings.
The worst facilities appear on Medicare’s Special Focus probationary list. Currently there are 82 listed, including one in tony Greenwich, Connecticut with the misleading name Regalcare. Even that list isn’t foolproof. James Square wasn’t on it, despite horrors uncovered there.
Some states keep publicly available tallies of the number of complaints filed against private nursing homes. It’s worth checking. Still, facilities with numerous complaints stay open, filling beds with unsuspecting patients.
Amazingly, state-run facilities are often less accountable. “Secrets are brushed under the rug,” says New York State Assemblyman Anthony Brindisi, who has been trying to uncover facts about Steven Wenger, a 41-year-old man unable to speak, walk, or breathe without a ventilator due to a car accident. Wenger lived at a state-run disabled-care facility in Rome, New York. Earlier this month, the Associated Press reported that maggots had infested Wenger’s throat. Information on abuse and neglect in state institutions is almost never released to the public, the AP says. Officials claim they’re protecting patient privacy.
New Jersey enacted Peggy’s Law this month, imposing fines on employees who witness neglect or assault and fail to call police. It will empower caregivers to do the right thing. Every state should enact a similar law. To spare patients the agony of living with abuse and dying from it.