During the debate over construction of a $750 million county hospital by the Marion Co. Health & Hospital Corporation, I devoted a great deal of time explaining just how it was that HHC said it could build a new hospital without raising taxes. Several years ago, HHC began acquiring nursing homes all over the state of Indiana in partnership with American Senior Communities. Under a loophole in the federal law, nursing homes operated by a county hospital which serves a disproportionate share of indigent patients is permitted to receive reimbursement rates from Medicaid that are 50% higher than other nursing homes providing the exact same services.
The nursing homes acquired by HHC but operated by American Senior Communities, a for-profit corporation, are making moneys hands over fists compared to other nursing homes. WTHR's Sandra Chapman finds that HHC's 59 nursing homes are generating a whopping $545 million in operating revenue a year now. That's up from only $6 million HHC was earning from its nursing home operations in 2007. At the same time, other nursing homes are struggling to make ends meet on the ever-tightening funds made available by the government to provide long-term care for persons who lack insurance or the financial means to pay for care from their own funds. The bad news in this story is that the quality of care at HHC-owned nursing homes fares worse on average than nursing homes that are paid much less by the government to care for their residents.
Chapman learned that 32 of HHC's 59 nursing homes "ranked below average or much below average, meaning they are performing poorly" according to data compiled by the state's Department of Heath. Chapman's report indicates that staffing is a problem at many of the HHC-owned nursing homes. Just recently a wrongful death lawsuit was filed against HHC and ASC after a resident at one of its nursing homes in Fort Wayne died after being assaulted by another patient. According to the lawsuit, the nursing home officials misled the deceased resident's family about the cause of her death. Nursing home officials told them she had a stroke and fell in a dining room when no staff was present. In fact, an assault by another resident left her with a severe head injury that ultimately took her life.
HHC tells Chapman that it takes the quality of care at its nursing homes seriously. "We take that very seriously. These are our nursing homes," HHC's Sheila Guenin told 13 Investigates. "Yes, we provide our facilities with a generous operating budget. That's one of the things I look at with our managing company," Guenin said. "We provide for our facilities to be well staffed," she added. Notice that when a story deals with bad news, HHC's CEO Matt Gutwein is nowhere to be found. He only steps in front of the cameras when he's talking about something that makes the HHC look good. Guenin tells Chapman that HHC is no longer acquiring new nursing homes. "They've got work to do on the ones they already own and that includes monitoring, training and making sure corrective action plans are followed," Chapman said.
I don't know how the federal government can continue to allow this racket to continue in light of the serious financial problems it's facing and its need to control spending on government entitlement programs. It has never made any sense to me that a county hospital should be paid a higher reimbursement rate to run a nursing home than somebody else providing the identical services. The Bush administration agreed and attempted to close the loophole after a GAO report drew attention to how much it was costing the federal government. Not surprisingly, Congress stepped in and gave its blessing to the practice. With the implementation of Obamacare, one has to wonder how much longer this will be allowed to continue. County hospitals like HHC claim they need a higher reimbursement rate because so many of their patients are uninsured. If Obamacare works, there should be considerably fewer uninsured patients coming through the door of the hospital.
WTHR provides a link to a document that shows how each of HHC's nursing homes rank, which you can view by clicking here.
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