California Nursing Home Abuse Lawyer Blog

The New York Times is out with an article about lack of oversight given to the more than 400 long-term acute care hospitals that operate in the United States. These hospitals, most of which operate as for-profit organizations, are supposed to provide care for individuals that are too sick for traditional nursing homes, but too stable to require regular hospitalization. According to the article, long-term care hospitals were much more likely to be cited for serious violations of Medicare rules than regular hospitals, and had a higher incidence of bedsores and infections.

While the care might be questionable, the no one will question the profitability of these health care providers. In 2007, the profit-margins on long-term care hospitals was 6 percent on Medicare patients, which regular acute-care hospitals lost an average of 6 percent on Medicare patients. How does that happen? In a presentation last month by Select Medical, an owner of several long-term care hospitals, to its investors, it revealed that it maintains its profits by monitoring staffing and lowering supply costs.

Those of us who represent victims of neglect in long-term care facilities know that "monitoring staffing" is another way of saying that it keeps staffing levels at the lowest numbers allowable by law. That usually means a lower quality of care. As for Select Medical, this approach is victimizing patients.

Medicare inspection reports, however, describe preventable patient injuries and deaths, and they portray Select’s hospitals as understaffed and with high turnover. In the last three years, inspectors have found 22 violations of care standards at 12 Select hospitals so serious that, if uncorrected, could lead Medicare to ban those hospitals from admitting Medicare patients.

The 22 violations represent only an estimated 2 percent of the serious violations Medicare found nationally, but similar stories can be told all over the country. Right here in Southern California, Riverside County's Vista Hospital of Riverside has come under tremendous scrutiny by Medicare, and is under threat of being closed down. This law firm filed a lawsuit against last year for allegations of malpractice and neglect for the death of one of its patients.

The New York Times story - which can be found by clicking here - describes many instances of abuse and neglect it suggests is due to a failure to adequately regulate these hospitals; hospitals that frequently care for the sickest and most fragile patients.

The abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults who have been abused or neglected in the nursing home, long-term care, and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

As America's elderly population continues to explode (it will double by 2030), an important question that has received little attention in the national healthcare debate is how the U.S. will be able to deal with 78 million aging baby boomers. Those of us who practice elder abuse and neglect law regularly see the costs associated with long term care, and let me tell you, it ain't cheap.

For many nursing home residents the story goes like this: there is an event that causes them to be hospitalized, whether it's an injury such as a fractured hip, or an illness. It is determined that after the hospitalization, nursing home rehabilitation is in order. The hospitalization and the first 100 days of nursing home care will generally be covered by Medicare. When the 100 days is up, and the person is determined to be too frail to return home, the financial obligation falls upon the resident, or his or her family. At $5,000 - $10,000 per month, this can quickly be financially devastating. If there is no money, or the resident's spends it all in the first months of care, they are typically qualified for Medi-Cal, and the taxpayers foot the rest of the bill, even if the patient spends the next five years in the nursing home.

This article at NewAmericanMedia.org addresses this very question.

Unlike any other economically advanced country, continuing-care coverage available to older Americans and people with disabilities is available mainly through Medicaid, a poverty program forcing people to "spend down" until they are poor enough to qualify. Private long-term care insurance is generally unreliable and covers only 6 percent of older Americans.

That's true. We rarely see clients with long term care insurance. As stated, the vast majority are Medi-Cal recipients, many of whom ended up there after spending down all their assets for prior care.

The high costs of long term care is an important issued that has been lost in the national debate over the capacity of the U.S. economy to handle the cost of comprehensive health care reform. Even though conservatives and the cable media have instilled fear in the American public that modest reforms would break the Treasury if they hit a staggering $1 trillion over 10 years — that amount would represent merely three percent of the $30 trillion projected over the coming decade in U.S. health care spending.

To read the entire article Health Care Reform's Missing Piece: Elder Care click here.

The elder abuse and neglect lawyers at the Walton Law Firm represent seniors and dependent adults who have been abused or neglected in the nursing home and assisted living setting. Call (866) 607-1325 for a free and confidential consultation.

Most plaintiff attorneys who represent elderly injury victims have a nightmare story in dealing with the Medicare Secondary Payer Act. The Act requires any Medicare beneficiary who is injured by a third-party, and then collects money from that third-party, to reimburse Medicare for the money it paid to treat the injured party. Understandable, right? But for most of the injury victims (and their attorneys) the error-prone and painfully slow service provided by the Medicare contractor can cause even the most calm and unexcitable person to pull their hair out.

Mother Jones is out with an article that thoroughly explains this frustrating process (Medicare's Repo Man). The article explains how, in 2006, the various Medicare collection agencies were consolidated into one massive agency, then, under a law that permitted granting no-bid contracts to Native American corporations, awarded the collection contract to the Chickasaw Nation Industries. In the effort to step up collection efforts, however, the confusion and inefficiencies have just gotten worse.

Part of the problem is that for many years, Medicare had no systematic way of learning when someone got a settlement or judgment, making its collection efforts hit or miss. For a while, the agency tried to lean on plaintiff lawyers, threatening to sue them if they turned over settlement or insurance money to their clients before paying any Medicare liens. In many cases, though, courts sided with the lawyers who argued that Medicare was exceeding its authority. The issue was headed to the Supreme Court, but in 2003, Congress passed the Medicare drug benefit and included a small provision that officially put the onus on lawyers to make sure Medicare got its money.

The problem with the elderly, though, is that Medicare is frequently paying for medical care that is not related to an underlying accident. For example, if a 72-year-old is in an car accident that results in $10,000 in medical bills, but in the following two years, as the accident claim is being pursued, the person incurs another $10,000 in medical bills unrelated to the accident (not uncommon for someone 72), Medicare can't tell what's caused by the accident, and what's not, and will attempt to collect the entire sum from the personal injury recovery.

While the confusion might be understandable, getting Medicare (through the Chicksaw Nation) can be a ridiculously slow and arduous process. Worse yet, if Medicare thinks you haven't sufficiently paid, the debt-collection efforts against the elderly beneficiaries can be gut-wrenching, as discussed in the article.

Click here to read the entire Mother Jones' article.

The San Diego personal injury lawyers at the Walton Law Firm represent individuals and families who have been injured in all types of accidents and malpractice matters. Call (760) 607-1325 for a free consultation.