Coronavirus has ravaged America’s nursing homes, leaving thousands of residents seriously ill and leading to thousands of deaths. But this crisis could prove to be a windfall for nursing homes, according to a May 3, 2020 article published by the Los Angeles Times.
A new Medicaid reimbursement structure that went into effect in the fall of 2019 pays nursing home providers significantly more if they accept patients who have just been released from the hospital. Newly-released residents can bring in more than $800 per day in Medicaid reimbursement. In contrast, a long-term resident with dementia can bring in as little as $200 per day.
This difference in potential compensation could lead some nursing home operators to displace non-COVID residents in favor of residents with COVID, putting the lives of current residents and staff at risk. Some hospitals have not been checking to see if patients are still infectious before releasing them. This oversight has potentially put residents and staff at risk. On April 22, 2020, a lawsuit was filed against Alaris Health at Hamilton Park in Jersey, City, New Jersey. A former nurse alleges that a certified nursing assistant (CNA) was exposed to the coronavirus after a patient was readmitted to the nursing home from a hospital. The CNA treated a coronavirus patient without proper PPE and later died.
In order to contain the spread of coronavirus, certain facilities are being designated specifically for coronavirus patients. What happens when a nursing home is designated as a COVID-only facility? County Villa South, a California nursing home, was recently designated as a “COVID-19-only facility.” Family members of COVID-negative residents, however, were left in the dark as to this decision. One family member had no idea the facility was preparing to become a COVID-specific institution until a nurse informed her that she “might want to get her loved one out of there,” according to the Los Angeles Times. County Villa South has long struggled with infection control procedures under normal circumstances, receiving a one-star rating from the Centers for Medicaid and Medicare Services (CMS). This caused the above family member to be suspicious about why the facility would want to become a COVID-only facility. Connecticut and Massachusetts have also designated certain facilities as COVID-only.
There has been much discussion about nursing homes being forced to take COVID-19 patients. An April 24, 2020 article from the New York Times reported that New York state law dictates that nursing homes cannot refuse to accept a resident simply because they have been diagnosed with the coronavirus. The new CMS reimbursement scheme, however, sheds light on why nursing homes might actually be incentivized to accept coronavirus patients recently discharged from the hospital.
It is unfortunate that some nursing homes could potentially be using the coronavirus crisis to line their own pockets, putting residents at risk in the process. If you have concerns about a loved one in a nursing home, don’t hesitate to call a nursing home attorney. Call (877) 238-4175 or email firstname.lastname@example.org for your free case consultation.