Recently my friend and author Teri Case wrote about her family’s nursing home experience. Her mom, Bonnie, was discharged to a nursing home for rehabilitation after being hospitalized for pneumonia. This isn’t unusual. Nursing homes are often used for short-term rehab. On the one hand, this is a good thing. Hospitals are not healing places and a rehab facility can be a good place to recover until it’s safe to go home.
On the other hand, according to 2015 data from the Centers for Medicare and Medicaid Services (CMS), 70% of nursing homes are private, for-profits. They make money when their beds are full and once someone’s in a bed it’s to the facility’s advantage to keep them there. Teri’s family saw their mother declining with very little rehabilitation happening. At the same time, they received lots of pressure to move her in permanently rather than returning her to the assisted living facility she called home. Teri writes with humor and eloquence about how they busted their mom out and got her home where she has recovered nicely. It’s a story with a happy ending because Bonnie reached out to her family and they listened, asked the facility questions, and acted when they didn’t get the answers they wanted.
A faulty system
This is not to say that private, for-profit rehab facilities are inherently bad or even that in Bonnie’s case the staff at the facility didn’t truly believe they were acting in her best interest. In general, health care professionals enter the field because they care about people and want to help them. But they’re working in a faulty system. When health care and profits become so tightly entwined, profit more often than not wins out over quality patient care.
This makes it all the more disturbing that the Trump administration is working to relax regulations on nursing homes and make it harder for residents to sue for substandard care, abuse or neglect. The administration argues that dealing with health inspections and meeting regulatory requirements is taking staff away from spending time with patients. They ignore the fact that facilities are routinely understaffed and staff are grossly underpaid and inadequately trained because that would cost money and reduce the overall profit. They also ignore the fact that mistakes and neglect in patient care can lead to injury and death. Oversight and regulation help minimize these problems.
Once again the Trump administration is working for corporations at the cost of the people who pay for their services. Next time you write or call your representatives, consider raising concerns about this issue. And next time you or a loved one need nursing home, or any health care, make sure you ask lots of questions and don’t assume they always know what’s best.
Also (sidenote), if you’re looking for a moving and engaging read, check out Teri’s new book, Tiger Drive.