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Yet more damning evidence has just emerged of the dangers, neglect and abuse facing our most vulnerable citizens in nursing homes across the country.
Meanwhile, a new report in the Journal of American Medical Association says that even as private-equity firms buy up more nursing homes, the quality of care in those homes tends to go down—and the emergency room costs associated with residents goes up.
Let’s start with the extraordinary ruling out of California. A state Superior Court has just ruled that the Department of Public Health, which is supposed to be protecting nursing home residents and investigating all allegations of abuse and neglect in a timely manner, is doing no such thing. The court found that the department is sitting on a backlog of over 5,000 complaints, including many dating back to 2018. The department tried to blame the pandemic, but according to the state auditor, in the year before the pandemic, from January 2019 to March 2020, “the average age of pending investigations nearly doubled.”
As of three months ago, the auditor added, the department still hadn’t implemented recommendations it made back in 2014.
Under California law, there is a clear legal time frame for investigating nursing home complaints. The department must launch an investigation within 10 days of receiving a complaint. It must complete the investigation within an outside limit of 120 days, and generally within 60. Yet for the fiscal year 2018-9 the department still had 5,286 investigations incomplete, and 2,351 had been open for more than a year, the court found. For the fiscal year 2019-20 there were 5,663 investigations still open, including 2,351 open for more than a year.
“The record demonstrates the respondent’s endemic inability to meet the statutory deadlines,” rules Judge Ethan Schulman of the superior court. These “are not isolated incidents, and respondent’s inability to meet the statutory deadlines is institutional and longstanding.”
The ruling came as a result of a long-running legal campaign by the nonprofit Foundation Aiding the Elderly, which helps nursing home residents and their families in cases of abuse and neglect.
Judge Schulman has ordered the department to produce a written plan to start complying with the law.
The Department of Public Health, in an email, said it “does not comment on pending litigation.”
California will not be the only state where this scandal is taking place.
As for the new JAMA report: private-equity funds now own about 5% of all nursing homes, and the number is rising. An analysis of homes owned by private equity found that just in the second quarter of this year residents were 11% more likely to end up in hospital emergency rooms for preventable conditions (known as “ambulatory-care sensitive” conditions), and 9% more likely to end up staying in hospital for such conditions.
Private-equity funds are known for a single-minded focus on improving stockholder returns by slashing costs as well as maximizing revenues. Fund managers receive gigantic (and tax-sheltered) bonuses for squeezing the most profit out of their investments. And companies owned by private equity, as they are not listed on the stock market, are largely shielded from public scrutiny.
Ironically some of the biggest investors in private equity are the same public sector pension funds and university endowment funds that like to brag about their “environmental, social and governance” or ESG records. They won’t own oil stocks, but appear to have no problem profiting from the abuse of the elderly.
It shouldn’t need saying but this isn’t a technicality. Nursing home residents are the most vulnerable people in America: They are even more vulnerable to abuse than children, because they will never grow up to demand justice against their abusers. The catastrophic number of nursing home deaths of the past 20 months raises questions about how effectively they are being protected or prioritized.
While there has been a lot of public hand-wringing about nursing home Covid deaths, how sincere is it? New York Gov. Andrew Cuomo eventually resigned for sexually harassing several people, but not for covering up thousands of nursing home deaths (or for ordering sick Covid patients back into the homes). Indeed he landed his $5 million book deal after presiding over thousands of nursing home deaths.
FATE has been battling for years to get this legal ruling in California, and the nonprofit’s head, Carole Herman, says she fields calls daily from distressed relatives across the country.
Nothing to see here, folks. Move along. Lucky growing old will only happen to other people, isn’t it?
