The Center for Public Integrity continues its investigative reporting project on the nursing home industry. This installment focuses on government subsidized loans provided to low-rated nursing homes.
Nursing homes providing poor care routinely have received HUD-insured acquisition, construction, refinancing and improvement loans all over the country. In fact, since 2001 hundreds of the nation’s worst-ranked nursing homes have received one, and in many cases two, low-cost, HUD-backed mortgages worth close to $2.5 billion, according to the Center for Public Integrity’s analysis of loan and ratings data.
Even though HUD restructured the office that runs the program in 2008 to streamline the mortgage application process and requires submission of the latest quality reports in evaluating potential construction and rehabilitation loans, the number and volume of one-star facilities that got HUD insurance rose each year from 2009 to 2012. Almost two decades of stinging government reports about the program — from the Government Accountability Office and HUD’s Office of the Inspector General — don’t seem to have made much difference.
This installment of the project includes a map that shows all the one-star (out of a five-star rating system) have benefitted from low-cost government-backed mortgages. That map lists two in Arkansas in Arkadelphia and Camden. UPDATE: Though the map lists these homes as being operated by a Texas-based chain, that chain says it sold the two homes to SLC Operations LLC in 2009.
An earlier installment of the CPI project pointed out gaps between nursing home staffing levels on a public website and staffing as reported for government reimbursement. Arkansas fared poorly in this study. My mention of that drew an objection from a nursing home operator. He said the picture is unfair to Arkansas because of its tough standards on reimbursement for staffing. In short, the public figures on, for example, registered nurses are accurate, he said, but a registered nurse who serves in administrative capacity isn’t counted in staffing reimbursement figures for direct care. He did not, however, offer a defense of some individual cases of poor care cited in lawsuits against another corporate nursing home operator (not his own) in Arkansas.
UPDATE: A lawyer who sues nursing homes takes exception to the view of staffing offered by the nursing home owner. His response on the jump:
Tough standards? BULL
First we have set unreasonably low “minimum staffing standards” it is a ratio of nurses to the number of residents per shift.
The nursing homes have to report this to the state and if they meet the “minimum” for at least 80% of the shifts they are safe.
That’s their goal – the minimum. Nothing more.
The law also says that they legislature can’t make them have more staff without giving them more money.
The federal standard and state standard in the actual regulations are that you must have “sufficient staff to meet the needs of the residents.”
Nursing homes take individuals who need a lot of care directly from the hospital so they they can get reimbursed from Medicare.
Depending on the acuity level of the resident the daily rate for reimbursement can be over $500.
The rate for Medicaid is substantially less around $200.
Do they hire more staff when the have people who need more care.
So when there is a bad outcome – and you say you should have had more staff – they tote out their little chart and proudly say – we met the minimum standard!
And you know what – all the Michael Morton and the Adams brothers contributions are going to do for them?
They will press for a cap on noneconomic damages this session and with all the red and green($$) – they’ll probably get it.
So they will abuse our elderly and there will be little way to hold them accountable because I doubt the new AG who received all that nursing home money will do a thing about it. Maybe do like Dustin did and kick around a few of the poorer homes.