The great nursing home swindle

It’s the biggest scandal — and the biggest swindle — you’ve never heard of: Dementia patients are being shipped back and forth between nursing homes and hospitals in a calculated attempt to raise their cash value.

And boy does it ever work.

State Medicaid programs usually pay an average of $175 a day for the long-term care of dementia patients.

Usually.

But when those patients are sent to a hospital and then returned to the nursing home, Medicare steps in and pays triple the fees — because the agency believes these patients now need skilled care to help with the recovery.

Ka-ching!

As you can imagine, nursing homes have caught onto this little game in a big way: A new study finds that a fifth of all advanced dementia patients are sent off for dubious hospitalizations in the final months of their lives.

The study labels these transfers as “dubious” because the end was clearly near for these late-stage patients and hospitalization wouldn’t have made a difference — and obviously didn’t, since the patients died anyway.

Instead, they’re shipped around and put through sheer torture, often suffering bedsores and needing feeding tubes. Many of them can’t handle the stress and the movement — making their conditions worse, not better.

What’s more, many of those hospital stays were for conditions nursing homes can and should handle on their own: pneumonia, urinary and other infections, swallowing problems and dehydration, for example.

“These are people who are unable to recognize their relatives, they’re bed-bound and they’re now usually having problems with swallowing. This is a population where the burdens of hospitalization often outweigh the possible benefits,” study co-author Joan Teno, a palliative care physician and health policy professor at Brown University, told the Associated Press.

“These patients actually do better when they stay in a nursing home,” she said.

And that’s exactly right, because the research on dementia care shows clearly that patients in all stages of the disease respond better to familiar surroundings, comfort and kindness than they do to the dangerous — not the mention zombifying — off-label meds they’re so often given.

The sad truth is that no one’s ever gotten rich by selling compassion — but it looks like there’s plenty of money to be made in swapping dementia patients.

Ed Martin
Editor, House Calls

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