Crusading to protect the elderly

In late March, the U.S. Department of Justice (DOJ) announced the launch of 10 regional Elder Justice Task Forces to coordinate efforts by local, state and federal law enforcement agencies and organizations that serve the elderly to “pursue nursing homes that provide grossly substandard care to their residents.”

Long-Term Living’s coverage of the news, “DOJ: Substandard nursing home care will not be tolerated,” reported the details of the task forces and quoted acting associate attorney general Stuart F. Delery as saying, “All too often we have found nursing home owners or operators who put their own economic gain before the needs of their residents.” The task forces “will help ensure that we are working closely with all relevant parties to protect the elderly,” Delery added.

Keesha Mitchell, president of the National Association of Medicaid Fraud Control Units and director of the Ohio Medicaid Fraud Control Unit, said in the DOJ announcement, “By actively participating in the Elder Justice Task Forces…we will strengthen our efforts nationally to protect the most vulnerable of our population who reside in our nursing homes and other care facilities.”

All of that pretty much ticked off Mark Parkinson, president and CEO of the American Health Care Association (AHCA), who called the initiative a “smokescreen aimed at finding cost cutting measures that would threaten life-improving post-acute and long term care services for millions of seniors.”

Parkinson has plenty of reasons to make that assertion, considering the constant efforts by lawmakers and regulators to cut costs in the nation’s healthcare system, all while posturing about the need to protect the elderly, frail and vulnerable patients who rely on elder care services.

Payment flaws

“Creating task forces under the guise of fraud and abuse is actually pointing a finger at a flawed Medicare payment system,” said Parkinson. “We support comprehensive payment reforms, which would revolutionize the system to further enhance services while producing cost savings for the government.”

Ironically, on the very day of the DOJ announcement, the Centers for Medicare & Medicaid Services (CMS) issued data showing that nursing home deficiencies have declined. That, Parkinson said, demonstrated “that quality is on the rise.”

That report, the Nursing Home Data Compendium 2015 Edition, shows a steady decline in the mean number of health deficiencies cited in U.S. nursing home surveys from 2005 to 2014 with a high of 7.2 percent in 2006 and 2007 to 5.7 percent in 2014, the most recent data available. The report also shows a steady decline in the number of nursing home surveys with deficiencies for actual harm/immediate jeopardy and substandard quality of care. The number of those reports with zero health deficiencies increased.

“America’s skilled nursing care centers are united and focused on improving the quality of care we provide,” Parkinson said. “Efforts like our Quality Initiative push our profession forward and culminate in a culture of excellence. The results speak for themselves.”

Unfortunately, the DOJ task force announcement and the hyperbole used by officials to promote the initiative seem to suggest the industry is rife with bad actors and facility operators who prey upon the vulnerable elderly and their families. It fails to recognize the industry’s aggressive initiatives to improve—and those care goals have been, and continue to be, achieved.

Scoring points

It would not be surprising to see politicians attempt to use the industry as a whipping boy to score points with the DOJ announcement as a way to generate press. Establishment of 10 regional task forces in California, Georgia, Kansas, Kentucky, Iowa, Maryland, Ohio, Pennsylvania, Tennessee and Washington state certainly opens up that opportunity for politicians in those regions.

In fact, the day of the announcement, Sen. Chuck Grassley, R-Iowa, chairman of the Senate Judiciary Committee, announced creation of the task force in his state, indirectly taking credit for the DOJ’s new initiative.

Of course there are plenty of lawyers ready to pounce as well. Pintas & Mullins Law Firm, based in Chicago and self-described as “nursing home abuse attorneys,” issued a press release April 1 about the new task forces and ended with this statement:

“We believe everyone should be treated with dignity and respect, especially seniors. That is why we staunchly advocate for their rights. If your loved one was abused in a nursing home, our lawyers can help! We serve clients nationwide. Call today for a free consultation!”

It’s no wonder that Parkinson and his team at AHCA are not pleased with the DOJ’s announcement. But it really shouldn’t be surprising, given that the industry’s overall image can be almost irreparably damaged whenever a single facility is found to be abusing patients or providing such substandard care.

In my February column, I questioned whether CMS was considering sufficiently the results of AHCA’s national effort to improve nursing home quality, including reducing hospital readmissions. It seems like the federal agencies and Congress often develop their initiatives based on bad publicity and the resulting negative image rather than focusing on the facts and on actual improvements that are being made by a competent and well-intentioned industry.

The creation of these new DOJ task forces could well fall into that category.

Robert Gatty has more than 40 years of experience in journalism, politics and business communications and is the founder and president of G-Net Strategic Communications based in Sykesville, Md. He can be reached at bob@gattyedits.com.

Robert Gatty

Robert Gatty has more than 40 years of experience in journalism, politics and business communications and is the founder and president of G-Net Strategic Communications based in Myrtle Beach, South Carolina. He can be reached at bob@gattyedits.com.