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Mom and Dad Are At Risk: Ohio Nursing Home Inspectors Are Seriously Understaffed

Mark Napier

The Cleveland Plain Dealer reported on April 23, 2017 that Ohio’s nursing home inspectors are seriously understaffed. The U.S. Centers of Medicare and Medicaid Services (“CMMS”) regulates and monitors nursing homes in part by inspections. The purpose of these inspections is to assure that nursing homes are following the federal regulations that promote a safe environment for the nursing home residents.

In most states, CMMS hires the state’s health department to inspect that state’s nursing homes on behalf of CMMS. Likewise in Ohio, CMMS contracts with the Ohio Department of Health to conduct mandatory annual and complaint inspections, also known as surveys. The ODH hires and trains nursing home inspectors to conduct these inspections. But, since 2011, ODH has failed to meet the federal deadline for conducting annual inspections. The reason is serious understaffing of nursing home inspectors.

In Ohio, there are currently 153 nursing home inspectors who examine Ohio’s 960 nursing homes and over 600 assisted-living facilities. But, many more are needed. The newspaper reported that Ohio’s neighboring states Michigan, Kentucky, and Illinois have one inspector for every four nursing homes. Using the numbers above, Ohio has one inspector for every ten nursing home and assisted living facilities.

The recruitment and retention of qualified, experienced nursing home inspectors is difficult because of the low pay. These inspectors are nurses, dieticians, environmental health professionals, and social workers. The state’s median entry level salary is $31,014. But, a registered nurse in Northeast Ohio can make $20,000 more in an entry-level position, according to interviews and statistics from Lorain Community College.

For more details, and to read this excellent report.


Another Nursing Home Chain is Sued for Overcharging Medicare

Mark Napier

The U.S. Department of Justice announced on April 21, 2015 that it has intervened in three False Claim Act lawsuits and filed a consolidated Complaint against HCR Manorcare. The Complaint alleges that HCR Manorcare knowingly and routinely submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically necessary.

HCR Manorcare is based in Toledo, Ohio. It is one of the nation’s largest providers of short term post-acute and long term care. It operates approximately 281 skilled nursing facilities in 30 states, including seven facilities in the Greater Cincinnati area.

The DOJ’s Complaint was filed in the U.S. District Court for the Eastern District of Virginia. The Complaint alleges that HCR Manorcare pressured its skilled nursing facilities’ administrators and rehabilitation therapists to meet unrealistic financial goals. This resulted in billing for unnecessary services to residents.

According to the DOJ, HCR Manorcare set prospective billing goals designed to significantly increase revenues without regard to patients’ actual clinical needs. And, it threatened to terminate its skilled nursing facility managers and therapists if they did not administer the additional treatments necessary to qualify for the highest Medicare payments. In addition, HCR Manorcare also allegedly kept patients in its facilities longer than medically necessary so they could increase its receipt of Medicare payments.

HCR Manorcare in response has argued that the DOJ made the decision to intervene in the civil lawsuit despite its full cooperation with the government’s investigation. HCR Manorcare has stated the lawsuit is unjust and it will vigorously defend the company in court.

Follow this link for more information.



KY Residents Call Your State Rep Today to Oppose SB9

Mark Napier

On Feb. 5, the nursing home industryintroduced SB 9 in the KY Senate. The bill calls for the creation of a medical review panel system to screen proposed malpractice complaints against long-term care facilities such as nursing homes. SB 9 passed the Senate on Feb. 13 with Republicans voting for it and Democrats against it. The bill now moves to the KY House.
Instead of focusing on improving the quality of care for seniors or persons in need of long-term care, the industry is again seeking to avoid accountability. Overall, Kentucky nursing homes need much improvement. Kentucky ranks the worst in the nation in average number of deficiencies per nursing home according to the publication Nursing Home Inspect. And, according to the federal Centers for Medicare and Medicaid Services’ Nursing Home Compare Database, 2012, forty per cent of Kentucky nursing homes rank overall “below average” or “much below average.”

The Louisville Courier-Journal issued an editorial against SB9 (click here).   So did The Lexington Herald (click here).

If you are a Kentucky resident, please call your state representative today at 1-800-372-7181 and urge him or her to vote NO against any bill that reduces accountability for KY nursing homes. To find out who are your legislators, click here.