NPR: State Regulators Cracking Down on Involuntary SNF Discharges

The Administration for Community Living logged more than 9,000 complaints about involuntary discharges from long-term care facility residents across the country in 2015, and now lawmakers are taking notice.

In particular, officials in Maryland and Illinois have begun investigating discharge rates in their states, according to a recent report from NPR. Maryland Attorney General Brian Frosh took aim at a small chain of skilled nursing facilities, Neiswanger Management Services, which Frosh claims accounts for more than half of all involuntary discharges in the state.

“Your odds of getting evicted from an NMS nursing home are about a hundred times what they are of any other nursing home in the state,” Frosh told NPR.


Frosh and the state of Maryland filed a lawsuit against NMS for Medicaid fraud at the end of last year, alleging that the operator improperly rushed to discharge residents shortly after their Medicare long-term care payments ran out; the Medicaid reimbursements that kick in after 100 days of care are typically much lower. In e-mails reprinted in the state’s complaint, NMS administrators call on employees to clear out Medicaid recipients to make room for higher-paying Medicare-eligible residents.

“IT IS TIME!” one of the emails read, according to Maryland’s lawsuit. “We have been officially full for over two weeks. We have quantity not quality.”

Further to the northwest, Illinois State Sen. Daniel Biss introduced legislation in March that would give the state’s Department of Public Health the power to forcibly readmit residents who had been discharged from skilled nursing facilities — under penalty of a $250-per-day fine.


“We’re seeing nursing homes that have made a financial decision that they would like a certain type of resident,” Biss told NPR, claiming that nursing homes in his state can simply discharge residents who may be less than compliant with staff or require too much attention.

As an example, NPR included the story of Vincent Galvan, a 57-year-old Chicagoan who claims to have been evicted from a nursing home and sent to a hospital psychiatric unit in 2012 “for complaining too much.”

A representative from the Illinois Health Care Association told NPR that Biss’s bill would go too far, claiming that complaints don’t necessarily indicate malfeasance at nursing homes, and that fines would only harm SNFs’ ability to care for residents.

Illinois legislators could vote on Biss’s bill sometime this year; Biss, whose district covers a wide swath of Chicago’s northern suburbs, is also seeking the Democratic nomination for Illinois governor in 2018.

Written by Alex Spanko

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