Trump's Attack on Seniors
Those who are closest to it know the truth: Holding nursing homes accountable for their poor care and substandard facilities is a thing of the past. Trump is now making things even worse.
Many American nursing homes are abysmal, and far more than a few are abusive and predatory criminal enterprises.
Federal records show that roughly 40% of all nursing homes have been cited at least once for serious violations since 2013. Those violations are not even ones that are complicated to address, with simple measures to avoid cross-infection within such institutions regularly being ignored. Those include steps such as washing hands, keeping contagious patients apart from others and separating sick nurses, aides and other medical support staff so they cannot infect the patients. Such mistakes are not minor issues. According to an investigation by Kaiser Health News (KHN), infections that happen after patients enter a nursing home – rather than being the reason why the patients arrived at the nursing homes in the first place – create 25% of the medical injuries Medicare beneficiaries experience there. A separate government calculation suggests that such injuries may be contributing to as many as 380,000 deaths a year.
There are also issues regarding neglect and mistreatment of patients, with reports in some nursing homes of patients not even receiving basic care, such as helping them bathe (when needed), emptying bedpans on a regular basis and ensuring proper follow-up care on all issues.
Despite this, both the reporting of health care violations related to these and disciplinary action follow-up after such reports are quickly being scaled back. Under new
rules provided by Centers for Medicare & Medicaid Services (CMS), regulators are strongly being urged to avoid assessing nursing home fines if the violations, however serious, are deemed to be just isolated mistakes. For more serious mistakes that had existed for some time before inspectors found them, instead of following the past practice of assessing backdated daily fines to when they were recorded, inspectors are being asked to just assign one-time fines for an entire string of problems.
This is all happening in an environment where antibiotic-resistant germs like MRSA, the well-known acronym for methicillin-resistant Staphylococcus aureus, have spread rapidly within such facilities. CMS, however, says that even in these situations, fines for infection control are not important.
Excuses abound for why these problems exist. It is very clear that understaffed support within nursing homes, something that should be a citable offense in itself, plus low wages, poor training and overworked staff all contribute. Without proper supervision and after long hours, nursing home staff can make the health conditions for their patients even worse in a surprisingly short amount of time. And this can also turn into a very dark and serious situation if nothing is done about the poor care immediately after it has been flagged.
As one example, KHN had investigated the specific situation with Georgina Morris, who was a patient at the Astoria Nursing & Rehabilitation Center in Sylmar, Calif., in October 2015. While she was there, it appears she contracted an infection from a highly dangerous strain of Clostridium difficile, also known as C. diff. She developed severe dehydration and was eventually sent to a hospital, where she stayed for 10 days. The only problem was that she was sent there not at the urging of the center but instead at the request of James Morris, her son, who had watched in horror how she was being treated.
What he had observed at the center, by his own accounts, was that “workers were coming in and out without washing their hands.” He asked for help to investigate the facility.
Eighteen months later, state inspectors finally checked the center. It was discovered that Astoria employees had not been properly cleaning their hands while treating Georgina Morris. Unfortunately, because that had been going on for such a long period of time, according to KHN, “they could not definitely determine whether Ms. Morris contracted the infection there or before she arrived.”
That nursing home was eventually cited, for the second year in a row, for substandard inspection control with the potential to harm residents. No fine was assessed, though, so the pain for the institution went away rapidly – even if not so for Ms. Morris, who continued to suffer afterwards for some time.
Even after all that, along with the 6,500 nursing homes being cited annually for nursing home violations and the many patients who became sicker and incurred higher Medicare expenses in many cases as a result, the industry has pushed back against a call for further reform, monitoring, citations and penalties against them. In December 2016, Mark Parkinson, President of the American Health Care Association, wrote President-elect Donald Trump pleading for help, saying that “it is critical we have relief.” The relief he was seeking was to have Medicare’s health insurance program penalty protocols changed and eased.
For the evil and stupid Trump administration, which when asked to choose between the common good and the enrichment of big business favors the latter, the choice was clear. Those regulations were eased, and since then, fines – as well as reporting requirements – have been cut back substantially for nursing home owners who have not taken proper care to keep their patients safe and on the road to health.
The health care providers, on the other hand, are looking forward to a far more profitable future without the modest costs of providing safe and healthy conditions for their clients.