Subpar nursing homes reap billions of taxpayer dollars

SAN FRANCISCO — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The U.S. Department of Health and Human Services’ inspector general said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care standards laid out by the federal agency that administers Medicare, investigators estimated in a report released Thursday.

The elderly and other patients who need daily help from a nurse or therapist typically are sent to skilled nursing facilities, which can get reimbursed by the government for much of the care they provide.

By law, they need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people’s health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the na- tion’s sweeping health care overhaul.

“These findings raise concerns about what Medicare is paying for,” the report said.

The review also drew sharp criticism Thursday from the head of the Senate Special Committee on Aging.

“Spending t axpayers’ money on facilities that provide poor care is unacceptable,” said the committee’s chairman, Sen. Bill Nelson, D-Fla. “The government must do a better job of ensuring Medicare beneficiaries receive the highest quality of care.”

Investigators estimate that in one out of five stays, patients’ health problems weren’t addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient’s use of two antipsychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn’t need, which the report said was in the nursing homes’ financial interest because they would be reimbursed at a higher rate by Medicare.