When Profit Interferes With Patients Health

I am commenting on an article in the New York Times on 9/20/2020 about Nursing Homes who seek to remove low income Medicaid recipients from their facilities. Many of their Medicaid patients have the big "D", Dementia. And, if you know anything about dementia patients, they sometimes get angry.

Apparently, Nursing Homes in California, Texas, Kansas and other states, have evicted Medicaid patients with dementia for a minor outburst to Hospital phycological wards, homeless shelters, or to Behavioral Health Facilities for treatment. When the hospital or other entity tells the Nursing Home there is no treatment required, the Nursing Facility refuses to take back the patient. Why, you may ask?

Because the Nursing Home may be getting $400 a day for caring for the Medicaid dementia patient, and $1,000 or more per day for a Medicare dementia patient. According to the article, Federal law mandates nursing homes follow strict guidelines when evicting patients. They are required to:

1. provide a 30 day notice, and 

2. a plan to transfer the patient to another nursing home that could meet his or her needs.

But, many nursing homes flout these guidelines, because they are never penalized. This is even when the nursing home is told to take back the patient they evicted, they rarely do. The only thing a State Health Care Agency can do, is fine the Nursing Home $50/day for each day of refusal. This is hardly a slap on the hand.

Why should Medicaid patients be treated any differently than private pay, or Medicare patients? Would you label this as another form of discrimination? Even in healthcare, low income patients are often not welcome.

This has got to change! Health care is an equal right that all people are entitled to, regardless of the insurance you possess.