Nursing Home Residents May Find Themselves on the Street After Medicare Payments Stop

December 7th, 2016 by Attorney Roger Weinberg

Some Maryland nursing homes are more concerned about their bottom line than the treatment of their residents. Many residents are discharged before they’re capable of caring for themselves or before they can be placed in an appropriate facility because they simply can’t pay for their care or Medicare payment stops.

The issue is illustrated by the treatment of a 59-year-old cancer survivor from West Virginia, Vonda Wagner, according to the Capitol News Service. Last December she was left outside a homeless shelter in Baltimore (where she has no close friends or family) without any money. Due to throat cancer surgery, Wagner couldn’t speak either.

She had been cared for by the NMS Healthcare nursing facility in Hagerstown, but it discharged her because her temporary Medicare benefits expired and she couldn’t afford to pay for her care herself. NMS sent her to an unlicensed assisted living facility in West Baltimore, Isaac Supportive Living Service LLC. Wagner’s stay there didn’t go well.

  • Its owner, Sharon Isaac, was arrested for second degree assault and theft after an altercation with Wagner, who claims Isaac pushed her to the floor and tried to choke her.
  • Wagner also claims Isaac took her bank card and cellphone. Wagner got a restraining order against Isaac and ended up being dropped off at the Our Daily Bread Employment Center in downtown Baltimore.
  • Isaac denies the charges.

The situation shows a critical problem with nursing home care and Maryland’s unwillingness or inability to enforce rules. Regulatory agencies often find out about abuse and neglect too late.  If a resident is discharged, he or she must go where it’s safe and secure. Many are discharged for financial reasons.

Medicare pays more than Medicaid, but for only a limited time (generally 100 days). If the resident can’t pay out of pocket for care or the facility doesn’t want to settle for lower Medicaid payments, a nursing home could break the rules and send residents to places where they don’t belong, such as an unlicensed and unregulated group home or assisted living facility.

Some of these unlicensed facilities have been cited by the state of Maryland but continue to operate. Due to insufficient funding and resources at the Maryland Office of Health Care Quality (OHCQ), it’s business as usual for many of these “off the radar” facilities.

Nursing home residents need to be given notice that they’re being involuntarily discharged, and they can contest those discharges at the Maryland Office of Administrative Hearings. It reported 1,048 requests for such hearings from 2010 to 2015. There were 163 requests in fiscal 2010 fiscal year and 242 in fiscal year 2015.

Eileen Bennett, the Long-Term Care Ombudsman program director for Montgomery County told Capitol News Service that two nursing homes issue far more discharge notices and they are both managed by NMS (Silver Springs and Springbook). From July to December 2015, Bennett says she received 161 notices of involuntary discharge from NMS Silver Spring and Springbrook and 71 notices from the other 32 nursing homes in the county.

NMS chief operating officer Mark Yost admitted the company is “a little more aggressive than other nursing homes with the discharge statements,” but said that’s because they tend to take less healthy, lower income residents. Yost argued that the involuntary discharges are “to protect our facilities,” because NMS can’t pay its employees and bills if patients aren’t paying. He said the discharges are mostly for financial reasons, though he claims NMS follows applicable regulations concerning discharges.

Despite NMS’s obligation to place Wagner where it’s safe and secure, Yost denied any responsibility for what happened to her after she left his facility. He said in an interview. “(I)t’s not something we could have controlled. We can only control what happens in our facilities.” And, apparently, what may be happening is non-compliance with regulations meant to protect residents.

If you believe that your loved one was improperly discharged from a Maryland nursing home and suffered an injury as a result, we can help you address the situation and hold those responsible accountable for their actions. At the Law Offices of Roger S. Weinberg, you’ll find compassionate support and experienced advocates to help your family through the tough times. Call 410-825-3161 today to schedule a free consultation.

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