Elderly care divides interests

By KENT S. COLLINS

Nursing homes across the United States are fighting ferociously with Washington, D.C., for more government dollars and respect. They claim they don't get enough money to care for the elderly or enough respect for their service to our country. Congress, on the other hand, continues to fight overspending and Medicare fraud at these facilities.

If you know someone in a nursing home or think you might be in one someday yourself, you had better watch the fight.

Several weeks ago, Vencor, Inc. --- operator of 349 nursing homes and long-term care hospitals in 46 states --- filed for bankruptcy. News reports at the time noted the company had been accused of Medicare fraud and was deep in debt. Other nursing home operators, however, were more concerned with the bigger picture: cuts in various government payments that put nursing home facilities in a budget crunch.

Vencor CEO Edward Kuntz blamed the bankruptcy on "changes impacting the long-term care industry, most notably decreased Medicare reimbursement."

Linda Keegan, of the American Health Care Association, a trade and lobbying group, explained: "It becomes clearer every day that the deep Medicare cuts from the 1997 budget deal are devastating critical health providers, while at the same time providing severe patient access problems for certain types of care.

"Our nation's Medicare beneficiaries deserve the skilled nursing care they are entitled to," Keegan said.

"Right now, some of us are getting by with dramatically reduced resources," Blaine Hendrickson, an independent nursing home operator, said at recent congressional hearings. "Small providers like me, who fly below your radar, are finding it very difficult to survive. We are struggling with a government asking us to do much more with much less --- demanding higher levels of quality in the face of drastic cuts. It simply doesn't make sense. It's hurting America's elderly. And America's seniors deserve better."

Of course, some federal investigators and state agencies complain that some nursing home operators have been getting too much for too little. They note Medicare fraud and overpayment cases. They complain services are cut to save costs and maximize profits for private operators. And they are pushed to react suspiciously toward nursing home operators when the loved ones of nursing home residents complain.

These patients --- even in the best of facilities --- can have difficult health problems and special needs. Families see their condition and panic and then fuss at regulators to do something.

And when some nursing home operators try to --- or actually do --- evict government-financed residents in favor of private-paying patients, all involved scream and point.

The nursing home industry has asked Congress to provide more funding to care for the elderly. Congress balks because of the raw cost and because of the complaints of regulators and inspectors. Families want more services, and they want their loved ones to be as comfortable as possible, while taxpayers wonder where and when the costs will be contained.

Los Angeles Times Syndicate

Copyright 1999
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