If a nursing home doesn’t have enough nurses and aides to provide basic care, such as bathing and turning to prevent pressure ulcers, then residents suffer. It’s a simple truth. This isn’t a new concept. But one state has found a novel way to hold a large nursing home chain responsible. The state has taken action on elder abuse by suing the chain for fraud. Specifically, the state intends prove the facility accepted money for care it didn’t provide.
New Mexico’s attorney general, Hector Balderas, has used a tool from industrial engineering to prove that nursing homes couldn’t be providing the care for which they’re charging the government. His team utilized time and motion studies to show how long it takes to perform individual basic care activities. They timed staff bathing, feeding, and repositioning a resident. They then compared these times to the actual care required by residents of several nursing homes owned by the same corporation. The numbers didn’t add up. It was physically impossible for the staff to have given the care the nursing home billed.
Attorney General Balderas has sued the nursing home corporation. He claims fraud on the grounds that it lied when it billed for care it couldn’t have provided. Balderas told NPR, “These are companies that profited and made hundreds and hundreds of millions of dollars in revenue,” and the state paid for the majority of this care via Medicaid.
This groundbreaking action on elder abuse has the nursing home industry taking notice. The trial lawyers defending the nursing home claim it complied with federal regulations. Those regulations require only 2.5 hours of nursing care per patient per day. But the state has responded that those regulations are just a minimum, and the argument may not be enough to overcome the allegations that the nursing home billed for care it did not provide. This is a case to watch!