Group Files Lawsuit Over Alleged Nursing Home Resident Dumping
On Monday, California Advocates for Nursing Home Reform filed a lawsuit against the state Department of Health and Human Services over alleged Medi-Cal patient dumping practices by nursing homes, Consumerist reports.
Medi-Cal is California's Medicaid program.
According to CANHR, federal laws require states to develop readmission hearing processes for nursing home residents who are temporarily hospitalized. Under such laws, states are required to "promptly ... provide for admission or readmission of an individual to a facility" if the hearing goes in the patient's favor.
The plaintiffs in the case each have won hearings earlier this year, but none have been readmitted, according to Consumerist. One plaintiff has been waiting since May, according to the complaint.
The California Department of Health Care Services' Office of Administrative Hearings and Appeals has said it does not have the authority to enforce its own readmission orders. However CANHR argues that the state does have the authority, adding that a nursing home's failure to comply with such an order violates the Medi-Cal Provider Agreement for Institutional Providers.
In October, CANHR met with HHS Secretary Diana Dooley, who said the state was "doing something" to remedy the problem, according to the complaint. The response included possible enforcement actions, but CANHR said none would require DHCS to enforce readmission or help the plaintiffs.
Details of Lawsuit
CANHR filed the lawsuit in a federal court in San Francisco on behalf of three nursing home residents covered by Medi-Cal. The suit names Dooley as a defendant.
The lawsuit alleges that that the agency has been complicit in nursing homes' failure to readmit the plaintiffs after they had been hospitalized. CANHR alleges that the unenforced orders were financially motivated.
CANHR argues, "Facilities do this to increase revenues and make space for more lucrative Medicare and private-pay residents."
The lawsuit seeks:
- An injunction against the state's lack of readmission order enforcement; and
- Unspecified damages and legal costs (Morran, Consumerist, 11/9).