NURSING HOME INDUSTRY: Series Traces Failures, Successes

      Investigative reporter Thomas Cole uncovers the far-reaching effects of Medicare reform among nursing homes in an ongoing series that began in Sunday's Albuquerque Journal. Cole traces nursing homes' struggle since Medicare slashed payments in 1997, noting, "Nursing-home chains, along with companies that sell medical services and supplies to nursing-home residents, have laid off thousands of workers and reported losses in the hundreds of millions of dollars." In an accompanying article, Cole reports that "one-fourth of the nation's 17,200 nursing homes are found by inspectors to have deficiencies that caused actual harm to residents or placed them at immediate risk of death or serious injury." Another article examines the numerous incidences of overbilling discovered by the General Accounting Office, including $1,503 wheelchair cushions and $45 gauze bandages.
      On Monday, Cole presented the other side of the story, revealing nursing home industry representatives' difficulties in staying afloat amid shrinking reimbursements. In an accompanying article, Cole reports on health advocates' plea for income raises for home health aides, noting "a direct link between the quality of care in homes and the level and quality of CNAs and other staff."
      On Tuesday, Cole explored why some nursing homes continue to operate in the black, while others accrue enormous losses. In particular, he looks at the performance of Sun Healthcare Group, a $3 billion-company, noting that state inspectors "found nearly 39% of 321 nursing homes operated by Sun ... caused actual harm to residents or placed them in immediate jeopardy of serious injury or death."
      Yesterday Cole profiled Haley Barbour, former Republican National Committee Chair, who proved pivotal in drafting the cuts legislated by the Balanced Budget Act of 1997. In what some characterize as an ironic switch, Barbour today is a nursing home lobbyist, claiming the cuts he helped orchestrate were too deep. Another article rehashes HCFA's warning to states that in the wake of the nursing home disturbances, they need to be fiscally ready to deal with the consequences. In a letter to state health departments, HCFA officials wrote, "[W]e are ... concerned that the quality of care residents receive in chain facilities citing financial pressures be protected." The letter further suggested that states prepare to use "receivership laws to take over operation of homes if necessary" and asked them to have backup plans for relocating residents. A concluding piece in yesterday's sub-series notes that a Congressional Budget Office analysis concluded this spring that savings from the cuts may have been more substantial than planned, lending some hope that nursing home reimbursement levels may be -- at least partially -- restored to higher levels (Cole, 8/1-8/4).