With great interest and no small degree of consternation I listened intently to President Obama’s brief comments during his recent address on the so-called medical malpractice crisis and the national debate which has ensued.  A bill has emerged from the Senate, though much can happen in the coming months.

At present, we have very little detail as to what the administration or congress plans to do to address this very small component of  a healthcare policy overhaul.  In the end, there are at least a few issues we can all agree upon.  In a perfect world, all United States citizens would have access to quality medical care at a fair price, provided by quality healthcare professionals.  The challenge, of course, is paying for it.

As an attorney for twenty years and an elder advocate devoting my entire practice to the welfare, protection and safety of nursing home residents, I noted that conspicuously absent from the public debate is the conduct of a small yet prominent assemblage of large nursing home corporations who have cost the United States tax payers countless millions of dollars.

Throughout the course of my practice I have represented many families whose loved ones have starved to death while they paid $6,000.00 a month to highly profitable nursing home corporations, loved ones who have become so dehydrated that they have required expensive, painful and degrading hospitalizations, multimillion dollar facilities that spend less than $5.00 per day on each resident to cover three full meals and two snacks (delivering food that is less appealing and cheaper than a couple of cans of Alpo), nursing home residents who have been viciously beaten by staff members or fellow residents, patients who have been so horrifically neglected that they have developed softball size bedsores in their backs – so large and so deep that I have actually seen their spines from outside of their body.  On each of these occasions, our investigations have revealed that the injuries and often deaths have occurred from corporate decisions made to save modest amounts of money and increase profits.

There are two very specific areas of the fallout of these irresponsible choices made by the corporations.  The first is obvious:  People suffer and die.  The second is less so.  Namely, in each of the circumstances I have described as a mere snapshot of some of the horrors I see in my practice, non-profit hospitals are forced to pick up the pieces and Medicare and Medicaid pay the bills for extensive treatment resulting from these choices.  The costs are astronomical.  In the end, it is you the taxpayer who bears the burden of lining the pockets of this small percentage of nursing home corporations who choose to act in this manner.

There is a further important item that is absent from the national debate.  When lawyers such as me take on these very difficult, time consuming and heart wrenching cases, we are obligated to act on behalf of the government to recoup those costs.  For cases in which we prevail, we obtain recoveries from the nursing homes and their insurance companies to pay back the Federal government for any treatment which is determined to have been caused by the negligent and irresponsible choices made by the nursing homes.  As a whole, elder advocates who defend the rights of nursing home residents annually recoup millions of dollars every year for the Federal and State governments from these wrongdoers.  Efforts are underway to obtain a specific accounting from the U.S. General Accounting Office to quantify these funds.  I am confident that the number is extraordinarily significant and serves as a great benefit to taxpayers.

There is yet a third element to this debate that I have heard in the past but not recently.  That involves Medicare and Medicaid fraud.  I would reiterate that most nursing homes and their staff provide honest, compassionate and devoted work to protect the most vulnerable citizens in our society.  However, I have uncovered through review of public records a significant number of nursing homes wherein the owners place relatives in salaried positions at their nursing homes and ultimately bill Medicaid for the work that they are supposed to do.  When I interview staff members, they have sworn under oath that these people have never shown up for their so-called positions.

It is shocking that this still occurs in this State and at this late date in our history – although I have direct evidence that it does and has.  This is not limited to New Jersey.  I have provided this information to the Attorney General’s office on at least one case and greatly hope that action will be taken.  As with the issues above, the fallout is both obvious and twofold.  In the first instance, the absence of a paid individual charged with the care of nursing home residents not showing up for the job harms the residents.  The second aspect is financial.  Taxpayers are paying for individuals all over the State of New Jersey and elsewhere to perform tasks that they simply do not perform.  This represents a dramatic waste of resources and, as noted above, inevitably leads to injury – whose treatment becomes the burden of taxpayers as Medicaid and Medicare pay for exorbitant hospital bills by non-profit hospitals.  Ultimately, these non-profit hospitals and taxpayers indirectly fund the often record setting profits by some for-profit corporations in the nursing home industry.
As this lively and often contentious debate ensures, I strongly believe that the wrongdoers in the otherwise essential and quality nursing home industry need to be investigated and addressed.