Two federal regulatory agencies have reprimanded nursing homes and their collectors, warning they may be breaking the law with summary efforts to charge relatives and friends for the care of ill, injured and debilitated residents in long-term institutions.
Conclusion: Many of the forms you can sign for a loved one when they are admitted to a nursing home are downright illegal if they claim to make you responsible for paying the facility’s bills.
The Consumer Financial Protection Bureau (CFPB) conducted hearings and released a report as well as a joint letter with the Centers for Medicare and Medicaid Services (CMS), the agency overseeing nursing homes and other facilities. long-term care.
Too many ordinary people have suffered unwarranted legal and financial threats from nursing home debt collection efforts, the CFPB found in public hearings and reported in its recent ‘issue focus’. , as well as via a legal circular.
Federal regulators say consumer nightmares date back to the agonizing moment when a loved one or friend suffers an injury or illness so serious that they require nursing home care. Few people foresee this. But a cascade of complications ensues when, for example, hospitals notify patients that they are well enough to move on to another facility. Hospital costs are so high that federal regulators have pushed these care facilities to get patients off their units, pronto.
But it can create domestic crises as patients, relatives and friends search for suitable housing nearby that is affordable, suitable and will accommodate a new resident. During this stressful admissions period, nursing homes can bury loved ones and friends with piles of paperwork – all of which must be digested and accepted in a hurry.
The CFPB and CMS have both warned nursing homes that federal regulations prohibit them — particularly if they receive Medicare and Medicaid funding that most facilities rely on — “from requesting or requiring that a non-resident personally guarantees the cost of nursing home care as a condition of admission, expedited admission, or extended stay at the facility. The ban applies to all residents and potential residents of a nursing care facility, whether eligible for Medicare or Medicaid. Yet some nursing home admission agreements include clauses that appear to obligate third parties to pay residents’ fees.
The consumer protection agency, in its report and in public hearings, found that too many aggrieved family members and friends of care home residents were being stalked by care homes and their debt collectors. , with too many cases based on admission contracts with questionable clauses about who would be “responsible” for resident care costs.
Relatives – who may be distant family members – and friends have found themselves sued by nursing homes or their collectors for resident care costs, even though the legal basis for such actions is questionable, have declared the CFPB and the CMS. Defendants in such cases are unlikely to possess the legal knowledge as to the summary nature of nursing home financial liability lawsuits, nor should they be burdened with the cost and stress of fighting such cases. case.
The consumer protection agency has blasted care homes and debt collectors for suing residents’ relatives and friends on another dubious motive, relying on a contractual model, as reported by the CFPB :
“In addition to alleging breach of contract, debt collection lawsuits may also allege that a third party has engaged in financial wrongdoing. The majority of third party lawsuits reviewed by the CFPB included allegations that the third party or resident had intentionally misused, concealed, or stolen the resident’s funds.Apart from the nursing home bills remaining unpaid, these claims generally lacked supporting information.This raises the possibility that some lawsuits could allege financial malfeasance without substantiation of the claim and potentially as a coercive technique.
This is unacceptable. In my practice, I see not only the harm that patients experience when seeking medical services, but also the harm that can be inflicted on them and their loved ones through neglect and abuse in care homes. nurses and other long-term care facilities.
The coronavirus pandemic has laid bare the growing failures of the long-term care sector, which cried out “poor me” and sought ever-increasing support from taxpayers. This is happening even as large private investors gobble up facilities, raise prices, cut services and make their operations, management and ownership increasingly opaque to outsiders. With overcrowding, understaffing, faulty infection control practices, slow vaccination practices and other issues, nursing homes and long-term care facilities have seen 200,000 of their residents and their staff die – a quarter of the staggering number of more than one million deaths nationwide due to the disease.
More than a million residents and staff of nursing homes, already frail and weakened, have been infected with the disease. Tens of millions of residents have endured overwhelming loneliness, isolation and further erosion of their mental and physical health during the pandemic closures of their care facilities. Too many residents and loved ones still grapple with the difficult choice of potentially pursuing justice and redress in the civil system for long-standing, well-known and unacceptable wrongs in nursing home care.
But those appalled by certain aspects of long-term care and seeking legal redress may find their efforts challenged — again, by documents signed under duress and during the admissions process.
Too often, facility owners and operators have residents and their loved ones sign arbitration agreements. This means their complaints will be rammed through a legal system in which, in many ways, the decks are against them. Their cases will be heard by mercenaries, arbitrators who often work themselves for large legal firms who have frequent dealings with nursing home operators, including if they are retained in the first place, which means that they can benefit from maintaining favorable relations with them.
Arbitrations do not take place in open, public courtrooms, but often in secure office buildings or closed corporate headquarters, sometimes those of the disputing parties. They do not always follow the rigorous evidentiary standards that courts must meet. The decisions of the arbitrators are binding and may require heavy legal charges to be challenged and overturned.
While alerting the public to scams involving nursing home debt collection, the CFPB highlighted some key points about the widespread importance of keeping these care facilities honest in our rapidly aging country, reporting:
“There are approximately 48 million family members and friends who care for adults with health or functional needs in the United States, and nearly one in six adults support the health and well- being of an elderly person due to illness or disability.”
The agency also reported this:
“As demographic changes increase the demand for long-term care, costs are expected to rise. By 2060, almost a quarter of the US population (94.7 million people) will be at least 65 years old. After age 65, almost half of all adults will need long-term paid services and supports, such as home help, assisted living or nursing home care, and more than a quarter will receive care in retirement home. Nursing home residents stay for significant periods of time. The average nursing home stay among current nursing home residents is 1 year and 4 months, and more than half of current residents have stayed in the nursing home for at least 100 days. From the age of 65, it is estimated that 15% of elderly people spend more than two years in a retirement home. Also, life expectancy is expected to increase until 2060. With increasing life expectancy, older people are also expected to have age-related health care needs for longer periods of time.
Incidentally, the agency reported this about the peak load for this care (see CFPB table, above):
“Several factors contribute to the likelihood that older people who need nursing home care will go into debt. Nursing home care is expensive. In 2021, the annual median cost of a single room in a nursing home was $108,405. Between 2004 and 2020, this cost has increased by more than 60%, or 19% if adjusted for inflation. This price growth has consistently outpaced the growth in consumer prices and medical care. »
We have a lot of work to do to reform nursing homes and long-term care to ensure safety, accessibility, affordability and quality. We must also protect our legal system, so that those with serious and legitimate claims for harm and injury have appropriate access to courts that are not cluttered with dubious and venal claims.