An influential Medicare advocacy group has called out a large skilled nursing home corporation for going into its facilities and scaring elderly residents into thinking their healthcare benefits will be worse if health reform provisions in H.R. 3200 are voted into law.
"The nursing home industry is scaring residents, telling them that healthcare reform will lead to poorer quality of care and the loss of the staff who provide them with essential care each day," says the Center for Medicare Advocacy's senior policy attorney Toby S. Edelman. "This outrageous misinformation campaign must stop."
Her organization called on Health and Human Services Secretary Kathleen Sebelius to put an end to the campaign, as it has in an effort to stop alleged misinformation perpetuated by the Medicare Advantage industry.
The Washington, D.C.-based Center for Medicare Advocacy's director, Judith Stein, pointed specifically to efforts by Genesis HealthCare as an example of the orchestration of the misinformation campaign. Genesis owns more than 200 skilled nursing homes and assisted living communities serving 26,000 patients in 13 eastern states.
"Year after year, multiple reports by the Government Accountability Office and the Medicare Payment Advisory Commission have shown that the Medicare program overpays skilled nursing facilities by billions of dollars. For seven years in a row, MedPAC reported that aggregate profit margins for freestanding nursing facilities exceeded 10%. In 2007, the profit margin was 14.5%.
"Worse yet, despite enormous overpayments, the Centers for Medicare and Medicaid Services documents that nursing facilities have not increased their staffing.
"Where do these billions of dollars go? The overpayments go to profits to corporate nursing homes and to excessive executive compensation, not to the care and services needed by residents," Edelman says.
She emphasized that in H.R. 3200, America's Affordable Health Choices Act of 2009, that the changes in the bill would "correct fraud and abuse in reimbursement, while recognizing that Medicare rates need to be increased for the small number of nursing home residents with special care needs, including those who use ventilators."
According to a report earlier this month in the The Day, of New London, Conn., a Genesis vice president, Laurence Lane, told a roomful of residents at Genesis' Groton Regency, that they should sign petitions and send letters to Congress opposing HR 3200.
He reportedly held up a thick black binder containing the 1,118-page bill and said it would cut $2 billion per year in federal payments for nursing home care to help pay for other provisions in the bill, or about $40 per day per nursing home, and would directly affect staffing levels and quality of care.
"To cut skilled nursing home care, skilled home care and hospice care at a time when our population is changing and those services are needed is downright dumb," Lane reportedly told many of Groton Regency's 162 residents.
Contacted last week, Lane acknowledged the visits and the concern about Medicare reductions and said the visits by him and other Genesis representatives to their patients is "our version of 'town hall' meetings" to explain that H.R. 3200 indeed would slice value from their daily care.
In an interview late Friday, Lane says Medicare payments for a skilled nursing home beneficiary would be reduced by approximately $6 a day. He adamantly denied that there is that much fraud or excess that could be cut from nursing home care.
He elaborated in a lengthy e-mail:
"If you take these CBO calculations and tabulate them, you will find that CBO estimates that over the course of the coming decade, Medicare is projected to spend $7.4 trillion. H.R. 3200 displaces $539 billion, or about 7.3% of projected outlays.
"Of that sum, about $320 billion is reallocated back to Medicare outlays (primarily a shift in spending to support physician fee schedules) and $219 billion, or about 3% of total projected outlays, is cut.
"Our primary concern, and the concern that was expressed in our meetings with our constituents, is that a disproportionate share of the cuts impact post-acute skilled nursing and skilled home care. In aggregate, when you calculate what would be spent under current Medicare law with what would be spent under H.R. 3200, Medicare post-acute services – skilled nursing, skilled home care and hospice services – are reduced nearly 16%."
"I raised the question of whether with the fastest growing population over the next decade being 85 plus were these reductions in resources reasonable and fair?
"The overwhelming response was that these were the wrong cuts, at the wrong time, to the wrong patient population."
"The simplistic notion that all this legislation does is weed out fraud and abuse, and that it only impacts providers, not beneficiaries, falls short of reality."
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