One of the great tragedies of the coronavirus pandemic is the disparate impact it has had on some of our most vulnerable citizens including elderly patients residing in Southern California nursing homes. Thousands of elderly nursing home residents across the country have died from coronavirus. Indeed, one of the first coronavirus outbreaks occurred in a nursing home in Kirkland, Washington where 129 residents, staff, and visitors fell ill with covid-19 and 40 died. In an unexpected twist of logic, many nursing homes are discharging long-term residents to care for patients with coronavirus. Why? Money, of course, even though this presents an increased risk to other residents of nursing homes and to their staff.
Caring for a patient sick with Covid-19 earns a Los Angeles nursing home, for example, significantly more money than can be charged for a non-Covid-19 patient who needs assistance with long term more mild conditions. In the fall of 2019, Medicare funding changed offering increased payments to nursing homes caring for patients who have recently been discharged from the hospital. The first weeks after their discharge, nursing homes earn up to four times of the daily amount offered for a long-term resident. For example, a nursing home can earn $800 per day for a COVID-19 patient while earning only $200 per day for a patient with dementia.
Thus, nursing homes have great incentive to attract those patients recently released from hospitals who are severely ill and require skilled nursing. To have the space to care for those patients, nursing homes must free up beds in their facilities. How does that happen? The long-term, less valuable patients are discharged, often under conditions that imperil their health and safety. Families of the soon to be discharged patients are called and told their loved one will be discharged sometimes in as few as 10 days, leaving no time to plan for or to find appropriate alternative housing for the patient. Little consideration is given to a patient’s level of income or to their well-being. Instead, the nursing homes while turning their backs on their vulnerable long-term residents tout their care of Covid-19 patients as a public benefit.
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