Brookdale Senior Living is a nursing home chain with more than 700 facilities in the U.S., with 12 here in Indiana. Now California Attorney General and other prosecutors recently filed a lawsuit in California Superior Court against the company, accusing its administrators of gaming Medicare/Medicaid’s nursing home rating system to get higher ratings. The system is partially based on the honor system, and administrators exaggerated the amount of time nurses spent with each resident. This is reportedly one of the first lawsuits of its kind.
The star-rating system ranges from one to five stars, and it is employed to rate an estimated 15,000 eldercare facilities in the United States. This information is subsequently made available to consumers through Medicare’s website as an aid to help families pick and monitor a facility. The ratings use 15 different metrics — including levels of illness, prescriptions use and other details taken directly from the resident’s charts. Another essential factor is in-person inspections. While it is not a company-wide policy, there is evidence in California of administrators encouraging staff to misreport their hours.
Money a driving factor
The higher number of stars subsequently leads to attracting new customers. These higher ratings can also be the difference between profitability and bankruptcy. According to the New York Times:
- Five-star nursing homes earned $2,000 per bed in profit.
- Three or four-star homes earned $1,000 per bed in profit.
- One or two-star were typically not profitable.
Happily, Medicaid board members made officials aware of the self-reporting loophole, which prompted Medicare to audit data provided by the chain.
Families need to be vigilant
It is important to check in with loved ones who are residents of the facilities to ensure they get the care they were promised and deserve. But, monitoring data issued by Brookdale and other elder care facilities is also a smart way to help ensure that they do as they claim.