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Medicaid Shields Nursing Home Reputations At Patients' Expense

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The Tampa Tribune

Published: December 29, 2007

Federal Medicaid officials released the names of the 52 worst nursing homes in America last month, then patted themselves on the back for a job well-done in protecting the nation's frail elderly.

Florida has three homes on the list - St. Petersburg's Apollo Health and Rehab Center, Palm Rehabilitation and Nursing Center in Lauderdale Lakes and Key West Convalescent Center. The homes were identified as persistently poor performers by Florida's Agency for Health Care Administration.

The list is helpful, no question. But it is not complete.

The full list is reported to be much longer - some 128 homes with repeat problems. These homes have been given numerous chances to correct themselves, but yo-yo in and out of compliance with the federal government shielding their identity.

A group of U.S. senators is demanding that the U.S. Centers for Medicare and Medicaid Services release the full list. Surprisingly, neither of Florida's two senators - Bill Nelson or Mel Martinez - is backing the effort for greater transparency.

Washington should give the public the tools needed to make decisions about nursing homes.

One has to wonder who Medicaid decision-makers think they should protect first - nursing home residents or the companies that own these troubled homes?

If they put patients first, they wouldn't withhold information on homes that temporarily solve problems but revert to form after inspectors leave.

True, in states such as Florida, which has a strong public-records law, intrepid family members can root through nursing home inspection reports and find the information for themselves. But families moving a relative into a nursing home are rarely positioned to troop down to their nearest AHCA office and dig through a thick file. And those who rely on Medicaid often face no choice; they must take a spot in any nursing home that will take them.

If the government has the information and can easily create a list, it should do so.

In a recent letter to the Des Moines Register, which first reported on the senators' demands, Kerry Weems, acting administrator for the Centers for Medicare and Medicaid Services, said the other homes have not been named because many have shown improvement.

Even so, such homes should not be rewarded for finally or temporarily fixing serious health and safety violations. That's their responsibility.

Medicaid's responsibility is to protect the patient.

Homes that bounce in and out of compliance do not deserve to be shown deference, especially when it comes at the expense of Florida's most vulnerable citizens.

Besides, putting their names on the worst-offenders list might shame some nursing home owners into sustained action.

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