What a sad irony. On April 1, the Democrat ran a front-page story that covered the rape and beating of an 80-year-old woman in a Perry nursing home. The next day, its editorial suggested that the nursing home industry – not its helpless residents – needs more protection.

Let’s set the record straight: The nursing home industry is no longer a hodgepodge collection of small, community and faith-based homes. Nonprofit and not-for-profit facilities have largely been swallowed by giant nursing home chains.

These corporations have grown fat by defrauding taxpayers and denying proper care for their residents. It wasn’t until American juries and the Congress began to hear about the fraud, abuse and neglect that were rampant in nursing homes that these corporations finally began to be held accountable.

In 1995, the Governmental Accounting Office (GAO) reported that Americans were being robbed blind by the nursing home industry and that the Medicare reimbursement system desperately needed reform. Taxpayers were being charged for care that was never delivered and shell companies had been set up for the sole purpose of bilking the government. All of us paid in dollars, but many helpless elders paid with their lives.

In 1997 Congress instituted a new payment system that made it more difficult for the industry to defraud taxpayers.

A GAO study last year reported that many of these corporations had gone into debt with lavish spending and irresponsible expansion. When Congress put the brakes on, these corporations slashed staff, cut back on critical supplies and squeezed patient services to dangerous levels. With its large population of nursing home residents, Florida has paid a heavy price for those irresponsible actions:

• The Agency for Healthcare Administration (AHCA) reports that nursing home violations increased 50 percent from 1997 to 1998.
• Two-thirds of Florida’s nursing homes have appeared on AHCA’s “Watch List” with serious or repeated deficiencies.
• A University of California study shows that Florida nursing home care has dropped to unacceptable levels and that Florida homes had 40 percent more violations than the national average. Although industry members complain about insurance rates, they refuse to address the real problem: care in their homes is bad and getting worse.
• It is absurd that these nursing home corporations are now demanding even more of our taxpayer dollars under the implicit threat that our elders will be thrown out on the streets. On Justice Department official was even quoted as saying that some of the nursing home chains apparently have “built in fraud as part of their business strategy.” Here is just a small sample of the industry’s abuses:
• In February, Beverly Enterprises was forced to repay $175 million of the $460 million it stole from taxpayers.
• Later that month, Integrated Health Services filed for bankruptcy. It had forgiven principal and interest on a $4 million loan to its CEO, Robert Elkins, who earns $44 million a year.
• Vencor nursing homes were forced to repay $90 million and some of its executives went to jail. The U.S. Justice Department is seeking $1.3 billion in fines from Vencor for “intentionally defrauding the government.”

Meanwhile, Florida ranks 49 th of the 50 states in spending on nursing home alternatives. At the Coalition to Protect America’s Elders, we believe Florida must crack down on the worst nursing homes, set a higher standard of care in all of them, and lead the nation in providing alternatives such as at-home care.

The state should provide incentives for smaller, community and faith-based nursing homes where the quality of care takes precedence over profit. Above all, we must not rob elders of the few protections they have under law.

Barbara Hengstebeck is the Executive Director of the Coalition to Protect America’s Elders, and Florida’s former long-term care ombudsman.

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