Not all horror stories involve malevolent spirits, zombies or monsters in the dark. Some are written by businesspeople who use taxpayer dollars to run nursing homes where patients are neglected and abused.
That’s a simplified but bluntly true reduction of a pair of stories this week by MLive investigative reporter Matthew Miller that left me stunned and angry.
A Michigan company, Mission Point Healthcare Services, is among the 20 worst nursing care companies in the United States con fines and citations for abuse or neglect. Its 24 facilities in the state have racked up 1,300 violations since 2020.
And we’re not talking about an error on a form or soup being served too cold – we’re talking maggot-infested wounds, assaults, people not seeing a care worker for days, patients who were not revived when their directives called for it.
“You don't get on those worst-in-the-nation lists without some pretty serious violations,” Miller said. “And those all have to do with things that put the safety of patients in immediate jeopardy.”
Miller’s reporting began last fall and involved researching federal databases, reviewing multiple court cases and interviewing dozens of patients, their families and former employees of Mission Point.
The resulting investigative stories surprised me on several levels. First, I’ve only had one personal experience with a nursing home, at the end of my father’s life. The facility was clean, well-staffed and the employees were compassionate and attentive. The Mission Point violations truly horrify and sadden me for the patients who are subject to neglect and abuse and for their families.
The second surprise was well, not as surprising: Most of the money flowing to nursing homes comes from the taxes we pay, and the federal and state regulations and oversight are complex and bureaucratic in a way that makes reform and accountability difficult.
Nursing home companies can farm out critical parts of their operations – food service, administration, real estate, etc. – to other companies they own to avoid legal liability and reporting requirements.
“You can’t tell how the money is being spent,” Miller said. “It has the net effect of making it a lot harder to hold them accountable. I’ve heard stories where plaintiffs will set out to sue a nursing home and they end up suing seven or eight different companies.”
That business arrangement allows individual facilities to remain understaffed, show operating losses and claim that Medicare and Medicaid reimbursements are too low.
Another of Miller’s findings is that the inspection system appears to work, in terms of finding and citing deficiencies. But it fails as a deterrent. That’s because the nursing home companies find it a more profitable approach to pay the fines than to improve care. And that’s even with the average fine coming in at more than $15,000.
“The amount of money they can make providing substandard care is more than what they’re going to end up paying in fines,” Miller said. “The advocates I’ve talked to say we need to do more to create consequences for companies like Mission Point.”
That component – what can be done? – is an important part of investigative reporting at MLive. Miller tackled that with an entire story that looks at solutions. Some include raising fines, preventing the worst-offending companies from expanding and changing regulations to make operators’ finances more transparent to government agencies and consumers.
And there’s always one more solution that is in the hands of you and me: Doing our homework before entrusting a care company with vulnerable loved ones. Miller recommended using these government and journalistic resources that track violations and provide ratings:
I’m pleased that MLive has added Miller’s public service reporting to that resource list.
“I just hope that when people Google ‘Mission Point’ from now before sending their grandmother there that they at least have a sense of what it's like,” he said.
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