Senior woman with headache sitting in the bed at home

A federal watchdog will be taking a magnifying glass to the process of nursing home evictions. It will issue a report later this year on evictions, calling them a potentially “unsafe and traumatic experience” for residents. 

The Office of the Inspector General for the US Department of Health and Human Services announced Monday that it has “ongoing work” looking at whether nursing homes are meeting the Centers for Medicare & Medicaid Services’ requirements for “facility-initiated discharges. The announcement noted that recent media stories have “highlighted a rise in nursing homes eviction” and that data from 2011 to 2016 from the Long-Term Care Ombudsman Program found that evictions are the most frequently cited complaint about facilities, it said on its website.

But Mark Reagan, managing shareholder of Hooper, Lundy & Bookman and general counsel for the California Association of Health Facilities, said that unless the Inspector General’s office makes a significant effort to understand the reasons facilities take such drastic action, the report is likely to “miss the mark.”

“The OIG’s decision to spend its time in this area is concerning, unless they take the time and effort to go much deeper into the facts that have led to the facility’s determination of the need to effectuate a transfer,” Reagan told McKnight’s Long-Term Care News on Monday. “My experience has been that the most common grounds for facility action in this sphere is that the affected resident cannot be appropriately cared for by [a] facility without presenting a clear and present danger to the wellbeing of other residents and staff. This is not easy for the families of the resident and may cause disagreement and a resulting complaint.”

Reagan has worked in the long-term sector for more than three decades, advising the Massachusetts Senior Care Association, the American Health Care Association, and others on multiple issues. He said there has been a “dramatic increase” in behavioral health challenges that have fueled facility discharges, including “potentially and actually violent residents” who threaten other residents and staff. 

“When confronted with this situation, families of other residents are frightened and staff no longer want to stay at the facility if the threatening resident remains at the facility,” Reagan said. 

There have been situations, though, in which facilities have been accused of dumping residents for less-than legitimate reasons. McKnight’s has reported on several high-profile cases, including a 2018 lawsuit against Sava Senior Care claiming the company “routinely refuse[d] to provide residents with an advance written notice of discharge or their rights to contest that discharge.” In March, McKnight’s reported that Heart & Hands, a post-acute care and rehabilitation center in Santa Cruz, CA, had remedied enough staffing issues to drop its fines by $200,000, including halting the use of law enforcement to manage “difficult” residents with dementia or substance abuse issues and then discharging them. 

In 2015, the group California Advocates for Nursing Home Reform filed a lawsuit against the state alleging it failed to stop “patient dumping” by nursing homes of Medicaid residents to make room for higher paying private insurance and Medicare patients.