Indianapolis Area Nursing Homes are in Unprecedented Trouble
The Indianapolis Star, a local media agency, conducted an 18-month investigation into the state of Indiana’s nursing home administration—and the results have uncovered widespread fraud, understaffing, and inefficient operation that is having catastrophic effects on the residents who call these facilities home. While Indiana’s overall focus on profit over adequate care is not unique to the state, Indiana ranks as one of the worst in the nation for overall care of their elderly residents, and the state’s death toll is gravely higher than the national average.
One of the most pressing concerns in Indiana is the more than one billion dollars in Medicaid funds being diverted for profit as a result of a legal loophole connecting hospitals and nursing homes. On paper, more than 90% of the state’s nursing homes (of which there are more than 500) are owned by county hospitals.
Due to a law stating that government-owned nursing homes may tap into extra Medicaid funds in order to maintain their services, hospitals (which, as county facilities, are owned by the government) that go on to acquire nursing homes may benefit from this Medicaid funding stipulation—acquiring almost $700 million in 2019. Indiana receives more Medicaid funding than anywhere else in the United States, yet provides sub-par nursing home care when compared to other states.
The Link Between Hospitals and Nursing Homes
The system is constructed with the intention that the hospitals that own the nursing homes would collect extra Medicaid funding, and then pass it on to the long-term care facilities where it is needed. However, somewhere between one and three billion dollars have never reached Indiana’s nursing homes, accounting for approximately 70% of the funding acquired. Hospitals saw a resulting surge in new buildings, including the Sidney & Lois Eskenazi Hospital valued at just over $750 million, and many of the top executives benefited from substantial pay increases.
Despite potential billions earmarked to assist nursing homes with critical issues such as staffing, Indiana remains one of the most poorly staffed states in the US. The state currently sits at 48 out of 50 in terms of the ranking of average resident to staff ratio per state. Malpractice litigation and inspections have revealed the consequences of this chronic understaffing: broken bones and brain injuries as a result of frequent falls, bedsores so large and severe that entire limbs must be amputated, and residents left entirely unsupervised. The current death rate at Indiana nursing homes sits above the 13% national average at 20%.
Reforming the System
An additional defrauded $35 million was recently uncovered as part of IndyStar’s investigation into a previously unknown report detailing more than 20 independent schemes to pocket nursing home money. Alongside this discovery came further details regarding the Johnson Memorial county hospital, which has been accused of furnishing $6 million per year in kickbacks in exchange for having elders referred to nursing homes owned by the organization. Community Health Network’s former CFO is currently spearheading a whistleblower lawsuit in an attempt to bring these issues to light.
Multiple efforts have been made to reform Indiana’s nursing home environment, to little effect. State officials being lobbied with millions from nursing home orgs have consistently ignored or directly refused pleas for change. The current goal is to tie Medicaid disbursements to inspection-confirmed markers of nursing home quality, but so far, such measures have been struck down.
Taking Control
If you suspect a nursing home or assisted living facility is harming residents through indifference, recklessness or poor care, report the facility immediately.
