Recently, South Haven Health and Rehabilitation, a Montgomery, Alabama, nursing home, was notified that it would be losing its Medicare and Medicaid funding. Local news outlet WSFA reported that South Haven was losing Medicare and Medicaid benefits for its residents beginning March 1, 2017. The decision was made at the suggestion of the Alabama Department of Public Health (ADPH) in conjunction with the Centers for Medicare and Medicaid Services (CMS).
CMS is the federal agency that oversees the operation of long-term care facilities, such as South Haven, that receive government benefits for their residents. It is a rare occasion when a nursing home loses its certification and benefits. In the case of South Haven, it is not known completely at this time what the basis for the decertification is, but history tells us that the offenses must be multiple. The ADPH has reported numerous violations of federal law that warrant the withdrawal of governmental benefits.
The decertification of this facility provides a clear sign to residents of these facilities not to rely too heavily on the “star” rating system. A search of this facility reveals that it has received four or more stars on a five-star rating system, indicating this is a quality health care facility. In fact, the investigation of the government agencies reveals just the opposite.
Federal regulations require that nursing homes comply with 42 CFR Part 483, Subpart B, in order to receive Medicare and Medicaid benefits. Inspections of nursing homes are supposed to be unannounced, and inspection of the facilities may cover many days. Inspections cover a host of issues, such as staffing, training of staff, health condition of the residents, number of reported incidents, quality of the facilities, competency of staff, record keeping and recording, and the like.
Our firm has a case pending against this facility and is currently investigating at least one other. The facility is owned by Sava Senior Care, a health care company that owns nursing owns in several states.
The issues with South Haven highlight concerns that our firm has had with Alabama’s law that tend to protect these facilities. Nursing homes and other long-term care facilities are allowed to use that unconscionable benefit of arbitration. The claims filed against these facilities, especially those that are relegated to arbitration proceedings, occur in relative secrecy. Also, when a lawsuit is filed against these facilities where the allegations relate to substandard patient care, an injured party’s lawyer may not discover how many patients have been similarly harmed. Even if that information can be collected by other means (such as a request upon the ADPH or CMS), the information collected cannot be admitted into evidence in the arbitration proceeding.
Our senior citizens who have reached a point in their lives where long-term care is in their best interests need more protections than are presently being afforded to them. Expanded discovery and relaxed evidentiary rules are a must for nursing home patients in Alabama. The legislature needs to make changes in the current state of the law in Alabama. If you have any questions relating to Nursing Home Litigation, contact Ben Locklar, who handles Nursing Home litigation for the firm, at 800-898-2034 or by email at Ben.Locklar@beaselyallen.com.
Sources: WSFA.com and CMS.gov