Bonuses paid to nursing homes with no regard to quality care
November 10th, 2008 by Jennifer Walker-Journey
The Centers for Medicare and Medicaid Services is paying millions of dollars in taxpayer money each year to nursing homes, some of which have been cited for below-average care, according to a report by the Des Moines (Iowa) Register. The monies come from bonuses paid to nursing homes for following programs that in many cases are legally required, such as paying minimum wages and installing fire sprinklers for resident safety.
The Des Moines Register reviewed 81 bonus payment programs in 36 different states. Iowa, which began participating in the bonus program six years ago, was one of the first to establish a bonus program.
Of the 36 states that participate in the bonus program, eight do not disqualify a nursing home from receiving bonus money based on regulation violations. Fifteen of the bonus programs are based on quality of care. Points also are awarded for having a large percentage of patients on Medicaid and for offsetting expenses such as property taxes, fire sprinklers, or paying the minimum wage.
Nursing homes that receive the most bonus money do not necessarily have the best rating, the report points out. The bonus program may appear to be an incentive program or to reward quality care; however, its purpose in some cases is to reimburse or offset cost of bringing homes up to state or federal standards or encourage more homes to accept Medicare-dependent patients.
The bonus program first came to light in March after the Des Moines Register reported that some of the state’s most deficient homes were receiving money from the bonus program. Since then, Iowa has begun revising its program, reducing payments to homes that have recently been cited for causing “actual harm” to residents and eliminating payments to homes that put residents in “immediate jeopardy” of death or injury.