The largest source of revenue for nursing home corporations comes from taxpayer dollars through the Medicare and Medicaid programs. In exchange for receiving payment of taxpayer money through Medicare and Medicaid, the nursing home and its controlling shell corporations must comply with the Nursing Home Reform Act of 1987 which was signed into law by President Ronald Reagan. This law imposes tough minimum standards with which nursing homes must comply.
The dirty little nursing home industry secret is that the sicker the resident becomes while at the nursing home, the more money the nursing home makes. In other words, it is financially lucrative for a nursing home to allow a resident admitted for rehabilitation to become sicker rather than properly care for them and, ultimately, allow them to be discharged home. This is due, in part, to the fact that Medicare and Medicaid will pay more money to the nursing home when the resident is sicker and more dependent on staff to meet their basic needs. The intention is that the nursing home will use the additional money it receives to hire more staff and provide the greater care that is required. But does this always happen? Or do nursing home corporations pocket the extra money in order to invest in and acquire more buildings in an ever-reaching effort to become bigger and more profitable?
The nursing home scores bonus dollars if it can talk the family into signing the resident up for hospice during their nursing home admission, thereby effectively allowing the nursing home to charge as much as four times what they would otherwise receive. And what about the therapy the resident is supposed to be receiving? Is the nursing home billing Medicare for therapy that is not actually being provided? If you suspect that a Florida nursing home is committing fraud, you may report it to the Florida Agency for Healthcare Administration at (888) 419-3456.