February 20, 2018: It was a hot summer day when the nursing home staffer loaded a woman with severe dementia into a car. But this was no community outing to the beach. When they arrived at the home of the woman’s son, the staffer left the woman in the driveway and drove off. Later that day, the son returned to find his mother wandering outside.
Why would a nursing home do such a thing? In a word, profit. It’s not uncommon for nursing facilities to discharge Medicaid recipients involuntarily for alleged non-payment, even though the residents are not in default. They do it to make room for Medicare recipients or private-pay applicants because those reimbursement rates are higher than what Medicaid provides. On February 20, the Court of Appeals of Maryland ruled that the state Attorney General can sue nursing homes for patient dumping, seeking broad injunctive relief on behalf of residents who are in danger of being involuntarily discharged in violation of the Patient’s Bill of Rights.
The State had filed the lawsuit, State of Maryland v. Neiswanger Management Services, against several nursing facilities that allegedly discharged numerous residents without notice or time to prepare. In pursuit of increased profits, the facilities left the residents in unsafe conditions that could endanger their physical and emotional health. The Public Justice Center’s Murnaghan Fellow, K’Shaani Smith, authored a supporting brief to inform the Court of Appeals of the traumatic and harmful effects of the involuntary discharge of nursing home residents.
Joined by AARP, the AARP Foundation, Long Term Care Community Coalition, Maryland Legal Aid, and the National Consumer Voice for Quality Long-Term Care, the brief described the vulnerabilities of nursing home residents nationwide and in Maryland, noting that the majority have physical impairments in four or more activities of daily living and a large percentage have cognitive impairments as well. The brief explained that the Patient’s Bill of Rights was created in part to prevent the negative effects of involuntary discharge or transfer, including rapid declines in health and hastened death. The brief also noted that nationwide the most frequently reported complaints from nursing home residents are about involuntary discharge.
In its decision, the Court of Appeals agreed that the Patient’s Bill of Rights is intended to protect nursing home residents’ health and safety and limit involuntary discharges and transfers. The Court ruled that the Attorney General is authorized to seek broad injunctive relief when nursing home facilities systematically discharge or transfer residents involuntarily in violation of the Patient’s Bill of Rights. We are glad that the Court has affirmed the State’s ability to protect nursing home residents from patient dumping.