"Nursing Homes Mask Neglect To Lift Ratings" is an over-the-fold headline in today's NY Times. The on-line version as of this moment has a more sensational headline: "Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public."
You don't have to read the story to be able to sense what happened. Turns out the US Government has set up a system for rating nursing homes, and the nursing homes -- like the good WRAITHs they are -- have used their artificial intelligence to game the system and achieve artificially high ratings.
Now that we have a mostly non-manipulable (asterisk for the WRAITH that controls the governorship of New York) empirical metric -- the number of COVID-19 deaths -- it turns out 5 star nursing homes are no better than 1 star homes.
None of this is surprising. As you'll see below, 70% of nursing homes are for-profit and many are owned by private equity firms. In other words, they are WRAITHs, programmed to maximize profits. If the benefits from cheating on reporting requirements exceed the costs, they will cheat. If figuring out when inspections will occur in advance, and overstaffing and putting their best foot forward for the inspection will help them achieve a five star rating, they will do that too. If it will hurt a home's rating to report that residents are falling and breaking bones, are developing pressure ulcers, are infested with maggots, and are being sexually abused or raped, then under-reporting will occur. These are all calculations that WRAITHs make under any system of regulation, and this is clearly one where the "cost" of lying and cheating did not outweigh the "benefit," leaving the nursing homes unprepared for a crisis like COVID-19, and consequently leaving thousands of residents dead, without a chance.
Once again, it's not satanic child-molesters that are causing these problems. It's WRAITHs and Alt-QAnon. QED.
This is really important so I'm going to quote the key findings here:
- Much of the information submitted to C.M.S. [Centers for Medicare and Medicaid Services] is wrong. Almost always, that incorrect information makes the homes seem cleaner and safer than they are.
- Some nursing homes inflate their staffing levels by, for example, including employees who are on vacation. The number of patients on dangerous antipsychotic medications is frequently understated. Residents’ accidents and health problems often go unreported.
- In one sign of the problems with the self-reported data, nursing homes that earn five stars for their quality of care are nearly as likely to flunk in-person inspections as to ace them. But the government rarely audits the nursing homes’ data.
- Data suggest that at least some nursing homes know in advance about what are supposed to be surprise inspections. Health inspectors still routinely found problems with abuse and neglect at five-star facilities, yet they rarely deemed the infractions serious enough to merit lower ratings.
- Of the more than 3,500 homes rated with 5 stars, over 2,400 were cited for problems with infection control or patient abuse.
The article goes on to note that:
At homes whose five stars masked serious problems, residents developed bed sores so severe that their bones were exposed. Others lost the ability to move.
But the most important impact may be that the nursing home industry was ill equipped for the pandemic. The rating system allowed facilities to score high grades without upgrading the care they provided.
You should read the rest of the article yourself, but if you don't have time, the subheadings give you a pretty good sense of it:
Unaudited Data
In this segment, the article points out that the rating systems was developed in response to the fact that private equity firms -- the ultimate WRAITHs -- were buying up nursing homes. It also points out that 70% of nursing homes are for profit -- i.e. unquestionably WRAITHs (of course, even nonprofit organizations are often WRAITHs but that's beyond the scope of this discussion).
Not Disclosing Serious Falls
For example, between 2011 and 2015, 40% of falls requiring hospitalization were not reported to Medicare. In one nursing home -- Clove Lakes in Staten Island -- only 15 of 72 falls requiring hospitalization were reported.
Exaggerating Nurses’ Hours
Before 2018, CMS relied on self-reporting of nurses hours, but then got the bright idea to check payroll records, after which nurses' hours plummeted. But even after 2018, the NY Times found that the nursing homes were greatly exagerrating the amount of time the nurses actually spent with patients.
‘I Wouldn’t Send My Dog There’
This is a quote from someone who checked into a 5 star nursing home and did not get a shower for a week, and where nobody responded to calls to help her get to the toilet.
Overmedicating Patients
Apparently there has been a tendency to overmedicate with antipsychotic medications, which are known to cause bad reactions in the elderly. We can guess that various pharmaceutical industry AISOs profited well from this practice, and may even have contributed to it. Given Purdue Pharma's role in the opioid crisis, that stands to reason, although the article doesn't go there.
Rape at Reo Vista
Multiple examples of rape and other forms of sexual abuse in nursing homes. This section also describes one patient whose wound became infested with maggots when a bandage was not removed for several days.
Not-So-Surprise Inspections
One health inspector was convicted for taking $500,000 in bribes to let nursing homes know when inspections were coming. Again, bribery like that is classic WRAITH behavior. On average, homes increased staff time by 8% on days of inspections and for 800 facilities inspection day just happened to be the best-staffed day of the year (statistically impossible if random chance is assumed).
Outbreak
As already mentioned, the five star homes did no better than the one stars, since the ratings were based mainly on self-reporting and also on presenting their best face at inspections.
No comments:
Post a Comment