Perspective | When nursing homes dump some patients to make more money (2024)

The answer is I might be put out. And this is a national problem, according to AARP, which has become involved in a California case that is worth following.

The case involves Gloria and Bill Single. She’s 83 and he’s 93.

As NPR reported, “Nationwide, eviction is the leading complaint about nursing homes. In California last year, more than 1,500 nursing home residents complained that they were discharged involuntarily. That’s an increase of 73 percent since 2011.”

AARP pointed out that the Maryland attorney general’s office is suing a facility in that state for dumping patients out the minute they no longer can bill Medicare for their care — instead of helping them to become Medicaid recipients because the Medicare rates are so much higher.

As The Washington Post reported last year, “A nursing home operator in Maryland aggressively and illegally booted residents from its facilities to maximize payments it collected from public health plans and in many cases dropped the residents off at homeless shelters or inadequate living facilities, the state’s attorney general alleged in a sweeping lawsuit. The nursing home operation discharged patients without their consent once their Medicare coverage ran out and without the planning the state requires for placing them in a ‘safe and secure environment,’ the lawsuit says.”

William Alvarado Rivera, AARP Foundation’s senior vice president for litigation says, “The problem of patient dumping is one of the most troubling complaints of nursing home residents throughout the country. This is basically a form of abuse by nursing homes that dump these patients, especially Medicaid patients, to fill their beds with ‘better’ residents. Until someone holds them accountable, they can keep doing these things.”

What’s been your experience with nursing homes? Send your comments to colorofmoney@washpost.com.

Retirement rants and raves

I’m interested in your experiences or concerns about retirement or aging. This space is yours. It’s a chance for you to express what’s on your mind. Send your comments to colorofmoney@washpost.com. Please include your name, city and state. In the subject line put “Retirement Rants and Raves.”

Last week, I wrote about the GOP tax bill and the effort by Republicans in the House to eliminate the tax deduction for medical expenses.

I’ve been hearing from lots of seniors concerned that they will end up paying higher taxes if the deduction goes away. Even with the higher standard deduction proposed by the House, these folks say they will get a higher tax bill.

In writing about the issue, I said that for seniors age 65 and older, the threshold to meet the medical expense deduction for an itemized return was reduced to 7.5 percent for the 2013 to 2016 tax years. The threshold for other taxpayers is 10 percent of their adjusted gross income.

A sharp reader, Ben Keyser of Knoxville, Tenn.,pointed out something I need to clarify.

“Until 2013 the threshold for everyone deducting medical expenses was 7.5 percent of adjusted gross income. In the name of offsetting some giveaway to millionaires, the threshold was raised to 10 percent effective in 2013. People over age 65 were allowed to continue the 7.5 percent threshold until the end of 2016. Beginning with the 2017 tax year, everyone must meet the 10 percent figure. My point is that seniors were not given a reduction in the threshold. They were allowed to continue with the threshold as it had been for years.”

As I mentioned last week there is a bipartisan bill – the Seniors Tax Hike Prevention Act of 2017 — that would allow for a two-year extension, thus keeping the medical expense deduction to 7.5 percent for people 65 and older.

Helen Lloyd, New Braunfels, Tex.,is concerned about the medical deduction.

“Please fight to keep the medical deduction.” She wrote. “My husband is a heart transplant recipient of 18 years and counting. If it were not for the medical deduction at 7.5 percent we would not be able to pay our income taxes without great sacrifice of a comfortable life with no government assistance.”

Ann Sciarini of Ohio wrote, “If we want to do something to help the vast majority of people in the USA, it isn’t a cut in estate taxes. All this bluster about doubling the standard deduction — hog wash!”

Elaine Charton of Arizona weighed in, too, writing, “I am 63 and had to take early social security at 62. I have several medical issues, which caused me to stop working in 2010. I should mention my husband is diabetic, takes four different meds. Even with his insurance, his co-pays run $100 to $150 a month. We’ve been able to cut that down with different programs the drug companies have, but we still pay. The only consolation was we could claim it on our taxes. It’s fine for the Republicans to talk about middle class. Let them have our health insurance and see what changes.”

Howard Chabner wrote to his representative, Charlie Dent of Pennsylvania, objecting to the elimination of the medical expenses deduction.

In part he wrote, “Eliminating the deduction would hurt Americans who have a catastrophic illness or injury and incur high medical expenses in one or a few years, seniors in nursing homes who pay for their own care, and those with disabilities and chronic medical conditions who have high medical expenses year after year after year, essentially for life.”

He went on to point out, “These taxpayers spend significant percentages of their income on medical expenses such as personal care/nursing services, assistance with activities of daily living, long-term care (including in nursing homes), wheelchair accessible vehicles, medical transportation, construction/operation/maintenance of home modifications (including ramps, elevators, accessible bathrooms and kitchens), medical equipment and supplies, drugs, guide and service dogs, disabled dependent care expenses, the costs of keeping a person who is developmentally and intellectually disabled in a special home, special education for children with learning disabilities, and therapy received as medical treatment.”

Chabner concluded, “I urge you to preserve the medical expense deduction and to reform the Internal Revenue Code by restoring the threshold to 7.5%, as it had been for nearly 30 years before the Affordable Care Act. This is a matter of basic fairness. Eliminating the deduction is simply wrong.”

What a letter. It was reasonable, respectful and impassioned. I hope Dent took the time to read it.

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Please note it is my personal policy to identify readers who respond to questions I ask in my newsletters. I find it encourages thoughtful and civil conversation. I want my newsletters to be a safe place to express your opinion. On sensitive matters or upon request, I’m happy to include just your first name and/or last initial. But I prefer not to post anonymous comments. (I do make exceptions when I’m asking questions that might reveal sensitive information or cause conflict.)

Have a question about your finances? Michelle Singletary has a weekly live chat every Thursday at noon where she discusses financial dilemmas with readers. You can also write to Michelle directly by sending an email to michelle.singletary@washpost.com. Personal responses may not be possible, and comments or questions may be used in a future column, with the writer’s name, unless otherwise requested. To read more Color of Money columns, go here.

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