While many low income individuals who have Medi-Cal (California Medical Assistance Program) are thrilled to have state-provided medical insurance, it may not be enough to provide them the coverage they require to stay in nursing homes long-term. Recently, the California Advocates for Nursing Home Reform, a watchdog group, alleged that administrators of nursing facilities throughout California have been sending patients covered by Medi-Cal to hospitals to free up beds to make room for patients with insurance that can pay the nursing home more. Because of that, many low income patients only have the option of staying in hospitals indefinitely because no nursing facility will readmit them back in.
By federal law, states are required to provide patients a readmission hearing after an initial hospital stay is over and they have been formally discharged. However, California has been slow to enforce this requirement, creating a loophole for nursing home administrators to generate greater profits. The lawsuit filed by the advocate group claims that this refusal of a readmission hearing mandates that welfare patients must remain in the hospital to receive much-needed care. This lack of enforcement directly violates the 1987 Nursing Home Reform Act when Congress passed sweeping reforms to ensure that residents of every nursing facility would receive optimal medical care and hygiene assistance.
To remain financially lucrative, many nursing facilities receiving Medicare funds will turn away low income potential residents in favor of lucrative clients with better insurance. The practice of “patient dumping” often goes unchecked, especially when the patient is suffering a severe mental or medical health condition.