'I WANT TO GO HOME': All over the country, nursing homes and senior care facilities are breaking the law, evicting elderly residents, and getting away with it.

• Author: Lueders, Bill

IT WAS THE WORST THING THEY COULD HAVE DONE TO HER. THE ABSOLUTE WORST.

In late October, my ninety-seven-year-old mother, Elaine Benz, was evicted from the senior care facility in Wisconsin where she had lived for ten years. It happened from one day to the next, in an apparent violation of state law. The Regency New Berlin, in Waukesha County near Milwaukee, decided that she had become too much work.

What followed was a nightmare for our family. My sister, Diane, who lives in New Berlin and has visited Mom daily for years, was unable to see her for weeks because the physical rehabilitation facility she ended up being stranded at was in a COVID-19 lockdown.

During this time, I was unable to talk to her by phone, as I try to do every day. (She can no longer use the phone by herself, so Diane calls me during her visits and hands the phone to Mom.) Twice, Diane stood in the cold outside of the rehab facility to wave at Mom through the window to her room. Once, they spoke by phone. T need you," Mom said.

Elaine, who has been in assisted living since February 2020, after years in independent living, was sent to the rehabilitation facility after a fall. She was supposed to be there for about two weeks and return home on the morning of October 29. At 4 p.m. the day before, someone from the Regency told Diane, for the first time, that our mom could not come back.

Wisconsin law requires facilities in the licensing category that includes the Regency--officially ProHealth Care Regency Senior Communities, New Berlin--to provide at least thirty days' advance notice before booting a resident, and even then only for certain reasons, which were not present here.

Across the nation, laws like these on the books at the federal and state level are routinely ignored without serious consequence. Federal agencies have known for years that improper discharges are a problem, yet the laws against them have been allowed to atrophy into irrelevance, due to a lack of enforcement.

In our case, the Wisconsin Department of Health Services launched an investigation based on my complaint. The investigator assigned to the matter filed a report on or around November 10. State health officials assured me there would be an enforcement action, including fines. But as of mid-January, nothing more has happened. Purportedly, the matter is still "under investigation." We have reams of documentation, backing up what I'm saying here, that no one from the state has asked to see.

While we waited in vain for the state to act, Diane and I tried to work out a way for our mom to stay at the Regency, where she and her late husband Don had lived happily. But that effort collapsed under the weight of its deliberate impracticality. The Regency wanted her gone, and the Regency prevailed. My mother has already paid her penalties. The Regency charged her $5,685 for the month of November, during which she required no food and no assistance of any kind--because she was barred from the facility. (In fact, she was initially double-charged for this month, as I'll explain.) She lost her home, and her connection to her friends and caregivers.

On November 17, we moved Elaine into a new place. It was, as we expected, a difficult transition. When my wife, Linda, and I visited her a few days later, Elaine was sullen and despondent. She would not eat her breakfast and, for more than an hour, did not say a word as we put up shelves for family photos in her new apartment. Then, as I knelt before her wheelchair, she looked at me and said, "I want to go home. I want to go home."

WHAT HAPPENED TO MY MOTHER HAPPENS TO ELDERLY PEOPLE IN THE UNITED STATES ALL OF THE TIME. It's against the law. It's cruel. It is driven by a desire to maximize profits--or nonprofit revenues, as we'll see. Yet it happens routinely, often without due process or recourse.

"It's a huge problem across the board, particularly when you look at assisted living or personal care, residential-type care homes where the protections for people are not as high as they might be in a nursing home," says Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, or Consumer Voice. "Many of these residents have spent hundreds of thousands of dollars in these facilities and then can be kicked out on a whim or just not accepted back." (A tally shows that, during the last ten years, Mom and Don paid the Regency more than $321,000 out of their Social Security and life savings, now mostly gone.)

"It puts families such as yours in a really difficult position because you generally are not being given a lot of notice," Smetanka tells me. "You're scrambling at the last minute trying to figure out where your loved one is going to live, as well as trying to assert your rights. And you are paying generally thousands of dollars a month for care and services that you're ultimately not receiving."

Smetanka says that even in nursing home settings, where the protections are more stringent, residents are often illegally evicted--sometimes "even with an administrative law judges order requiring the person to be taken back."

On November 18, the day after we moved Mom into her new place, the Office of Inspector General for the U.S. Department of Health and Human Services released a forty-page report on "facility-initiated discharges." It notes that "discharge/eviction" has for years been the single most frequent complaint recorded by the federal Long-Term Care Ombudsman Program, which operates in all fifty states and the District of Columbia.

The report was produced by Principal Deputy Inspector General Christi A. Grimm, President Joe Biden's pick for the office's top job. In April 2020, when she held the post in an interim capacity, Grimm was attacked by then President Donald Trump for releasing a report that documented shortages of protective gear and COVID-19 tests for use in hospitals early in the pandemic. He bashed Grimm for producing "another Fake Dossier," without knowing her name or gender.

"Where did he come from, the inspector general?" Trump demanded. "What's his name?" Trump's attempts to have Grimm removed from her job were unsuccessful.

Despite its tepid title, "Facility-Initiated Discharges in Nursing Homes Require Further Attention," the report clearly identifies a need for action.

"Our findings raise concerns about weaknesses in the safeguards to protect nursing home residents from harm that may result from inappropriate facility-initiated discharges," it says. In one instance, "police found one resident on the streets after a nursing home discharged him to an unlicensed boarding house without notifying his family."

The report says notices of discharge, required of nursing homes by federal law, are often not issued until after the resident has already left the facility. Several ombudsmen "volunteered that nursing homes have said that they would rather accept a deficiency or enforcement penalty than keep the resident." Other ombudsmen "opined that stronger enforcement actions could help to reduce these discharges." The report said differences in how ombudsmen, state agencies, and various federal offices approach their shared goal of protecting residents from harm "may, in fact, inhibit efforts to prevent inappropriate facility-initiated discharges." (For more on this report, see sidebar, "Measures of the Problem," page 25.)

In 2019, state ombudsmen nationally logged 10,508 discharge/eviction-related complaints involving nursing homes and 3,110 for other long-term care facilities. But the actual number of improper discharges is likely much higher--especially given how little good it does to complain.

OFTEN, AS WITH ELAINE, NURSING HOMES AND OTHER SENIOR CARE FACILITIES EVICT RESIDENTS WHILE THEY ARE TEMPORARILY MOVED TO ANOTHER FACILITY.

"There's a lot of discharges that are done this way throughout the United States, where they send people to the hospital and then just refuse to take them back," says Tony Chicotel, a staff attorney for California Advocates for Nursing Home Reform.

Again, this is something the government has known about for years.

"Sometimes facilities discharge residents while the resident is hospitalized for health concerns unrelated to the behaviors that form the alleged basis for the discharge," concluded a 2017 memo from the Centers for Medicare & Medicaid...