By Tom Henderson • Staff Writer • 

Care centers to be fined for frivolous 911 calls

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Comments

Bufordthe1st

One way or another this is going to cost the residents more. The care facilities will just raise their fees to compensate for the business license costs. I understand the need for more fire fighters and paramedics to be able to cover the population boom in our area. I don't think putting the cost on the care centers is the way to go. The resident/patient will lose in the long run. Either by no-one calling for help when they really need it or in the pocketbook when the facilities raise their rates. Being in a family with our mother in one of these care homes, it is already depleting her resources on a monthly basis as rent/care/living expenses already exceed by a long shot her SS income.

Tuvey

I have only scanned this article but my understanding is that if there is a fall the facilities are not allowed to help the resident but have to call 911 for help. is this a facility requirement or Medicaid?

PAO

I attended a city planning meeting a few months ago where this topic was discussed. Based on information presented at that meeting, I strongly object to these calls being called "frivolous." The care facility calls to EMTs are well-thought-out business decisions directed down to the local level by mainly out of state companies who own the facilities.

Simply, if EMTs are called in, the legal responsibility shifts from the care facilities to the EMT group. By calling the EMTs, care facility owners remove themselves from potential liabilities, oftentimes for basic services the facility should be providing.

I expect a care facility to have skilled nursing staff that is trained and able to give injections, to determine that an accidental fall isn't serious and didn't break any bones, and to plan ahead and arrange transportation to scheduled doctor appointments. If the primary service a care facility provides is to call the EMTs to triage and manage every minor issue, I could save a lot by simply providing my loved one with a medical alert device. It would achieve the same result.

These fees make the care facility owners' hand off of basic responsibility less financially attractive. It allows nursing staff to use the skills they worked hard to acquire. And it should remove some of the pressure on our local EMT resources.

Nick

PAO,
You are correct that it is a conscious financial decision for care homes to go to EMT's for often basic services. I know of several homes where the EMT's are going everyday to provide routine care because there isn't a staff member to do a basic lift.

Mac Native 66

I would say the the big care homes are under staffed. My wife use to work for one and they only had two people working the floor for 200 residents at night. I would have to say that the owners need to make sure that there's 8 floor staff for every 200 residents, 24/7. Under staffing is not a good thing to be doing.

Mudstump

Private for profit business entities seem to want the taxpayer to subsidize their profits. How wonderful to lower your overhead, make more money while the taxpayer picks up the tab. Instead of hiring skilled medical professionals that cost more money...they call the skilled medical professionals that you and I have hired and pay for. They are freeloading and passing the risk and cost to us?

It's sure seems like we need to reduce the taxpayers burden and put it back on the business where it belongs.

gregtompkins

I’m not surprised at this. When I was living in Mac at the Hillsdale Plaza on Hill and 2nd it seemed like every day emergency vehicles would come at the facility on Barbara St and across the way. And the paramedics never seemed to be in that much of a hurry with what they were doing.

tagup

Mudstump: Is the ambulance service or fire department not billing for the service?....If not, they should.....

sbagwell

Tagup: All of the calls are billed. However, almost all of these have to be billed at Medicare or Medicaid reimbursement rates, which fall well short of covering the actual cost.
If MFD could bill them to private insurance, it wouldn't be so concerned. It wold come out OK on that.
Also, in cases where Medicare or Medicaid is covering the care center cost, the center can't pass along any additional expense. It is limited to the government reimbursement rate.
Steve

tagup

Thanks Steve....Appreciate the clarification...

Trafik

As luck would have it, I live between MFD and half-a-dozen retirement communities. Sometimes, I feel as if local paramedics maintain a scheduled UPS-style route where, sirens blaring, ambulances make tours of the retirement homes, looking for “EMS yes” or “EMS no” signs in the homes’ front windows. So I totally understand MFD’s concern, if the frequency of calls is any indication of costs.

But my real worry is the retirement communities, famous for hiring unskilled, minimum-wage employees for 95 percent of employment positions, will now enact rigid cost-saving policies prohibiting the calling of EMS except in extreme cases. While the city and retirement communities will benefit from significant savings, our senior citizens won’t be so lucky. Personally, I think we owe them more than that.

Bluntly, even one dead senior is one too many when a tight-fisted elder care administrator is more worried about a bill from the city than about the well-being of one of his or her residents. Retirement communities already operate on minimalist resident-care budgets. The city may be helping its own bottom line but it’s not doing our senior citizens any favors with this new policy.

PAO

Trafik, I believe your concern is why the decision was to go with a per-bed fee rather than trying to bill costs for each individual call. Also, my recollection of the original meeting backs up Steve Bagwell's comment that Medicare limits what it will pay for services, regardless of the amount billed.

My understanding is that the per-bed fee doesn't fall under the insurance umbrella since it is billed to the facility owner, not the patient. I recall (not positive) that it was thought that it would be difficult for the facility to pass the per-bed fee along to the patient because there are limits to what insurance will pay to the facilities. Meaning, instead of the EMTs being limited by insurance company reimbursement levels, the facility owners will now be limited by the reimbursement levels. And since the per-bed fee isn't related to service calls, there is no "penalty" to incur if a facility does call EMTs.

Per-bed fees in the range of $500 were mentioned at the meeting. My PERSONAL OPINION is the current level of $200 is a warning to the facility owners that McMinnville is serious about not subsidizing their business. If the EMTs continue to be abused - which is different from used when needed - the fees could continue to be raised enough to either stop the abuse or fund enough additional personnel and equipment to cover the extra calls. Again, that is only my opinion.

Trafik

If so, PAO, a per-bed fee could lower perceived liabilities to the retirement communities and I suppose that’s desirable. But all too often, these facilities are de facto human warehouses, where any “unnecessary” expenditure is viewed with contempt. The cash cow doesn’t operate at maximum production when you allow its milk to be siphoned off in $200 or $2000 increments.

The real solution would be to force out-of-state corporations to operate their profitable communities with an eye to adequate resident care and proper staffing (including professionals who can determine medically based need for EMS), all guaranteed by meaningful oversight. But when the obligation to residents is subordinate to the obligation to shareholders, it’s pretty easy to figure out how administrators will act. And this is precisely why the issue of frivolous medical aid calls is before us now, in the first place.

I applaud our city leaders for acting in the interests of prudent fiscal responsibility. But I hope they monitor the outcome of this policy — our senior citizens shouldn’t pay for the city’s thrift with their lives.

Lulu

A century ago, older, infirm people died at home, cared for by family members in an era when extended relatives shared the same house. Now, care of these fragile individuals has transferred to third parties obviously in business to make a profit. Most facilities are hell holes; the majority of untrained employees earn no more than minimum wage while working nightmare jobs. This country is quick to profess respect for its most vulnerable--the very old and young. And yet, the reality never measures up to the lip service.