Nursing Home Concerns with the Affordable Care Act

Dave Farnbauch sits down with ABC's INsight to explain the basics of serving on a jury.

Dave Farnbauch sits down with INsight at the Sweeney Studios to go over incidents of injuries to our elders in our nursing homes. Host: Welcome back. We’re here in the Sweeney Studios. I’m with Dave Farnbauch from Sweeney law firm. We’re going to talk today about a report that was released recently. It was talking about the incidents of injuries to our elders in our nursing home, and it’s staggering numbers. It’s scary how many injuries there are. So let’s talk about this. What federal agency did the study on these injuries in nursing homes? Dave: So, Charity, it’s a relatively recent study that was issued by the federal government, the Office of the Inspector General. They did a four- year study and they were trying to study the incidents of injury and death in nursing homes caused by substandard nursing home care. Host: And it studied different kinds of injuries, some not as significant as others, but let’s talk about what this study said. So give me some details on the study. Dave: Well, it’s, it’s an amazing compilation of statistics about how big of a problem this is – Host: Uh-huh. Dave: -- in nursing homes. They determined that 22 percent of the patients who had a nursing home stay ended up having what they described as an adverse event and I’d like to read to our viewers what they characterize an adverse event to be. “Either a hospitalization, they were hospitalized for their injuries. They either sustained permanent injury, permanent harm, or they required intervention to save a resident’s life or they actually died as a result of substandard nursing home care.” So think about it. One in five patients who went into the nursing home during the time period that they studied, in a particular year, ended up with one of these types of adverse events. They cost approximately $2.8 billion in hospital care to take care of these residents who were injured as a result of an adverse event and, once again, it just sort of highlights that nursing homes, if you get in the wrong nursing home and don’t receive proper care, can be a very dangerous place. Host: Let’s talk about some of the take aways. These numbers are staggering. And we all worry about the care of our loved ones. What are the take aways from this study? Dave: Well, I’d say the major take aways are, what people have to keep in mind is that it’s sort of your responsibility, as a family, to do your homework and try to find the right facility. And even when you place your loved one in a nursing home facility, you have to keep your eyes and ears open to determine whether that nursing home is adequately staffed. Because there’s an old adage amongst lawyers like myself, who do nursing home neglect cases. We believe that virtually any kind of a case, any type of an injury or death in a nursing home, results, all stems from under staffing. Under staffing is the key to all these cases. So if you go to visit your loved one on the evenings, on the weekends, and they don’t appear to be, you know, adequately staffed, that, that’s a sure way to tell that there’s, your loved one is at risk for an injury. Host: And we can tell if, if our loved one’s been neglected. You can, you can sense that mom hasn’t had her hair brushed or hasn’t had water or, you know what I mean? Even those things that may not right now feel like something that’s caused an injury, but the beginnings of neglect that could then lead to. Dave: Well, I mean, if you, if you believe that when you go into a nursing home to visit your loved one that they don’t have adequate staff to meet your loved one’s needs, it’s time to look for another nursing home. Host: Yeah. Dave: And another take away from this study is, if you go to a nursing home and they want you to sign an arbitration agreement, where you sign away your legal rights to turn to the court system if they cause an injury or death to your loved one. If they want you to sign an arbitration agreement, where you agree to take a dispute you have with the nursing home through a private corporation that the arbitrator is selected by the nursing home, I would say, my advice would be, start looking for a different nursing home to put your loved one in because that’s a, that’s a pretty sure sign that that nursing home is concerned about their potential – Host: Uh-huh. Dave: -- liability and they’re trying to take measures to sort of prevent families from being able to exercise their legal right if something does happen to your loved one. Host: Absolutely. Well, we do want to make sure that our loved ones are taken care of. It’s so important. And, and we do need people to help us take care of them. So if you feel like your loved one has not gotten the care they need and it has led to an injury or some sort of problem, give the Sweeney Law Firm a call. Let them walk through the case with you and see if you have a case, if there’s something you need to do moving forward. Give them a call today or visit their website, sweeneylawfirm.com. We’ll be right back. Read the full transcript.

Attorney Dave Farnbauch sits down with INsight at the Sweeney Studios to talk about new federal regulations that make hospitals put their billing rates online. Host: Welcome back. We’re here at the Sweeney Studios with Attorney Dave Farnbauch. We’re going to talk about new federal regulations that make hospitals put their billing rates online. Dave: Right. Host: That seems like a big deal to me. Dave: Well, for many years, Charity, hospital billing rates, and we’re talking about a large list. I’ve seen some estimates, it could be 40 different thousand, 40,000 different items – Host: Uh-huh. Dave: -- that a hospital can charge for. They’ve claimed that this information about their billing rates is proprietary information or it’s a trade secret, so hospitals have been very reticent about, sort of, allowing access or disclosure of their billing rates. Host: So this federal regulation now makes them put these rates online. Dave: Right. Host: Why? Dave: Well, it’s for transparency. I think it’s going to be an effort, part of the effort to sort of drive the cost of healthcare down. In the United States, Charity, 17 percent of our gross national product is spent on health care, and the average family spends more than $9,000 a year for health care. And compared to other countries around the world, we, we spend a lot more of our, you know, disposable income on healthcare, so the politicians are trying to take measures to, you know, drive down the cost of healthcare, and one of the ideas behind this idea is giving consumers data, you know, for comparison about what different hospitals charge for different procedures and things that they do, and so consumers now have access to go online and do that research and compare apples to apples. Host: So will this drive prices down? Will this, I guess I’m thinking, when I get a bill from the insur-, or not even a bill, but when I get a statement from the insurance and it says, “Here’s what the cost was. Here’s what our discount was. Here’s what you owe.” Because we all know our insurance deductible now is, for most of us, is so high that -- Dave: Right. Host: -- most of the time we don’t meet it. Dave: The way this new law, I think, is going to impact, you know, particularly what we’re interested in, as lawyers, is hospitals tend to, with, you know, sort of having no transparency – Host: Uh-huh. Dave: -- about their rates, they tend to target people that don’t, are not covered by a health insurance plan. So there are some people that are uninsured that, obviously, are going to want to know, be able to – Host: The cash rates -- Dave: -- compare rates. And there’s also people that end up at a hospital that’s out of network – Host: Uh-huh. Dave: So they get charged with, what we call charge master rates. Those are sort of the, you know, the sticker price that the hospitals charge. They call those their charge master rates. And what we encounter in our practice is when clients of ours are injured in a motor vehicle accident, they’re frequently, will go to a hospital for treatment and these hospitals will file hospital liens where they try to recover their charge master rates, in other words, the sticker price -- Host: Uh-huh. Dave: -- of those charges, from the proceeds of a personal injury case. So what we’ve been trying to do lately, when hospitals file these hospital liens, is to get information about their billing rates, so that we can prove to a judge when we’re resisting paying these sticker price rates for hospital charges, we’ll now be able to show them on their own, you know, website or whatever, what the hospitals are charging for their services and these charge master rates are just ridiculous. So it’s a way that we can get ammunition or information that the hospital puts out to take to court to show to a judge and say, “Look, Judge, these hospital rates that they’re charging, as part of their hospital lien, are just very unreasonable.” Host: So the rates that they’re going to have to put online are not the charge master rates, they’re the actual rates that, let’s say, the insurance company puts on the -- Dave: Right. Host: -- bottom line -- Dave: No, they, no, they are their charge master rates. Host: Okay. Dave: Okay. So most, most people are covered by a health insurance plan, so the different health insurance plan negotiate a much lower – Host: Lower rate. Dave: -- much lower rate. Host: Okay. Dave: As does Medicare and Medicaid. They negotiate significantly reduced rates. So most people are not going to be sort of impacted by the charge master rates. But if you’re injured in a motor vehicle accident -- Host: That’s where it’s really going to count. Dave: -- and they file a hospital lien, you’re going to want to have access to those charge master rates, so that you can prove that those rates are unreasonable. Host: And it really is so, it gets so confusing, which is why, that’s where you come in. You know, my running joke is, “I’m not a doctor, I don’t play one on TV.” Turns out I’m not an attorney, either. And I don’t play one of those on TV, either. And so that’s where having experts like you guys at the Sweeney Law Firm is so very important because it can get really contentious because the hospital, they want their money and people don’t want to pay. It just gets contentious, and so why not let the experts be fighting for you. So if you’ve been in an accident, all you have to do is call the Sweeney Law Firm and let them help you out. They’ll be glad to look at your case and tell you if, if you need to move forward with that. Give them a call today or visit their website, sweeneylawfirm.com. We’ll be right back. Read the full transcript.