Showing posts with label scandal. Show all posts
Showing posts with label scandal. Show all posts

Friday, October 31, 2025

Nursing Homes' 'Bonus for Bad Care' Scandal: A Utah Spotlight on a National Crisis, and Why It Matters for Seniors and Families


A new investigation has peeled back the curtain on a troubling contradiction in American nursing home care: facilities receiving millions in taxpayer-funded bonuses for "high-quality" performance are often mired in allegations of neglect, understaffing, and abuse that endanger residents' lives. The
report, published by Fox13 in Salt Lake City,  centers on Utah's Upper Payment Limit (UPL) program, which has allocated over $1 billion in federal funds to nursing homes since 2017 to improve care for Medicaid-eligible elderly and disabled adults. Yet, an analysis of federal data by a law firm revealed that UPL facilities underperform compared to non-UPL ones in staffing, health inspections, and overall ratings, despite the subsidies. For readers of the Aging in Place Planning and Elder Law Blog, this isn't a distant Utah tale; it's a microcosm of a national epidemic where profit motives and regulatory expediency clash with patient safety.  These revelations underscore the urgent case for proactive planning to prioritize home-based care over institutional risks. As we've delved into in "Rethinking Elder Abuse Strategies: How Prophylactic Planning Can Safeguard Autonomy and Aging in Place," tools like advance directives, supported decision-making (SDM) agreements, technologies, aids, and trusts can help families sidestep these pitfalls, preserving dignity and assets amid a system where "bonuses for bad care" seem to be the norm.
The Utah Scandal: Millions in Bonuses Amid a Culture of NeglectUtah's UPL program, designed to boost Medicaid reimbursement rates for nursing homes serving low-income residents, has distributed over $100 million annually since 2013, ostensibly to enhance staffing, training, and quality. The Fox13 analysis of CMS data from 2017-2025, however, paints a grim picture: UPL facilities scored lower in staffing (average 2.8 hours/resident/day vs. 3.2 for non-UPL), health inspections, and overall ratings (3.5 stars vs. 3.8), while accruing more deficiencies tied to abuse and neglect. One chain, Beaver Valley Hospital (licensing more than 40 facilities), pocketed $26 million since 2016. Yet, St. George Rehabilitation facility (under Ensign Group) faces lawsuits alleging untreated bedsores, falls, and "beyond disgusting" care, including a resident left in feces for days. Another, Gunnison Valley Hospital, received $20.9 million amid "below-average" staffing and high turnover.
Families like Doni Hunt Webb's in St. George, featured in the Fox13 report, recount  "real people suffering," with CNAs averaging one per 20 residents amid "high turnover." The report ties this to a 2017 audit that revealed Beaver Valley kept 51% of the funds for administrative "seed money," with little oversight.  In other words, funds intended for improving care were instead used to subsidize profits. Utah DHHS defends the program as preventing closures, but critics, such as attorney Barry Toone, counter: "When you look at every metric, they're not doing better." Amid reports that nearly one in four facilities fail to meet staffing standards, this "bonus for bad care" raises red flags: taxpayer dollars (over $1 billion in Utah alone) are subsidizing subpar care, where neglect escalates to tragedy.Is This a Utah Problem or a National Epidemic?
While the report highlights Utah's UPL program, it's far from unique.  It's a microcosm of a nationwide crisis where bonuses reward reported metrics, rather than actual positive outcomes. Federal data repeatedly reveal that "the overwhelming majority of US nursing homes are operating with insufficient staffing to meet the basic needs of their residents."  According to Long Term Care Community Coalition (LTCC) federal data reveals that a shocking 9 in 10 nursing homes fall below their expected staffing levels. In the fourth quarter of 2024, 36% of facilities reported having zero (0) presence of a medical director, despite federal requirements that a medical director oversee the quality of clinical care provided in every facility.  Facilities aren't even making it easier for residents to cope; the average facility provided less than ½ minute (30 seconds) per resident day of a mental health service worker’s time. The CMS's Incentive Payment Program (IPP) and Quality Reporting Program (QRP) have awarded more than $10 billion in bonuses since 2018. For-profit chains (accounting for most of the market) continue to provide the worst outcomes.  This explains whmany residents view nursing home life as a "Fate Worse than Death," and why we warned that  "More is not Always Better" - CMS Adds Staffing Information to Care Compare.   Consider, also,  the following:   

What Does It Mean for Seniors and Their Families?For families, this means betrayal amid vulnerability. You select a "high-performing" home based on CMS stars, only to face neglect that drains savings, risks physical and psychological health, and emotional well-being, and strips seniors and their families of dignity.  For everyone, the financial toll is brutal: your taxes subsidize understaffing, leading to falls, infections, and worse, resulting in lawsuits and increased medical expenses, all of which are subsidized by taxpayer dollars.  Emotionally, it's devastating; trust is shattered, guilt amid suffering divides families and communities, and institutional alternatives only spread the misery, resulting in the "acuity mismatch" that we discussed in "Rising Malpractice Claims in Assisted Living."  Facilities profit from your trust, but care lags.Strategies to Avoid the Trap: Beyond Awareness to Autonomy
  • Home as Priority: Use advance directives. Deploy technology. Leverage HCBS waivers (Missouri/Ohio) for aides.
  • Caregiver Networks: Build SDM teams to monitor care; report red flags via ombudsmen (1-888-678-7277).
  • Advocate for Reform: Support calls for bonus audits; contact your senator to tie payments to verified staffing.
Conclusion: Bonuses for Bad Care Are a Call to Action
The Tennessee scandal reveals a system rewarding neglect, but you can opt out. While this article has provided a thorough analysis of taxpayer-funded care failures, it is by no means comprehensive. The landscape evolves rapidly. Readers must remain vigilant, consulting ProPublica, AARP, and elder law attorneys while evaluating risks. By combining awareness with SDM and trusts, families can safeguard independence and thrive while aging in place. For support, consult a professional—your security depends on proactive engagement. 



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