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Nursing Homes: Understanding How Residents Are Being Treated

July 08, 2020

cawleyI recently came across a story that I believe is one of the most heinous acts in treatment of older adults. I thought I have read some horrible acts but this one takes it to a new level of depravity. The New York Times discussed the treatment of elderly nursing home patients during the COVID pandemic. The story describes a systematic process of “dumping” nursing home patients in homeless shelters, rundown motels, or other unsafe facilities without the patient’s permission or without family being aware. Many of these evictions, known as voluntary discharges, violate federal rules that require nursing homes to place residents in safe locations and provide them 30 days’ notice before forcing them to leave. 1

Last fall, the Centers for Medicare and Medicaid Services changed the formula for reimbursing nursing homes making it more profitable to house the sickest patients for a short period of time. COVID–19 patients can bring in $600 more a day in Medicare dollars than people with mild health issues. In California, one of the largest health care companies that manage the largest number of for-profit nursing homes has been cited repeatedly for illegal evictions. One of the chief executives stated, “you are looking to replace the poorest, least profitable patients with the highest paying ones”. The story goes on to explain example after example of this illegal activity throughout the country. 1

If anyone has a family member in a nursing or long-term care facility, I recommend reading this piece—it will provide you insight. Please make sure you look out for your family members and protect them from this practice. Maybe you can prevent your loved one from ending up homeless and out on the street like a piece of trash. Our greatest generation deserve so much more.

Michael J. Cawley, PharmD, RRT, CPFT, FCCM, has more than 25 years of experience practicing in the areas of medical, surgical, trauma, and burn intensive care as both a critical care clinical pharmacist and registered respiratory therapist.


  1. The New York Times. “They Just Dumped Him Like Trash”: Nursing Homes Evict Vulnerable Residents. Accessed June 20, 2020.

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