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Nursing Care Patients’ Families Fighting Alleged Abuses

STOCKTON -- Some nursing home chains in California are coming under fire for a practice that illegally prioritizes some patients over others based on how much of a payout insurance will pay the individual nursing home for each.

“I always show her pictures. Sometimes it’s the same picture over and over again and she’ll see herself, and she’ll smile,” John Torres said, describing his interactions with his mother Esther. She is one of the more than 5 million Americans with Alzheimer’s.

Her decline has been devastating for her family. There are days she doesn’t recognize her own children.

“She starts going into that wonderland if you will. Not knowing where she is or who people are,” John said.

On top of their heartbreak, John and his wife Alicia now have a second battle on their hands.

The say they’ve put Esther in three Stockton based nursing homes already, two of which discharged her without giving them proper notice.

“They brought her from the facility inside the house. Opened the door, put her on a chair and left,” Alicia said. “They’re saying we will take care of your mom don’t worry, and you feel assured. But for some reason, something changes.”

Alicia handles Esther’s medical payments and history. She says the problems started when they switched her health provider from Medicare to MediCal.

“What’s happened is the money’s gotten the best of the providers," Tony Chicotel said.

Chicotel, a spokesman with the California Advocates for Nursing Home Reform, says what’s been happening to the Torres family is no coincidence. He urges consumers to follow the money.

"Medicare pays a significantly higher rate per day for nursing home care than [MediCal] or even private pay dollars do," he said.

According to Chicotel, the problem is Medicare only provides a few months’ worth of nursing home care to patients. When that runs out, as it did in Esther’s case, he says some nursing homes rush to fill her bed with someone else on Medicare.

“The more you occupy your beds with Medicare residents, the more money you’re going to make. Sometimes three or four times as much.”

It’s called patient dumping and it's illegal.

Under California law, nursing homes need to notify patients 30 days before they’re let go. Chicotel says in some cases that is not happening.

He’s working on a class action lawsuit filed against Sava senior care, one California based nursing home chain, where he claims patient dumping is prevalent. But he says it’s not the company doing it.

“It’s a very widespread problem. It involves dozens of nursing home chains in California, hundreds of individual nursing homes. It’s a problem that’s affected northern, central, southern California. We hear about it everywhere," Chicotel said.

Others have filed lawsuits. FOX40 found at least three other cases filed in California against other nursing home chains for similar issues.

In 2016, Genesis Healthcare, which owns the Creekside nursing home where Esther stayed in January, settled a federal lawsuit for $53.6 million.

According to federal investigators, the company was illegally billing Medicare on the backs of patients. The suit stated at some homes, “their services were grossly substandard and/or worthless."

Esther’s family isn’t part of the current lawsuit, but they suspect money is the driving force behind ester’s multiple discharges.

“Find a reason to move them out and wait for the next person who can pay. That’s the impression I’m getting,” John said. "How I feel is angry, frustrated, confused and sometimes defeated by how that system works.”

We reached out to two facilities from which Ester was discharged, Creekside and Lincoln Square. They did not respond to our requests for comment.

Sava Senior Care and Genesis Healthcare did not respond to our requests for comment.

But, a representative from Mission Carmichael, a care facility owned by Sava, did respond to the lawsuit, saying only that they’re “aware of the case” and “cannot comment about the specifics”

As for the California Association of Health Facilities, the agency in charge of nursing homes, a representative sent FOX 40 a statement, which
She says, in part:

"…inappropriate discharges may be taking place at an annual rate of .03 percent in California. While this may be statistically insignificant, we remain concern about any inappropriate discharges from skilled nursing facilities."

For the Torres family, any subtle changes to Esther’s life aren’t easy.

“It’s really hard for somebody with dementia to have unfamiliar surroundings. New hallways, new people, different color uniforms, I mean just the little things,” John said.

They’re hoping the courts might have an answer to spare other families from what they are going through.