I had just returned from a visit with my sister, who has lived at the Seashore Point Wellness Center in Provincetown since 2018, when I saw the Independent’s July 25 front-page story “Patients Suffer at Outer Cape’s Only Nursing Home.” I read it and the subsequent articles with great interest.
I have been very pleased with the care my sister has received over the past six years. With very few exceptions, I have found the staff pleasant, helpful, and understanding. My sister is clean and has no bedsores, which is remarkable for a wheelchair-bound, incontinent person. She is dressed most days (except when she doesn’t want to get up), her hair is shampooed and braided regularly by certified nurse aides, and she is fed on schedule and toileted as needed. The CNAs do a terrific job of caring for her.
Still, I have noticed a negative change since Point Group Care took over from Deaconess in 2019. Staffing is variable. I used to know who the administrator, social worker, and nursing supervisor were, but now it is not as easy. Maintenance is poor: light fixtures, heating units, and window blinds are broken. I haven’t seen any walls painted or rugs shampooed in years. I have wiped down my sister’s wheelchair many times, whereas they used to be power-washed on a regular schedule.
It is difficult for all nursing homes in Massachusetts to find CNAs and nurses to cover every shift. How does a $45,990 penalty imposed on Seashore Point by MassHealth help the nursing home find sufficient staffing? Where does the $4 million settlement reached by Attorney General Campbell with Next Step Healthcare go?
Why not create a CNA fund and give hefty bonuses (or increase their hourly pay) to those who fill open slots? Find a way to pay more to the frontline workers who change diapers, give showers, and spoon-feed our elderly residents.
The issue of potential fraud raised by Christopher Cherney and Ernest Tosh reminds me of the Steward Health Care crisis. “Management” companies, real estate brokers, and marketing outfits that are often just arms of the parent company simply siphon money from patient care into investors’ pockets.
Nursing homes focus on the custodial care of people who can no longer live on their own. Why would they take on sicker, more complex patients who need short-term rehabilitation? It’s the money. By billing Medicare and private insurers for rehab services (physical, speech, and occupational therapy), they can make up the shortfall created by the meager MassHealth custodial care payments. But just because you are good at custodial care doesn’t mean you’ll be good at rehab. Dignity Alliance Massachusetts is right to push for better outpatient rehab and home care, as the Independent reported last week.
Seashore Point proudly states it is in compliance with federal and state regulations. And that is the problem. The companies that control hospitals, physician groups, nursing homes, medical suppliers, and rehabilitation services focus on producing high profits. They are not part of a unified system of health care and health-care reimbursement. They simply prey on the most vulnerable of our citizens.
While you may rail against “socialized medicine,” until the U.S. moves away from a profit-motivated health-care model to a system that sees health care as a right, these issues will persist. Baby boomers will not be happy as they enter the golden years.
Donna Cooper is a retired internist with a master’s degree from the Harvard School of Public Health. She worked at Outer Cape Health Services and Mass. General Hospital and lives in Provincetown.
