- Policies that boost ‘accountability’ and ‘transparency’ — and a focus on nursing home profits — could better protect nursing home residents, advocates said Wednesday
- Lawmakers heard from residents, by video, that described poor care and neglect
- A nursing home industry representative countered that Michigan facilities provide more hours of care than many states; they do not hide profits, he said
Advocates for better nursing home care Wednesday handed Michigan’s lawmakers a wish list of at least four policy changes they say would boost quality of life for Michigan’s nursing home residents and save taxpayers money.
Following a Bridge Michigan investigation into nursing home conditions, advocates are demanding more transparency and accountability. Some residents go weeks without showers, eat meager or burned meals and endure linen changes that leave beds “saturated,” Salli Pung, who heads the state’s Michigan Long Term Care Ombudsman Program, told the Senate Oversight Committee.
“One resident asked us what (they did) wrong, because they felt like they were in prison,” Pung said.
“Another resident said he felt like he was a plant in the corner that the staff just had to water to keep alive,” she said.
In January, Bridge Michigan published an investigation into nursing homes that documented at least 5,915 cases of abuse, neglect, exploitation or quality of life and care violations in the past four years. In all, homes have been fined $21.5 million over the past three years and been denied a total of 6,451 days of Medicaid reimbursements.
Bridge found that nearly three dozen residents died of suspected abuse or neglect in the past four years.
Michigan is doing little to significantly improve care at other homes, even as other states are changing laws and policies to better protect their residents, Bridge found.
Pung and other advocates cited some of those changes elsewhere Wednesday. More than 44,500 residents now live in some 427 homes, she said.
Pung and others told senators that Michigan lawmakers should:
- Raise minimum staffing levels
- Tie Medicaid reimbursements to staffing and quality-of-care ratings
- Prescribe spending so that a certain amount is focused on resident care
- Expand the ability of the Michigan Department of Health and Human Services to audit nursing homes
“We recognize none of this oversight happens without staff to really do a deep dive, and examine and keep tabs on what nursing homes are really doing,” Alison Hirschel, director of the Michigan Elder Justice Initiative and a longtime advocate for improved nursing home care
Republican Sen. Ed McBroom, of Vulcan, pushed back on the suggestion to expand state oversight of nursing homes, noting criticisms of Gov. Gretchen Whitmer’s administration for its handling of nursing home policies during the pandemic. The administration also was accused of undercounting COVID deaths in long-term care.
The health department should not be in charge of expanded auditing, McBroom said, citing what he called “an unwillingness to really peel back unpleasant truths.”
For years, chronic understaffing in some of Michigan’s nursing homes has been a chief concern for critics. Michigan requires just 2.25 hours of care a day for a resident, Pung told lawmakers.
That minimum was established in 1978, and it falls far short of the recommended 4.1 hours a day. A Bridge analysis last year found that many Michigan nursing homes routinely exceed that minimum, but some fall short.
Related:
- Abuse, neglect common in Michigan nursing homes — and no one is coming to help
- 7 ways to fix Michigan nursing homes
- Few staff, little training. Misery can follow
- ‘Green Houses’ offer cozier alternative to Michigan nursing homes
Critics also say nursing homes can “tunnel,” or redirect, profits from quality care, allowing corporate owners to profit on the suffering of residents.
A lack of transparency sets up a “cat-and-mouse” game between nursing homes and regulators, Ashvin Gandhi, an economist at the Anderson School of Management at UCLA and a faculty research fellow at the National Bureau of Economics Research.
Gandhi examined budgets of Illinois nursing homes, concluding that the industry hid about 68% of profits by setting up related parties — businesses that provided services to the nursing homes, according to a 2025 paper for the National Bureau of Economic Research.
The “related parties” — also owned by the nursing home owners — overcharged for services, “tunneling” nursing home profits through the related party and back to owners, Gandhi told lawmakers.
Hirschel said the homes’ annual reports are detailed — yes, but “nearly indecipherable” to most Michiganders.
But a representative from the Health Care Association of Michigan, which represents most Michigan nursing homes, told lawmakers that Michigan’s facilities staff their homes at some of the highest rates in the nation — more than four hours, according to most reports, Richie Farran,the organization’s vice president of government services, said.
Farran also said nursing homes do not — and can not — hide profits. Annual cost reports are detailed and audited, he said.
Overpriced supplies or services would be flagged by the state, he said.
“Every single one of those dollars is reported on a cost report, and there is a robust auditing process through MDHHS to ensure that those are spent on allowable costs,” Farran said. “You can’t just pay $10 million for the therapist.”
Thank you to our Michigan Health Watch Sponsors
Bridge Michigan Health Watch is made possible by generous financial support from our sponsors. Sponsorship supports our independent journalism mission but does not constitute sponsor endorsement of individual articles or editorial content. Bridge Michigan journalism remains fact- and data-driven and independent at all times.
Please visit the About page for more information and to subscribe to Health Watch. Interested in becoming a sponsor? Contact Emma Carr.
Republish our articles for free, online or in print, under our Republication Guidelines. Questions? Email republishing@bridgemi.com
You must be logged in to post a comment.