Lies and Deception from the Nursing Home Industry

Last month [November 23,2003], Harriet McBryde Johnson wrote a wonderful piece for the New York Time Magazine titled: The Disability Gulag. I loved the article and feel that it is a great description of the fear of forced institutionalization that Americans still face. 

One letter in response to Harriet’s article shocked me. The President and CEO of the nursing home lobby wrote a letter to the editor about the piece, and it is as if he read a completely different article. I felt that the letter Charles Roadman, the head of the nursing home industry’s lobby, wrote exemplifies the lies and distortions that the lobby presses on Americans.

Following in italics is the text from Charles Roadman, with my comments mixed in. 

Johnson criticizes institutional long-term care and discusses long-term care only in terms of its relation to the government through the prism of Medicaid and the bureaucracy.

This statement is as if Harriet had only set out to criticize “institutional long-term care.” Of course, the article is actually about her life, fear and experience: institutional long-term care condemns itself. Do you want to live in a nursing home?

It's important for all involved in this growing, necessary public-policy debate to keep the ultimate delivery of quality care as the paramount focal point. 

AHCA is not concerned with quality of care and actively lobbies to reduce quality protections, staff requirements, health and safety standards.

We appreciate her desire for autonomy and control. We have called on policy makers to develop a comprehensive long-term-care plan, which should ensure people are cared for in the least restrictive setting based on their abilities, preferences and medical needs. 

The Nursing Home Industry does not want people just to have SIMPLE CHOICE, or REAL CHOICE, in long-term care. The letter misidentifies the “least restrictive setting based on the restrictions of ability, preference and medical need.” 

The ADA, however, does not say, “least restrictive setting based on ability.” It calls for a “public entity [to] administer . . . programs . . . in the most integrated setting appropriate to the needs of qualified individuals with disabilities.” It is clear that the Nursing Home Industry reads that mandate in the ADA paternalistically: “people with disabilities need medical attention and institutional help. Most Americans would read that as simple human need: Life, liberty and the pursuit of happiness; precisely the things that institutions cannot provide.

However, as the Olmstead decision noted, "That setting may be an institution.'' It also may be the choice of the patient and family. 

If Americans had REAL CHOICE they would not choose an institution and Mr. Roadman’s business would collapse. 
Furthermore, calling the person a “patient” begins to take away the individual autonomy of the person. Of course a patient needs a more restrictive setting, but Mr. Roadman does not deal with “people.” 

Finally, we take issue with Johnson's descriptions of long-term institutional care. Damning caregivers who perform with such heart and dedication is unnecessary. 

If caregiver work is so great, why does the Nursing Home Industry have such high job turnover and pay such low wages?

It is damaging to families and individuals who truly need and want the help of the long-term-care community.

Roadman acts as if Harriet attacked caregivers. He seems to want people to sympathize with the large, profitable nursing home industry because Miss Johnson is “damning” caregivers. Far from attacking caregivers Harriet discusses her own adult and professional relationship with caregivers and works to get reasonable state laws that will expand and improve the profession.

Charles H. Roadman 2d, M.D. 
President and C.E.O. 
American Health Care Association 
Washington

Please read Harriet Johnson’s article “The Disability Gulag.” I doubt you will sympathize with the multi-billion dollar, for-profit nursing home industry or their multi-million dollar lobby: AHCA.

- Tim Wheat