An 18-month Indianapolis Star investigation uncovered how government officials in Indiana took millions of dollars in federal nursing home funds and used it instead to pad the bottom lines of hospitals, leaving Hoosiers with some of the worst nursing homes in America as the COVID-19 pandemic struck.
The series, “Careless,” found that county hospitals across the state had bought up nearly all of Indiana’s 534 nursing homes, at least on paper, to access enhanced Medicaid funds available to government-owned homes. But much of the money – more than $1 billion – never reached the vulnerable nursing home residents for whom it was intended.
Instead, public hospital executives exploited the program’s loose rules and diverted most of the extra money to hospital construction projects. Some of those executives received big pay increases, too. And because they provided little oversight, millions more was lost to fraud, with allegations of $65 million at two hospital-owned nursing home systems alone.
Failures at every level of government allowed the system to persist. Federal and state Medicaid officials don’t track how the money is spent. Reports calling for reform gathered dust on the shelf. And state officials, who have received millions in campaign contributions from the industry, cloaked the spending in secrecy with unusual exemptions to the state’s public records laws.
The consequences have been devastating for Indiana seniors. The diverted funds left Indiana with some of the most poorly staffed nursing homes in America. IndyStar found inspection reports and wrongful death claims that painted a picture of dangerously understaffed facilities: Bedsores allowed to fester until limbs had to be amputated, repeated falls that left residents with fatal head injuries, violent attacks among unsupervised residents.
And that was before the pandemic.
Indiana’s nursing home workforce, already among the thinnest in the nation, was quickly overwhelmed by the coronavirus, leaving residents trapped in facilities that became tinderboxes for COVID-19 and contributing to hundreds of deaths that likely could have been prevented with better staffing.