Pearl River     No doubt about it, medical debt is a big thing.  It’s a case in point of how our old Latin teacher, a polio victim, used to define a coup de grace as “kicking a cripple.”  Someone is in desperate medical condition at the emergency room of a hospital or the admitting desk of a nursing home.  It’s not where they want to be, but it’s where they have to be.  They’re given a pile of papers, they sign whatever is put in front of them, and, if they are lucky, it all works out, and they live to fight another day.

Kaiser Health Network put out an outrageous and depressing piece the other day based on a survey they had done of nursing home patients.  About 1 in 7 adults who have had health care debt say they’ve been threatened with a lawsuit or arrest, according to a nationwide Kaiser Family Foundation poll. Five percent say they’ve been sued.  We’ve seen this story before from hospitals, including nonprofit, tax-exempt institutions that should have provided charity care and instead are putting liens on property and suing retired and minimum-wage workers for their bills.  But 1 in 7 nursing home patients hounded, and 1 in 20 sued, that’s crazy and just wrong.

There ought to be a law about that!  In fact, here’s what’s even wilder:  there is a law about that!  A federal law protects patients from such debt collection.  You would think that would settle the matter, but you – and I – would be wrong.  These nursing homes can’t sue the clients often, because they died and left the debt without resources to pay, so they are often suing family members.  As Kaiser point out: “Federal laws and regulations prohibit homes from requiring a resident’s relatives or friends to financially guarantee the resident’s bills. Facilities cannot even request such guarantees.”  But that’s not the end of it, “The nursing home industry has quietly developed what consumer attorneys and patient advocates say is a pernicious strategy of pursuing family and friends of patients despite federal law that was enacted to protect them from debt collection.”

Are you following this?  The homes can’t ask you to sign a financial guarantee, yet sometimes they slip that in the admissions paperwork anyway for someone to sign, and then later get their lawyers to sue you.  Many times, families ignore the debt collectors and lawsuits, frequently because they are in disbelief, but also because many can’t access or afford lawyers. They don’t show, so courts enter default judgements, and then the medical debts stick to them.  Sometimes families even pay, just to make it all go away.

Stories abound, and many are included in this report, of suits being filed against family friends and neighbors who may have visited someone in the home and never signed anything, but are sued.  Most of the suits filed in places like Rochester, New York, for example, didn’t include any proof that anyone had signed anything, but were essentially the public county facility and its law firm taking a shot anywhere they thought they might be able to collect.

I guess we could say that we’re lucky that only 1 in 20 get sued and only 1 in 7 end up with medical debt, but somehow that seems wrong, when the law is clear and the nursing homes breaking it know better.  The fact that these nursing homes, sometimes nonprofits and public facilities as well, know better and are supposedly about “care” not just money, even makes this more disgusting and infuriating.