We Need to Put a Stop to “Warehousing” in Nursing Homes

The term “warehousing” implies that a residential facility – like a nursing home – is providing only food and shelter for a resident. Typically, it’s used to describe the process of placing a person with significant mental health concerns into a nursing home or assisted living facility, despite that facility not having the resources or skills to help. The issue of warehousing individuals with serious mental illnesses in nursing homes is a significant concern.

Investigations into California nursing homes uncovered that nearly 22,000 residents, constituting about 22% of the total, have serious mental illnesses. Placing individuals with conditions like schizophrenia and bipolar disorder in facilities designed for different purposes has turned many nursing homes into “de facto mental health centers.”

Despite efforts to prevent such placements, the percentage of nursing home residents with serious mental illnesses has risen dramatically over the past two decades, reaching 1 in 5 long-stay residents in 2019. The Preadmission Screening and Resident Review (PASRR) process has failed to effectively prevent such placements.

Physicians and hospital systems have an ethical responsibility to refrain from discharging individuals with serious mental illnesses to nursing homes. Efforts such as repealing PASRR exemptions and expanding community-based alternatives would be good steps toward enhancing care and support for this vulnerable population.

How are patients screened?

All nursing home residents are meant to undergo a preadmission screening for mental illnesses of intellectual disabilities. This process, called PASRR, was set up in 1987 to make sure people with such conditions aren’t placed in nursing homes inappropriately. However, there’s a problem – if someone is expected to stay in a nursing home for less than 30 days for post-acute care (like after surgery), they are exempt from this screening. This loophole can lead to nursing homes unintentionally becoming places for mental health care, especially for those with serious mental illnesses, as they might end up staying for a long time. Strengthening the PASRR process is essential to prevent this and ensure that individuals with serious mental illnesses get the right care in suitable community-based settings.

Who is meant to live in nursing homes?

Nursing homes are for people who don’t need to be in a hospital, but can’t be cared for at home. They provide round-the-clock nursing care and may offer therapy services. Some feel like hospitals, with medical care and structured schedules, while others aim for a more home-like atmosphere. Special care units may cater to those with memory issues, and some homes accommodate couples. Nursing homes are not just for older adults; they serve anyone in need of 24-hour care.

Where can patients with mental illnesses live?

Assisted living communities specializing in mental health care do exist, providing tailored support, therapeutic activities, and medication management for residents. These communities, often referred to as behavioral assisted living facilities, offer counseling and psychotherapy to residents with conditions such as bipolar disorder, schizophrenia, or substance abuse disorders. Housing options include group homes, care homes, and assisted living communities, with age requirements and diagnostic criteria varying among them. The entry process may involve a doctor’s diagnosis, social worker assistance, or referrals, depending on the payment method.

At Garcia & Artigliere, our experienced nursing home attorneys are deeply committed to the well-being of individuals in assisted living facilities. The quality of care in nursing homes is paramount to our personal and professional goals. We understand the significance of ensuring that these establishments provide a safe and supportive environment for residents. Our dedicated lawyers are driven by the mission to assist those who believe they have experienced abuse or neglect in nursing homes. With more than three decades of experience, our team is committed to assisting clients in pursuing justice. If you’re prepared to explore your case, you can complete our contact form or reach out to our office to schedule a free consultation. We have offices in Phoenix, Long Beach, Los Angeles, Louisville, and New Orleans. Let us help you.