I thought it was crazy.”
Lucille Brooks, 74, Pittsford, NY
Approximate medical debt: $8,000
Medical problem: None. She was billed for her brother’s care.
What happened: Lucille Brooks was stunned to find that a nursing home in Monroe County, New York was suing her. She had never been patient there. Neither did her husband. “I thought that was crazy,” she said, thinking it must have been a mistake.
The bill was for treatment his brother, James Lawson, received in the summer of 2019. He was hospitalized for complications from diabetes medication. The hospital sent him back to the county-run nursing home, where Brooks had visited him a few times. Nobody ever talked to her about billing, she says. And he was never asked to sign anything.
Brooks and Lawson were part of a large family that moved north from Mississippi to escape segregation in the 1960s. Lawson had a career with the Rochester Department of Parks and Recreation. Brooks worked in insurance. They lived on both sides of the city. “My brother has always minded his own business,” she said.
Lawson spent two months at the nursing home. A year later, Brooks was sued.
The county alleged that Brooks should have used her brother’s assets to pay her bills and was therefore personally liable for her debt. Attached to the suit was an admission agreement with what looked like Brooks’ signature.
What is broken: Admission agreements often name the person signing as a “responsible party” who will help the nursing home collect payments or enroll the resident in Medicaid, the government’s safety net program.
Consumer advocates say nursing homes slip agreements into papers that family members sign when an older relative or sick friend is admitted. Sometimes people are told they have to sign, a violation of federal law. “They’re given a stack of forms and told, ‘Sign here, sign there. Click here, click there,” said Miriam Sheline, chief attorney at Pro Seniors, a Cincinnati nonprofit law firm.
Litigation is a frequent byproduct of the medical debt crisis in the United States, which, according to a KHN-NPR survey, has affected more than half of all American adults over the past five years.
According to a national KFF survey, about 1 in 7 adults with health care debt say they have been threatened with lawsuits or arrest. Five percent say they have been prosecuted.
The nursing home industry has quietly developed what consumer attorneys and patient advocates say is a pernicious strategy of suing patients’ family and friends despite federal law that was enacted to protect them from collection. of receivables.
In Monroe County, 24 federally licensed nursing homes filed 238 debt collection cases from 2018 to 2021 seeking nearly $7.6 million, KHN found. Nearly two-thirds of cases involved a friend or relative.
Many have been accused – often undocumented – of concealing residents’ property. The practice can intimidate people with means into paying debts they don’t owe, said Anna Anderson, an attorney at the nonprofit Western New York Legal Aid. “People see this in a trial and they think they’re accused of theft,” she said. “It’s frightening.”
What’s left: When the bill came, Brooks was so worried she didn’t tell her husband. “People like us live on a fixed income,” she said. “We don’t have money to throw away, especially when you don’t see it coming.”
Brooks turned to Legal Assistance of Western New York, a nonprofit organization, which has represented defendants in such cases. In time, Monroe County dropped its charges against her. Brooks said she believed the signature on the admission agreement had been forged from the nursing home’s visitor log, the only thing she signed.
Now she’s telling anyone who has a friend or relative in a nursing home not to sign anything. “It’s ridiculous,” she said. “But why do you think they would come after you?”
About this project
“Diagnosis: Debt” is a reporting partnership between KHN and NPR exploring the scale, impact and causes of medical debt in America.
The series is based on the “KFF Health Care Debt Survey”, a poll designed and analyzed by KFF public opinion researchers in conjunction with KHN journalists and editors. The survey was conducted from February 25 to March 20, 2022, online and by telephone, in English and Spanish, among a nationally representative sample of 2,375 American adults, including 1,292 adults with health care debt. and 382 adults with health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other poverty, race, and health status demographics to explore where medical debt is concentrated in the United States and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed the records of a sample of Chase credit cardholders to examine how customer balances can be affected by large medical expenses.
Reporters from KHN and NPR also conducted hundreds of interviews with patients across the country; spoke with doctors, healthcare industry leaders, consumer advocates, debt lawyers and researchers; and reviewed dozens of studies and surveys on medical debt.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health policy research organization not affiliated with Kaiser Permanente.