Nursing homes may be illegally refusing residents in need of addiction treatment

Nursing facilities routinely turn away patients seeking post-hospital care if they are taking medicine to treat opioid addiction, a practice that legal experts say violates the Americans with Disabilities Act.

After discharge from the hospital, many patients require further nursing care, whether for a short course of intravenous antibiotics, or for a longer stay, such as to rehabilitate after a stroke. But STAT has found that many nursing facilities around the country refuse to accept such patients, often because of stigma, gaps in staff training, and the widespread misconception that abstinence is superior to medications for treating addiction.

In Ohio — where 100 people a week died of opioid overdoses between August 2016 and August 2017 — a trade group representing more than 900 care facilities said in a written statement that none of its member facilities accepts patients who receive methadone or buprenorphine for addiction.

In Massachusetts, another state that is reeling from a flood of opioids, a nurse case manager at Boston Medical Center said it can be “next to impossible” to find a place that will accept a patient who takes these medications.

“It’s so bad — you’re just begging and pleading with these places,” said Maureen Ferrari, a nurse case manager who for nearly a decade has worked at Boston Medical Center finding post-hospital placement for patients. She said only two nursing facilities in the Boston area accept people on addiction medicines, adding that this roadblock can harm patients and turn a two-day hospital stay into one that is a week long, driving up health care costs.

Experts say it is illegal under the ADA for a nursing facility to refuse admission simply because a patient is prescribed addiction medicines.

“It’s well-settled in the case law that people with opioid use disorder have a disability as recognized under the ADA,” said Sally Friedman, legal director of Legal Action Center, a nonprofit policy and law group based in New York City.

“Opioid addiction is a chronic disease like any other, and nursing homes should be ashamed of themselves for excluding people who are receiving the most effective form of treatment for this chronic disease,” Friedman said.

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