Hundreds of DC's Medicaid nursing home patients sent to Maryland

There’s a growing crisis for some of the aging population in the nation's capital, advocates say. The News4 I-Team found some D.C. residents who need care are being sent long distances from the community they know. Hundreds of D.C. residents, some of them unhoused, are residing in Maryland nursing homes.     

On a hot September day, the News4 I-Team spotted Simon Reed, a Northeast D.C. resident, in his wheelchair along Stuart Lane in Clinton, Maryland, a suburb in Prince George’s County. He was panhandling outside a McDonald’s. 

He said he’s been living in the Clinton Healthcare Center for three years — longer than he ever expected. He said he was sent to Clinton after a medical emergency.

“I got my triple bypass, my heart surgery,” Reed said.

He told the I-Team a nonprofit that provides medical care to people experiencing homelessness in D.C. sent him to the Maryland nursing home.

Reed was one of many residents the I-Team observed over several weeks taking an almost daily dangerous trek along busy roadways in their wheelchairs and walkers.

It was that dangerous circumstance that first prompted viewer Melinda Williamson to contact the I-Team. She said she was concerned about safety for the nursing home patients.

“As you can look behind us, the residents are rolling up the hill in wheelchairs and many of them do not have motorized wheelchairs,” she said.

Williamson — a registered nurse who lives nearby — was so worried about what she saw she started talking with some of the nursing home residents to find out what was going on.

"A lot of it has to do with that there's no place for them to go is what many of them have shared with me,” she said.  

The I-Team found Simon isn't the only D.C. resident there.

DC lost 439 nursing facility beds in a decade

According to D.C.'s Department of Health Care Finance, 180 Medicaid beneficiaries had paid claims at the facility last year. The I-Team’s investigation found that this nursing home is part of a larger trend. 

Legal Counsel for Elderly Long-term Care Ombudsman Director Mark Miller said there's a reason more local people — especially the city's Medicaid patients — are being sent across the Maryland line.

"Right now, we believe there's probably close to 500 District residents that are in Maryland facilities, and D.C. Medicaid is paying millions of dollars for these people that are not in their own community," he said.

According to a 2021 long-term care study from D.C.'s Department of Health reviewed by the I-Team, the District lost 439 nursing facility beds in the past decade. Most of them were converted to other types of housing.

And when it comes to the D.C. Medicaid program, most nursing facilities enrolled — 31 out of 53 — were in Maryland. Three were in Virginia, though there were no D.C. residents in Virginia. 

"D.C. currently is under bedded in terms of nursing homes,” Miller said. “There's just not the capacity to meet the current need."

Miller called that more than an inconvenience, saying it’s also isolating for many of those residents. 

The I-Team found that it’s also potentially dangerous for some residents who find themselves in a new area. 

In August, Clinton Healthcare Center resident David Cunningham, who also uses a manual wheelchair, told the I-Team he was rushed to the hospital after being hit by a car — sustaining injuries that he said included a broken hip.

“I came across the street from the gas station, and the car hit me. And when it hit me, I blacked out,” Cunningham said.

DC's ability to look out for patients is limited when they are moved out of the District

Another patient died after being struck by a vehicle in 2016. After that incident, some of the nursing home residents told News4 the nursing home started providing reflective vests for those who leave the facility.

The I-Team took the neighborhood concerns involving some D.C. residents putting themselves at risk in traffic to Wayne Turnage, who serves as D.C.’s deputy mayor for Health and Human Services and the director of the Department of Health Care Finance.

“If that were to happen in D.C., the provider would find DC Health on their doorstep probably the next day,” Turnage said.

Turnage said the city's ability to advocate for its residents is limited when they cross state lines. While the city could pull the money it sends to facilities to care for its residents, that would possibly present a new set of challenges since there may not be anywhere else to put them.  

Turnage said he does not believe D.C. is building any new nursing homes right now. He said while the number of nursing homes has dwindled from 17 to 14, there is still space in some facilities. But he added not all nursing homes automatically accept every patient, especially those with more severe conditions.

"I can see situations where a person who was unhoused might have a difficulty finding a nursing home, especially if they don't meet the nursing home level of care criteria," Turnage said.   

Turnage told the I-Team his agency is looking at incentives for nursing homes that might have turned away certain patients in the past.

"We are evaluating our reimbursement methodology for nursing homes to see if there are things that we need to do differently to reduce the financial disincentive for taking patients who have these special needs.” Turnage explained.

A spokesperson for Clinton Healthcare Center emailed a statement, saying, “Ensuring the well-being of our residents is a top priority for the facility, and so is our focus and commitment to the safety of the surrounding community. The facility provides reflective vests and flags for residents’ wheelchairs. We have monthly resident council meetings educating the residents on safety precautions and do quarterly assessments to ensure they have the cognitive ability to make decisions. We take these responsibilities seriously and are an integral part of improving the broader neighborhood and being good community stewards.”   

The county is also doing something that could make things safer for residents. The Prince George’s County Department of Public Works and Transportation told the I-Team it's in the design phase for building new continuous sidewalks along Stuart Lane along with striping for a new crosswalk and streetlights. They estimate starting construction in 2025.

As for Simon Reed, he said he wants to get back to D.C. now, closer to his family.

"I go to visit them on the weekend,” he said. “Every other weekend I go to my sister's house."

Reported by Tracee Wilkins; produced by Rick Yarborough; shot by Steve Jones, Jeff Piper and Carlos Olazagasti; and edited by Steve Jones.