Hoping for God’s grace is a dangerous business strategy

It would be nice to believe that all long-term care operators are doing things the right way.

And, to be fair, many are.

They show up each day to do difficult, necessary work — often with limited resources and even less appreciation. They care for vulnerable people, support families, and serve as anchors in many communities, especially in small towns and rural areas.

But we’d be kidding ourselves to stop there.

Just last week, a troubling case out of New York made headlines. The Van Duyn Center for Rehabilitation and Nursing in Syracuse agreed to pay $12 million to settle allegations of Medicaid fraud, chronic understaffing, and resident neglect. 

According to the attorney general, the operators diverted public funds meant for resident care, padded their own pockets, and allowed conditions to deteriorate so badly that residents were harmed — and some died.

Unfortunately, this wasn’t an isolated incident. It marks the fourth time Attorney General Letitia James has mandated major reforms at New York nursing homes following investigations into abuse, neglect and fraud. Six other homes in the state are currently under monitor oversight. Altogether, facilities and owners have faced more than $70 million in penalties. And no, these issues aren’t confined to New York.

Most providers aren’t defrauding Medicaid or allowing clinical chaos to unfold. But some are. And the comforting notion that these are just a few “bad apples” may not be as accurate as we’d like to believe.

When we publish stories about facilities in trouble, the page views shoot up. Every time.

Sure, some of that is curiosity. But sometimes, it’s because the story feels familiar. Too familiar.

Because while not every operator crosses the line, more than a few may be getting too close. In a business this hard — tight margins, staffing shortages, intense oversight — it’s easy to rationalize a shortcut or two.

That’s not an excuse. It’s a warning.

The industry talks about accountability. But too often, self-regulation remains more theory than practice. Few incentives exist to call out peers, and silence can feel safer than scrutiny. But that silence has a cost — both for residents and operators playing by the rules.

So yes, most providers are doing their best. That matters. But good intentions aren’t enough.

If stories like Van Duyn keep surfacing — and the clicks on those stories keep piling in — it might be time for the sector to ask itself a harder question:

Is the problem really just a few bad apples?

Or is it something deeper, that too many are hoping won’t come knocking?

As a 16th-century preacher once said — and as more than a few operators might quietly admit:

There but for the grace of God go I.

John O’Connor is editorial director for McKnight’s.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.