The IndyStar’s Tony Cook discusses Health and Hospital Corp.’s Supreme Court case

For decades, people on federal assistance programs like Medicaid have been able to sue state agencies if they do not receive the benefits they’re entitled to. The Health and Hospital Corporation of Marion County – a government agency in Indiana – wants to change that. 

On Nov. 8, the Supreme Court will hear arguments on a case out of northwest Indiana that could have massive national implications. WFYI’s Farah Yousry spoke with Tony Cook, an investigative reporter at the Indianapolis Star who has reported on mismanagement of taxpayer money and concerns over the quality of care at nursing facilities across the state owned by the Health and Hospital Corporation of Marion County.

Farah Yousry: What exactly is the Marion County Health and Hospital Corporation? And what did your investigations into this government agency over the past few years reveal about their track record?

Tony Cook: So, Health and Hospital Corporation owns 78 nursing homes across the state and operates the public hospital here in Indianapolis and the [Marion County Public] Health Department. They bought up all these nursing homes to access extra Medicaid money that's available to government-owned facilities, but they divert a lot of that money to fund the hospital. 

And so, what we found is that the nursing home quality has really lagged [behind] the rest of the nation. And staffing is pretty low compared to the rest of the nation. Indiana's nursing homes ranked 48th in the nation for staffing. And that's really key to quality because these are the people who are, you know, helping the residents on a daily basis.

FY: So, a lot of mishandling of public money and patient care quality issues. And recently, the family of one of the former residents of an HHC nursing home is suing the facility for over medicating and chemically restraining him and involuntarily transferring him to other facilities. In response, the agency decided to take a very wide pivot and open a Pandora's Box. Can you walk us through what happened here?

TC: So, a lot of times with nursing home claims, they would file a malpractice claim in state court. But that can be super challenging, because there's a lot of barriers, there are caps on damages, you have to go before a medical review panel, which can take years. So in this case, though, the family sued under the federal law, and said that HHC violated the [Federal] Nursing Home Reform Act. 

And so, what HHC has done to defend itself is, it has claimed and has asked the Supreme Court to consider whether federal beneficiaries of these entitlement programs should be allowed to sue at all – period. And so that's a huge question that could affect millions of people across the United States and prevent them from suing state or local governments if they feel like their rights are being violated or their benefits are being improperly denied. 

FY: It's a very high stakes legal battle. And a number of officials and state representatives have urged the Health and Hospital Corporation to withdraw its Supreme Court petition. What have you been hearing about that?

TC: Yeah, I mean, the pressure has really ratcheted up because advocates for low-income people, the elderly, disabled people are all up in arms about this because of what it could do. And so are liberal policy groups who want to defend Medicaid because they see that as a Democrat achievement that they want to expand and protect. And so they're really upset with HHC, which, you know, all of HHC’s Board members are appointed by either the mayor, city council or the county commission, all of which are controlled by Democrats. And so there's been a lot of pressure. 

It's turned into a bit of a political firestorm. And now, there are a lot of state lawmakers and city council members who are Democrats who are calling on HHC to drop this petition. And they made quite a fuss at the last board meeting. But so far, HHC has pretty much just refused to comment and has held its ground. So, it will be interesting to see what happens before oral arguments on Nov. 8.

READ MORE: To learn more about the arguments surrounding this case and its potential implications on tens of millions of Americans who rely on federal assistance programs, check out our reporting:

• A SCOTUS case that started in a nursing home could have far-reaching implications for millions
• As SCOTUS hearing nears, lawsuit alleges Health and Hospital Corp. broke Indiana law
• Advocates and lawmakers urge Health and Hospital Corp. to withdraw SCOTUS case