Michigan cities balk at costly 911 calls to understaffed nursing homes

By Robin Erb, Bridge Michigan

Some Michigan cities are now charging nursing homes and other long-term care facilities to respond to nonemergency 911 calls made as a result of inadequate staffing at the facilities.

“I don’t like the word ‘threat,’ but I guess it kind of is,” said Mike Sova, EMS coordinator for Bloomfield Township Fire Department.

In 2019, the township passed an ordinance enabling the department to charge any assisted living, independent living, rehabilitation and “related and/or similar” facilities $200 to help staff lift a person who has fallen for example.

We’re happy to come out every time, but you will get a bill,” he said.

In Bloomfield Township, it worked so well that such calls immediately plummeted.

Sova said he couldn’t recall any facility actually being charged in those years: “It’s successful just having it in place.”

An increasing number of US communities have started charging for answering 911 calls in recent years, he and others told Bridge. That’s because staff at senior living facilities and nursing homes too often call 911 to request a ride for a resident to a doctor’s appointment or to help a resident who has fallen and isn’t hurt, but needs to be expertly lifted into bed or a wheelchair, he said.

That pulls emergency crews from more urgent calls — rushing a heart attack victim to the hospital or responding to vehicle accidents, for example. It pulls them, too, from station and vehicle maintenance or training, Westland Fire Chief Darrell Stamper told Bridge.

The southeast Michigan community passed its ordinance in June, allowing the fire department to charge facilities $350 for nonemergency transportation and $500 to help lift a resident. It was prompted by the 350-500 calls each year that the fire department responded to at such facilities, Stamper told Bridge.

Since the ordinance went into effect, he said, calls quickly dropped, he said, to “10 to 12 a month”

Sterling Heights can now charge facilities $500 to $800 for calls under a 2023 ordinance that specified that such calls are an “inappropriate and unwarranted drain on city resources,” blaming, among other things, a “lack of facility staffing, a disinterest by the facility in addressing these needs for their residents.”

A Sterling Heights spokesperson, through an email, said some senior living facilities “charge above market rates.” Nonemergency calls have dropped by about half since the law went into effect.

West Bloomfield Township Fire Chief Greg Flynn questions the practice, noting that emergency crews have a duty to safeguard community health and safety, not just respond to emergencies.

If a department decides it exists only to answer emergency calls, it must say “no” to nonemergency requests — plain and simple, Flynn said. It’s a “slippery slope” to charge some consumers for those calls and not others.

And it’s a matter of fairness. Even if fines are to be paid only by the facility, rather than individuals, those costs ultimately will be sifted into the residents’ rent and other increased costs, said Flynn, who is also chief of the EMS section of the Michigan Association of Fire Chiefs.

If a department takes a different approach, seeing its role of boosting the overall health and safety of its community, it typically will respond to residents in need — whether they are at home or in a facility, and whether it’s immediately life-threatening or not.

“This is why we’re here,” he said, speaking for West Bloomfield, “this is what we do.”

That’s true — to an extent, said Matt Sahr, president of the Michigan Professional Firefighters.

“When the tones go off our members go,” he said. But it’s up to the administration to make sure crews are “being used appropriately and effectively,” he said.

“We can’t be effective if we’re stretched too thin,” Sahr said.