According to a new federal report, nearly 80% of hospice care centers had deficiencies in care, some which were serious acts of abuse or resulted in life threatening injury.
The U.S. Department of Health and Human Services Office of the Inspector General has released two reports, which outline serious deficiencies conducted at more than 300 hospice care facilities in the U.S. that participated in Medicare.
The 2019: Vulnerabilities in Hospice Care reports also warns about the large number of facilities considered poor performers, and indicates that more than 80% of the facilities had at least one deficiency.
Nearly every hospice center in the United States that provided hospice care to patients through Medicare was included in the study. The report focused on patient care from 2012 to 2016.
In some cases, patients were seriously hurt by the poor care provided by facilities. In other cases, facilities failed to act in cases of abuse conducted by employees.
Severe complaints were lodged that focued on unsanitary conditions within the facilities. This included wounds that were badly treated or not treated at all. For example, wounds were left untreated and turned gangrene, eventually requiring amputation of the limb. In other instances, maggots were allowed to develop around a patient’s feeding tube.
More than 80% of hospice facilities had at least one deficiency, while most facilities had multiple deficiencies, and 1 in 5 had at least one serious deficiency.
Other deficiencies included failure to recognize signs of sexual assault of a patient and allowing a patient’s wound to remain untreated for two years.
In some cases, the facilities owners and employees faced criminal charges. In one facility in Texas, nurses admitted to overmedicating patients to quicken patients’ deaths and receive higher payments from Medicare. This resulted in several overdose deaths.
Other facilities admitted patients who weren’t terminally ill and altered their medical records to make them appear more ill.
Hospice care is typically offered to patients who are terminally ill with a life expectancy of six months or less and who often require palliative care to help ease severe pain. Medicare spent $17.8 billion for hospice care for nearly 1.5 million patients in 2017.
Offending centers were located in states across the country. The worst offending facilities were in California, South Carolina and Texas.
The reports offered recommendations to strengthen safeguards to protect Medicare hospice patients form harm. They called for the Centers for Medicare and Medicaid (CMS), the agency responsible for administering the Medicare program, to improve oversight of hospice facilities.
The recommendations also call for CMS to focus on enforcement tools as well as collection and analysis of deficiency data.
This year CMS issued new guidelines to inspectors of hospice facilities to help them identify issues quickly and prevent patients from experiencing safety and health issues.
Anyone who has experienced or witnessed abuse, neglect, poor care, or financial discrepancies in a hospice should contact the hospice administrator, the state department of health, or the Medicare hotline at 1-800-Medicare. If a potential crime has been committed the police should be contacted immediately.