A recent Office of the Inspector General report revealed the poor lack of oversight by Medicare over hospices that participate in the Medicare program. The OIG report recommends much stronger oversight “to protect Medicare hospice beneficiaries from harm.”
In one gruesome example, the Washington Post reported that a Missouri state inspector cited Vitas Healthcare, the country’s largest hospice for putting a patient in danger by skipping home visits and failing to determine the patient’s pain levels. The patient required a trip to the emergency room for a maggot infestation in a poorly treated pressure wound. Vitas didn’t agree with or dispute the report, but did say it would take steps to review patient supervision.
The OIG report further did not mention the hospice providers, or the states where their examples of harm occurred. The Washington Post was able, through its own research, to connect the Missouri case to one of the examples listed in the OIG report.
The OIG report included:
- A patient who needed an amputation because his/her bedsores became gangrenous
- A patient who was sexually assaulted, and whose assault was discovered at the hospital, not by the hospice workers
- A patient who was denied his/her rightful medication and “died in pain” as a result
What is hospice care?
Hospices generally provide care to people in their home or in a home-like setting. The hospice should care for a patient’s physical, emotional, and social needs. It should work with family caregivers. A hospice normally focuses on a person’s pain and making the best of their remaining days: “To qualify for hospice coverage under Medicare, a patient must be terminally ill with a prognosis of living less than six months. But as increased numbers of patients with Alzheimer’s disease and other forms of dementia enter hospices, many are living far longer than six months.”
Medicare’s lack of oversight
Most hospice care is covered by Medicare. The hospices “did not face serious consequences — largely because Medicare has few disciplinary tools at its disposal, the inspector general said.” Unfortunately, consumers have few options for lodging complaints with Medicare. Medicare doesn’t impose fines or sanctions. It can remove a hospice from the Medicare program, but it’s rare that this happens.
The Post further reported that as of 2018, hospices are inspected about once every three years. Hospice companies have few requirements for notifying Medicare of patient care violations. Medicare’s website does not help much when it comes to determining which hospices provide the best or, at least, quality care. The substandard examples such as the Missouri maggot infection generally go unreported on the website.
About two-thirds of the hospice care providers are estimated to be for-profit companies.
Can you sue a hospice for your injuries and damages?
Medicare may not be taking adequate steps to correct hospice abuse and negligence, but that doesn’t mean you have no options. Hospice providers are subject to civil lawsuits. If a hospice contracts to take care of a patient, it must provide reasonable medical care. While experienced legal counsel can verify that care was substandard, there are some challenges in filing hospice care negligence and abuse cases:
- The first is that the patient may die by the time the lawsuit is ready for trial;
- A second is that the hospice may claim the patient was already suffering, and that it bears no liability for that; and
- A third is that patients may often not be able to testify due to Alzheimer’s or other cognitive failures.
At Bailey & Greer, PLLC, our experienced Memphis injury attorneys work with gerontologists and other senior health care physicians to determine if poor hospice care was negligent, abusive, or medical malpractice. We work to show that even patients with short life expectancies deserve to be treated with proper care and that every effort should be made to extend their life as much as possible. A year or several years to a senior is a lifetime for many.
If a loved one wasn’t given proper hospice care, call 901-475-7434 or fill out our contact form to learn if your loved one and his/her family has a claim against the hospice provider. We represent patients and families throughout West Tennessee including Memphis and Jackson.