Privatized Hospice Fraud

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  • Ian McColgin
    Senior Member
    • Apr 1999
    • 51666

    Privatized Hospice Fraud

    [IMc - Below is a good short version. For the full Washington Post article: http://www.washingtonpost.com/busine...0a2_story.html
    It is not only possible but rather easy to find effective, loving, and compassionate hospice care, as we did for Mother and I have done helping families of various friends. You need to check the record since being ‘non-profit’ does not guarantee that the operation is authentically operating as a service rather than as a cash cow, but it’s not hard.]

    Published on Friday, December 27, 2013 by Common Dreams

    Investigation Reveals Rampant Fraud by Privatized Hospice Groups
    Siphoning billions of Medicare dollars, for-profit hospice companies found recruiting non-dying patients

    - Lauren McCauley, staff writer

    A Washington Post investigation into the world of hospice care published Thursday found that what was initially intended to be a peaceful end-of-life alternative led by religious and community organizations, has now evolved into a $17 billion for-profit industry ripe with scams and abuse.

    Hospice care, which focuses on providing comfort to the terminally ill rather than finding a cure, is funded primarily by Medicare—which makes an estimated 85 to 90 percent of all payments to hospices.

    Quick to capitalize on this booming industry, since 2000 the number of hospices run by for-profit companies has jumped from 30 percent to nearly 60 percent—with an even larger share of the patients; during the same period, Medicare expenditures on hospice jumped from $2.9*billion to $15.1*billion.

    And as the Post investigation reveals, in order to maximize profits, these for-profit hospice groups have begun aggressively recruiting patients who aren't actually dying.

    "Medicare pays a hospice about $150 a day per patient for routine care, regardless of whether the company sends a nurse or any other worker out on that day. That means healthier patients, who generally need less help and live longer, yield more profits," the Washington Post reports.

    Painting a picture of an industry that has morphed from merciful to miserly, the Post describes the efforts by companies to recruit new patients:

    Hospice “outreach specialists” and “community education representatives” seek out patients in a variety of ways: They solicit doctors and hospitals who might regularly deal with the terminally ill; they make connections at nursing homes, assisted-living developments and Meals on Wheels groups. They show up at the “health fairs” held at senior centers with, for example, machines that test blood pressure. For families struggling to take care of a loved one, they offer the promise of extra help.

    At AseraCare, officials gave advice to their recruiters on how to close a deal with families who are “not ready yet” for hospice, according to a company presentation for Alabama employees. It instructed recruiters to “focus families” by stressing the urgency of a decision, and saying things like, “We only have 10 minutes left.”

    “Effective communication is the transfer of emotion, not information,” the presentation said.
    Other companies reportedly offered employee bonuses for meeting "new patient" goals and one hospice group in LaGrange, Ga. went so far as to "cruis[e] neighborhoods, looking for elderly people with disabilities."

    “It must be strange to be told you’re dying and then not die,” said Jim Barger, a lawyer in Birmingham, Ala. who has filed a number of suits against these for-profit companies.

    According to Barger, while hospice requires that two doctors initially certify that a patient carries a life expectancy of six months or less, afterwards the hospice itself is charged with re-approving their stay.

    “It is common knowledge in the industry that a longer length of stay is going to be more lucrative,” Rachel Mason, who worked at Delta Hospice in California, told the Post. “If they come in very sick and die right away, it’s difficult to run a business that way.”
    _____________________
    This work is licensed under a Creative Commons Attribution-Share Alike 3.0 License.
  • George Jung
    Senior Member
    • Jan 2004
    • 31057

    #2
    Re: Privatized Hospice Fraud

    I've not encountered that one yet. But there's an awful lot of stinkers out there.
    There's a lot of things they didn't tell me when I signed on with this outfit....

    Comment

    • Ian McColgin
      Senior Member
      • Apr 1999
      • 51666

      #3
      Re: Privatized Hospice Fraud

      Population density helps this sort of fraud thrive. Not enough money in rural areas and people talk to each other too much.

      Comment

      • LeeG
        Senior Member
        • May 2002
        • 73004

        #4
        Re: Privatized Hospice Fraud

        I wonder about the statement below, in my limited experience non-ambulatory patients getting palliative care don't require as much care as patients wandering about, getting pt, wound care, and regular meals. The other thing is that some people on a downward spiral might sign up with hospice, recover, then sign off. I don't doubt some care institutions might have people engaging in practices for the shareholders benefit but I wonder how much of this story is lawyers finding new cases.
        I guess I've been on the volunteer, patient care part of hospice too much to think poorly of the institution. I'll reread the article.

        ""Medicare pays a hospice about $150 a day per patient for routine care, regardless of whether the company sends a nurse or any other worker out on that day. That means healthier patients, who generally need less help and live longer, yield more profits," the Washington Post reports."

        Comment

        • Ian McColgin
          Senior Member
          • Apr 1999
          • 51666

          #5
          Re: Privatized Hospice Fraud

          One way or another I've been at least tangentially involved with the hospice movement since 1971 and I came into the orb of Elisabeth Kübler-Ross and broke from the then conventional approach to pastoral clinical interactions with the dying that we were being taught. I had thought of hospice as essentially incorruptible but then I'd never thought of it on a well monetized for profit model. This is rather like the the Nixon era "Medicaid mill" phony HMO's in their day - creative crime.

          Most hospice operations are really wonderful and the small number of crooks that syphon off such a vast share of the dollars must therefore be more vigorously exposed and punished.

          Comment

          • George Jung
            Senior Member
            • Jan 2004
            • 31057

            #6
            Re: Privatized Hospice Fraud

            It all depends on the organization, and who's running it. The rural hospice in my former town was excellent - until there was a leadership change (administrator of the hospital); suddenly they were more interested in the bottom line than the care; the nurse who had made it work so well, with a team of three, left; they replaced those four with one nurse, and it basically imploded.

            AFA 'not enough money', there's a surprising amount here in Lincoln; 300,000 population or so; hospitals gobbling up practices as fast as they can; big players moving to take them over, as well, and succeeding. One thing they're very adept at is separating folks from their bank accounts. There's lots of stinkers here, as everywhere; it's just I haven't seen/heard of this particular fraud.
            There's a lot of things they didn't tell me when I signed on with this outfit....

            Comment

            • Ian McColgin
              Senior Member
              • Apr 1999
              • 51666

              #7
              Re: Privatized Hospice Fraud

              As an industry evolves and changes some will find new ways to steal. The hymn mentions that time makes ancient good uncooth, which is true but it's also true that time provides new and wonderful opportunities for evil.

              Comment

              • Concordia...41
                Grateful Member
                • Apr 2006
                • 6404

                #8
                Re: Privatized Hospice Fraud

                I've wondered about this as there seem to be three competing hospice services in this area????

                Comment

                • skuthorp
                  Senior Member
                  • Jan 2002
                  • 73698

                  #9
                  Re: Privatized Hospice Fraud

                  "There's lots of stinkers here, as everywhere; it's just I haven't seen/heard of this particular fraud."
                  Crooks come in white coats too it seems, though it's likely the big banks are involved as financiers of these schemes. Those banks again eh? Still, it's probably legal from a corporate profit point of view, looking after the shareholders etc.

                  Comment

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