Medicare Waste on Substandard Nursing Home Care Tops $5B in 2009Mar 4, 2013
The federal government spent more than $5 billion in neglectful, abusive, and substandard care at nursing homes across the country several years ago. Considering the cost of care is on the rise and conditions on average have declined, that cost is probably more in the years since.
According to an Associated Press report, an investigation from the Dept. of Health and Human Services found that Medicare reimbursements totaling $5.1 billion in 2009 went to nursing homes across the country that failed to meet the minimum standards of care for skilled nursing facilities. This included the cost of prescription drugs residents took that may not have been necessary or those that had dangerous interaction risks.
For a nursing home to be eligible to accept residents who are insured by the federal Medicare program, they must establish a baseline standard for the care of those residents. The increasing cost of health insurance and health care have taken its toll on nursing homes in the last decade and the standard of care across the board has declined considerably. Budget cuts have led to poor management and population increases at nursing homes have stretched skilled staff thin, forcing facilities to hire unqualified help who have proven more likely neglect or abuse residents.
Some states like Florida that were once considered havens for retirees or people that required full or assisted nursing care on a daily basis have become known for the converse now.
And while the quality of care has dropped, so has the federal government’s ability to keep its proverbial eye on many of the nursing homes it reimburses for the care they are or aren’t providing their residents.
The federal study found that one in three nursing home residents getting Medicare funding is staying at a facility that failed to meet minimum standards of care. Further detailed in the federal government’s report is the fact that one in five patients admitted to a nursing home that received Medicare funding did not have their specific medical problems addressed by the facility or its staff. In some cases, patients received care they didn’t need because the nursing home was more interested in receiving the money from Medicare funds than providing quality care to its residents.
All told, this equated to about $5.1 billion in waste in 2009, alone. Plainly speaking, the HHS report warns, “These findings raise concerns about what Medicare is paying for.” The agency issued several warnings in its report, including one to the federal government to increase oversight into the nation’s network of Medicare-eligible nursing homes. One way to do this is to tie the rate of Medicare reimbursements to the quality of care a nursing home or other skilled nursing facility provides.