Medicare Paid Billions for Bad Nursing Care

Government investigators report that Medicare paid out billions of dollars in taxpayer money to nursing homes across the United States. At issue is that the facilities were unable to meet basic requirements to meet the needs of their residents.

The report, said The Associated Press (AP), was just released by the Department of Health and Human Services’ inspector general and stated that, in 2009, Medicare paid $5.1 billion for patients to live in skilled nursing facilities that were unable to meet federal quality of care rules. Dangerous and neglectful conditions were sometimes involved. In fact, said the AP, about 30 percent of all patients in nursing homes in 2009 were being cared for in facilities that did not follow basic standards of care as set forth by the federal agency that administers Medicare, according to Department of Health and Human Services investigators.

Legally, facilities must document individualized care plans to better enable doctors, nurses, therapists, and other patient caregivers to take a collaborative, unified approach to the way in which patients receive care and to ensure patients reach the best possible physical, mental, and psychological state, said the AP. Sadly, not only is resident care lacking, but the investigation found that the government might be spending taxpayer monies on facilities that are potentially endangering patients, the report stated, said the AP. “These findings raise concerns about what Medicare is paying for,” the report said.

The Senate Special Committee on Aging also commented on the review. “Spending taxpayers’ money on facilities that provide poor care is unacceptable,” the committee’s chairman, Senator Bill Nelson (Democrat-Florida), stated. “The government must do a better job of ensuring Medicare beneficiaries receive the highest quality of care,” he added, according to the AP.

Some one in five stays involve patient health problems that are never addressed in care plans, according to investigator estimates, said the AP, which is not in line with government mandates. In just one example given, a facility had no plan in place for monitoring a patient’s use of two antipsychotic and one depression medication, despite that the drugs all have the potential to cause serious, significant side effects. Other cases involved patients receiving unnecessary therapy, which enables nursing home facilities to benefit financially by securing higher Medicare reimbursement, the AP explained. Other issues involved transition reports that were lacking or transitions that were not appropriately handled when patients moved to a different facility.

The report was based on the medical records from 190 patient visits to nursing homes in 42 states. The visits lasted at least three weeks, which provided investigators with a “statistically valid sample of Medicare beneficiaries’ experiences in skilled nursing facilities,” the AP said. That sample represents some t 1.1 million nursing home patient visits across the U.S. in 2009, the most current year for which data was available, the review indicated.

We have long written about the growing issue of elder abuse in nursing homes. With the senior population growing and living longer and with the elderly among our most vulnerable citizens, concern for the care of this country’s seniors is significantly important and relevant. More and more, people are finding themselves faced with the challenging decision of having to place older relatives and loved ones in nursing homes.

Families seeking care of elderly family members are often left with very limited options, a frightening prospect in today’s environment in which reports of nursing home abuse and neglect are rising. A devastating indignity that attacks these defenseless members of society on all levels, abuse encompasses physical, emotional, chemical, financial, medical, and sexual maltreatment. Not just abuse, but also neglect, mocking, and even workers who use patients in pranks are becoming more and more commonplace.

We have written about a number of nursing home neglect lawsuits that the national law firm, Parker Waichman LLP, has filed against a number of facilities on behalf of residents who have suffered severe, sometimes permanent, injuries. Parker Waichman has long been dedicated to protecting the rights of nursing home abuse and negligence victims and has, among other measures to protect this vulnerable demographic, prepared a number of video blogs, such as this one.