Our Blog

702-625-9260

Reports Find Hospice Deficiencies Go Unaddressed

Posted by Laura E. Stubberud | Jul 17, 2019 | 0 Comments

Hospice care is supposed to help terminally ill patients maintain their quality of life at the end of their life, but two new government reports find that serious problems in some hospices may be actually causing harm to hospice patients. The reports propose that additional safeguards are needed. 

Medicare provides a comprehensive hospice benefit that covers any care that is reasonable and necessary for easing the course of a terminal illness. Most hospice care is provided in the home or in a nursing home. State agencies or private contractors survey hospices to make sure they comply with federal regulations. If a hospice fails to meet a standard, the surveyor cites the hospice with a deficiency. 

A pair of reports by the U.S. Department of Health and Human Services' Office of Inspector General (OIG) found that from 2012 through 2016, more than 80 percent of hospices surveyed had at least one deficiency and one in five had a deficiency serious enough to harm patients. About 300 hospices were identified as “poor performers” and 40 had a history of serious deficiencies.

The reports found that the most common types of deficiencies involved poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries. Some of the most serious problems that were found included a beneficiary who developed pressure ulcers on both heels, which worsened and developed into gangrene, requiring amputation of one leg. Another beneficiary developed maggots around his feeding tube insertion site. Both of these beneficiaries had to be hospitalized, which hospice is meant to prevent. 

Meanwhile, the OIG found that it is hard for consumers to learn about which hospices are doing a good job. The Centers for Medicare and Medicaid Services (CMS) launched the Hospice Compare website in 2017, but the site does not include information from the surveyors' reports. Hospices also do not have as strong reporting requirements as nursing homes. In addition, CMS has limited ability to discipline hospices other than to drop the hospice from Medicare. 

The reports provide a number of recommendations to CMS to improve monitoring of hospices, including the following:
•    Expanding the data that surveying organizations report to CMS and using these data to strengthen its oversight of hospices 
•    Taking steps to include the survey reports on Hospice Compare
•    Educating hospices about common deficiencies and those that pose particular risks to beneficiaries
•    Increasing oversight of hospices with a history of serious deficiencies
•    Strengthening requirements for hospices to report abuse, neglect, and other harm 
•    Ensuring that hospices are educating their staff to recognize signs of abuse, neglect, and other harm
•    Improving and making user-friendly the process for beneficiaries and caregivers to make complaints. 

To read the OIG reports, click here and here.

For National Public Radio's coverage of the reports, click here.

About the Author

Laura E. Stubberud

Laura Stubberud has over two decades of experience in the practice of estate and family law in Nevada. After graduation from UCLA, she studied law at Southwestern University School of Law , graduating in 1992. With over 25 years of practice in Clark County, Nevada, Ms. Stubberud has substantial e...

Comments

There are no comments for this post. Be the first and Add your Comment below.

Leave a Comment

Call us today at 702.625.9260. You’ll receive the highest level of personalized service.

Contact Us Today


Affiliations

Menu