Wednesday, July 10, 2019

Poor Care in Hospice: OIG Report

Ugh, this article in the Washington Post covers a serious and worrisome topic. Hospices go unpunished for reported maggots and uncontrolled pain, watchdog finds reports on a recently released HHS Office of Inspector General report,  2019: Vulnerabilities in Hospice Care.

The OIG report is actually two reports "which found that from 2012 through 2016, the majority of U.S. hospices that participated in Medicare had one or more deficiencies in the quality of care they provided to their patients. Some Medicare beneficiaries were seriously harmed when hospices provided poor care or failed to take action in cases of abuse. OIG made several recommendations in both reports to strengthen safeguards to protect Medicare hospice beneficiaries from harm and to ensure hospices are held accountable for deficiencies in their programs."

The first report, Hospice Deficiencies Pose Risks to Medicare Beneficiaries, 07-03-2019 | Report (OEI-02-17-00020), found that

[t]he most common types of deficiencies involve poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries. In addition to these, hospices had other deficiencies that also posed risks to beneficiaries. These failings-such as improperly vetting staff and inadequate quality control-can jeopardize beneficiaries' safety and lead to poor care. In addition, one-third of all hospices that provided care to Medicare beneficiaries had complaints filed against them. Over 300 hospices had at least one serious deficiency or at least one substantiated severe complaint in 2016, which we considered to be poor performers. These hospices represent 18 percent of all hospices surveyed nation-wide in 2016. Most poor performers had other deficiencies or substantiated complaints in the 5-year period. Some poor performers had a history of serious deficiencies.

The full report is available here.

The second report, Safeguards Must Be Strengthened To Protect Medicare Hospice Beneficiaries From Harm, 07-03-2019 | Report (OEI-02-17-00021) found

[s]ome instances of harm resulted from hospices providing poor care to beneficiaries and some resulted from abuse by caregivers or others and the hospice failing to take action. These cases reveal vulnerabilities in CMS's efforts to prevent and address harm. These vulnerabilities include insufficient reporting requirements for hospices, limited reporting requirements for surveyors, and barriers that beneficiaries and caregivers face in making complaints. Also, these hospices did not face serious consequences for the harm described in this report. Specifically, surveyors did not always cite immediate jeopardy in cases of significant beneficiary harm and hospices' plans of correction are not designed to address underlying issues. In addition, CMS cannot impose penalties, other than termination, to hold hospices accountable for harming beneficiaries.

The second full report is available here. In addition there is a slide show available on YouTube,  a one page flyer available here, a one-page graphic of the top issues available here, a flyer on beneficiary rights available here and more.

https://lawprofessors.typepad.com/elder_law/2019/07/poor-care-in-hospice-oig-report.html

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