No One is Coming: Investigation Reveals Hospices Abandon Patients at Death's Door
‘No One is Coming:’ Investigation Reveals Hospices Abandon Patients at Death’s Door
As her husband lay moaning in pain from the cancer riddling his body, Patricia Martin searched frantically through his medical bag, looking for a syringe. She had already called the hospice twice, demanding liquid methadone to ease the agony of Dr. Robert E. Martin, 66. A family practice physician known to everyone as “Dr. Bob,” he had served the small, remote community in Wasilla (home of caribou barbie), Alaska, for more than 30 years. But the doctor in charge at Mat-Su Regional Home Health and Hospice wasn’t responding. Staff said he was on vacation, then that he was asleep. Martin had waited four days to get pain pills delivered, but her husband could no longer swallow them. Now, they said, she should just crush the drugs herself, mix them with water and squirt the mixture into his mouth. That’s why she needed the syringe.
“I thought if I had hospice, I would get the support I needed. They basically said they would provide 24/7 support,” she said, still shaking her head in disbelief, three years later. “It was a nightmare.” Patricia had enrolled her husband in hospice when the metastatic prostate cancer reached his brain, expecting the same kind of compassionate, timely attention he had given his own patients. But Bob Martin had the misfortune to require care during a long holiday weekend, when hospices are often too short-staffed to fulfill written commitments to families. The consequences, as documented through a review of official records and interviews, were dire.
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Yet as the industry has grown, the hospice care people expect — and sign up for — sometimes disappears when they need it most. Families across the country, from Appalachia to Alaska, have called for help in times of crisis and been met with delays, no-shows and unanswered calls, a Kaiser Health News investigation published in cooperation with TIME shows. The investigation analyzed 20,000 government inspection records, revealing that missed visits and neglect are common for patients dying at home. Families or caregivers have filed over 3,200 complaints with state officials in the past five years. Those complaints led government inspectors to find problems in 759 hospices, with more than half cited for missing visits or other services they had promised to provide at the end of life.
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Only in rare cases were hospices punished for providing poor care, the investigation showed.
Hospice is available through Medicare to critically ill patients expected to die within six months who agree to forego curative treatment. The care is focused on comfort instead of aggressive medical interventions that can lead to unpleasant, drawn-out hospital deaths. The mission of hospice is to offer peaceful, holistic care and to leave patients and their loved ones in control at the end of life. Agencies receive nearly $16 billion a year in federal Medicare dollars to send nurses, social workers and aides to care for patients wherever they live. While the vast majority of hospice is covered by Medicare, some is paid for by private insurance, Medicaid and the U.S. Department of Veterans Affairs.To get paid a daily fee by Medicare, hospice agencies face many requirements. They must lay out a plan of care for each patient, ensuring they'll treat all symptoms of the person's terminal illness. And they're required to be on call 24/7 to keep patients comfortable, but because each patient is different, there's no mandate spelling out how often staff must show up at the home, except for a bimonthly supervisory visit. Hospices must stipulate in each patient's care plan what services will be provided, when, and by whom, and update that plan every 15 days. Hospices are licensed by state health agencies, and subject to oversight by federal Medicare officials and private accreditation groups.
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http://time.com/4995043/no-one-is-coming-investigation-reveals-hospices-abandon-patients-at-deaths-door/
and here are hospices being fined for bilking medicare:
https://www.democraticunderground.com/10029776009
= new reply since forum marked as read
