Hospice and Medicare: Senior Abuse?

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My client’s 94-year-old mother was killed while in hospice. How? She fell out of bed, broke her femur, and died within days. She fell out of bed because the hospice provider didn’t believe my client and her family when they said she had a doctor’s order for bed rails. I wrote a letter to the hospice CEO alleging negligence and senior abuse and requested damages. The “Senior Counsel” finally replied, stating that they bore no responsibility. The good news is we can litigate negligence.

In his email, the attorney used initials without explanation. I was a bit surprised because legal writing 101 requires defining initials that are not widely used. For example, the initials USA are common for the United States of America, but DNR (Do Not Resuscitate) is not. Therefore, you can write USA without a definition but not DNR. I found out that the initials FG stood for the victim’s name, and DON meant Director of Nursing. Once I understood that the attorney was using initials to describe a patient under his company’s care, I had an #seniorabuse moment. This man doesn’t care about his company’s patients – he cares about liability and the bottom line. How does that help my client’s Mother?

The Real Problem With Hospice

I want to chastise this hospice provider and their callous attorney, but is it really fair? Attorneys mirror their clients. Ergo, as offended as I am that he would not spell out the patient’s name, he is as offended that I think he’s callous. As Cool Hand Luke’s jailer would say, “What we’ve got here is failure to communicate.” And the truth is, not only do he and I share that failure but so does the management of the hospice company and their patients. Hospice companies make money by billing Medicare for new beds, oxygen, wheelchairs, social workers, pastors, nurses … who has time to worry about the poor patient and their loved ones? The idea is to get the Medicare reimbursable people and equipment into operation to submit an invoice.

Disappointment With Medicare

And where is Medicare?! Two years ago, this hospice paid a $75 million settlement to Medicare to settle a False Claims Act brought against them. They admitted no wrongdoing. One of the most disturbing allegations against them was that the company convinced multiple patients and their family members that they were dying from a terminal illness when, in fact, they were not. The misrepresentation was allegedly conceived to convince patients that their terminal conditions would require hospice services which allowed the company to submit its false reimbursement claims to Medicare. So why doesn’t Medicare change the system? How can they simply allow huge checks to be sent without having a “secondary safety valve” within their billing technology? Can we really put all the blame on the hospice companies? Medicare is very aware of the endemic fraud in the system – can’t they program computers to monitor it? The answer is yes – but it’s not done. Why?

Is This Senior Abuse?

Why should the hospice worry about offending families in emails – their customer, Medicare, doesn’t, so why should the staff or the CEO? Medicare, whose budget is always on the chopping block, doesn’t hold its providers accountable. It results in large payouts to its nefarious “Medicare providers.” Note how no one goes out of business. This is senior abuse.

If you or a loved one are facing a hospice stay and relying on Medicare to pay expenses, please reach out to me at Parent Your Parents in Miami, Florida. I can support you and ensure quality care in an often frustrating situation. Whether you live in Florida or not, I am a senior advocate who helps point you in the right direction. Contact me, Frances Reaves, for a free consultation and elder law support for multiple senior concerns all in one place. If you prefer, you can call 786-418-3303 or email me at info@parentyourparents.com.