It is a frightening reality that money trumps morals all too often in our modern world. Sadly, one area in which this problem is especially pronounced is in the nursing home arena. As a Panama City elder care lawyer, Attorney Pittman has noticed that nursing home abuse often coexists with Medicare overbilling and similar financial transgressions, a problem recently discussed in a report from Bloomberg media.
Bloomberg researchers began with a November 2012 report in which federal health care inspectors found that the nursing home industry regularly overbills Medicare, charging the agency an extra $1.5 billion a year for treatments that patients don't need and/or never receive. Bloomberg then conducted further study efforts, focusing on the issue of profit motives. The study noted that federal investigators had deemed 30% of claims from for-profit facilities improper, while a significantly smaller (though still too high) 12% of claims from non-profit homes were deemed improper. Bloomberg noted that at least 6 other studies from government and academic entities in the past 3 years reached similar conclusions, finding that the rise in for-profit providers is creating an environment of waste and fraud that, in turn, fuels patient harm.
In the 5-year span from 2008 through 2012, federal prosecutors brought 120 claims against the nursing home industry, twice the number brought during the previous 5-year span. In some instances, nursing homes overbilled Medicare for unneeded procedures, causing harm and suffering to patients rather than providing needed treatment. On the other side of the coin, many claims involved companies skimping on staffing. This led to patient neglect including cases of malnutrition, patients being left in soiled clothing and denied baths, and patients suffering needlessly from preventable infections.
Notably, during the 2003 to 2008 timespan, the 10 largest for-profit nursing home chains employed 37% fewer registered nurses per patient day than were employed in their non-profit equivalents. That is likely one of the many problems that led the government to hand out 59% more deficiency notices to for-profit homes than they gave to non-profit facilities in that time span.
These issues extend beyond the senior care arena, with for-profits becoming a force in many health care arenas. 96% of U.S. outpatient surgery centers, a growing sector of the healthcare field, are managed by for-profit companies. Likewise, home healthcare and dialysis centers are shifting to a greater share of for-profit management. The problem of profits-versus-care seems to follow along with the shift to for-profit operation. For-profits in the hospice sector have also been cited for overbilling and approving unneeded services, an issue that Florida's attorney general is investigating in conjunction with federal officials.
As a Panama City nursing home neglect law firm, our team is all too aware of the abuses that run throughout the industry. Still, we were shocked by some of the examples in Bloomberg's report and the degree to which companies pushed for overbilling while limiting staffing and sacrificing quality of care to save on costs. In the case of one Florida facility, a staff member reported that "we have been encouraged to maximize reimbursement, even when clinically inappropriate."
Nursing home abuse must not be tolerated. Seniors deserve our respect and the very best of care. Instead, companies are taking advantage of a vulnerable population, sacrificing their health and their safety in order to increase profits. If you suspect a Florida nursing home or other facility has sacrificed care leading to injury of death of a resident, please call our team. As a Panama City nursing home lawyer, Attorney Pittman can help you get a financial recovery in civil court. This not only allows you to get better care for your loved one (or cover final expenses in the case of a tragic death), but it also sends the important message that companies will not be allowed to profit from abuse.