In a shocking report released by the Department of Health and Human Services Office of Inspector General (HHS-OIG), they revealed Medicare had overpaid around $5.1 billion for patient stays in nursing homes. The study was conducted by HHS-OIG and they based the findings on a sample of random nursing home stays in the year 2009. During each stay, the nursing homes that were evaluated did not meet quality of care standards that are clearly set forth by the federal government.
Federal law requires nursing homes to develop a care plan for each patient and then administer care following that exact plan. In addition, nursing homes are required to create a plan for each patient’s discharge. According to the 2009 data, during 37 percent of patient stays, either the nursing homes did not create a care plan that satisfied federal requirements or they did not provide the medical services that were designed under patient care plans. During 31 percent of those patient stays, nursing homes did not meet the discharge planning requirements. The HHS-OIG also found several examples of inadequate wound care, medication administration and physical therapy.
Just One Example of Poor Healthcare
A recent lawsuit filed in the state of Illinois shows the troubling increase in the number of healthcare nursing home deficiencies. During a jury trial, a panel of 12 jurors returned a guilty verdict in the federal district court of Illinois against Momence Meadows Nursing Center. The suit was filed against the nursing home for failure to provide proper care to Medicare patients.
Two former nurses of the Momence Meadows Nursing Center filed charges against their former employer. Both of the former nurses gave sworn statements that the nursing treatment several patients received was so bad that Medicare was actually entitled to recover the money they originally paid to the nursing home for services. After just a short deliberation, the jury found that the United States government had paid, through the Medicare system, over $3 million in services that did not meet the federal quality healthcare standards.
With such instances on the rise, it is vital for caregivers and seniors alike to be proactive in their healthcare. If your gut is telling you that something is not right, follow that feeling and speak up. Every senior has the right to receive top-notch healthcare.
Have you or a loved one ever received unsatisfactory healthcare in a nursing home? What did you do to rectify the situation? Tell us your story below.
Original Article by: Berger & Montague