Most of the hospices in Florida and around the country used to be run by charities, but things have changed. The end-of-life industry now generates about $22 billion each year, and many of the entrepreneurs attracted to the field are more interested in maximizing profits than caring for patients. Reports of hospice abuse and neglect have become far more common in recent years, and they have prompted the Centers for Medicare and Medicaid Services to introduce strict new guidelines for end-of-life facility inspectors.
Abuse and neglect
The revised CMS guidelines were introduced in January and went into effect immediately. Inspectors are now required to do some research before they conduct a physical inspection to find out if any allegations of elder abuse or neglect have been leveled against an end-of-life facility. They are encouraged to check news reports, scrutinize previous complaints and violations and read online reviews. When hospices are visited, inspectors are expected to look for signs of abuse by checking inpatient care and discharge practices.
Medicare fraud
Fraud in the end-of-life industry has attracted the attention of industry groups and lawmakers from both sides of the political aisle. Bipartisan groups from both chambers of Congress have called on the CMS to do more to stamp out fraud in the end-of-life industry, and trade groups seeking more rigorous oversight have compiled a list of fraud red flags. The new inspection guidelines could help to identify Medicare fraud because inspectors have been told to pay particularly close attention to live discharges. When an unusually large number of patients leave a hospice alive, it is often a sign that the facility is admitting people who do not meet the Medicare criteria for end-of-life care.
A welcome first step
The new CMS guidelines are good news for hospice patients and their loved ones, and they are likely to be followed because trade groups and our elected leaders seem to be very concerned about fraud. If fraud is stamped out, unscrupulous elements may flee the industry and leave end-of-life care to those who are drawn to the field by compassion rather than profit.
