Medicare Report Raises Concerns About Quality of Nursing Home Care

May 24, 2014
by Adler Markoff & Associates

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    Medicare Report Raises Concerns About Quality of Nursing Home Care

    According to a report recently released by government investigators, Medicare paid billions in taxpayer dollars in 2009 to nursing homes across the country that failed to meet basic requirements to care for their elderly and ill residents. The investigators detailed their findings in an eye-opening report, indicating that one out of every three times patients ended up in nursing homes that year, they were placed in facilities that did not meet basic care standards established by the federal agency that administers Medicare. If you or a loved one has received poor care at a nursing home facility in Oklahoma, or if you believe a loved one has been the victim of nursing home abuse or neglect anywhere in the state, contact our attorneys at AMA Law today. Our law firm is located in Oklahoma City, and our reputable lawyers have extensive experience protecting the legal rights of elderly individuals throughout the state.


    The elderly and other patients suffering from illness that require daily care from a nurse or therapist are typically sent to skilled nursing home facilities, which can receive reimbursement by the government for much of the care they provide for their residents. Federal law requires, however, that facilities write up care plans tailored to each resident so doctors, nurses and other caregivers can help residents reach the highest possible level of physical, psychological and mental well-being. The government report, released on February 28 by the Department of Health and Human Services’ inspector general, found that Medicare paid approximately $5.1 billion for patients to reside in skilled nursing facilities that failed to meet federal rules regulating quality of care in 2009, in some cases resulting in neglectful and dangerous conditions.


    According to these findings, not only are many nursing home residents going without the critical care they require, but the government may be contributing financial assistance to facilities that could actually endanger the health of the very people entrusted to their care. Investigators indicated that, in one out of five stays, patients’ health problems were not addressed in the care plans as dictated by federal requirements, and in one example, a nursing home facility failed to monitor a patient’s use of two anti-psychotic medications and one antidepressant, even through the drugs could have dangerous side effects. In other cases, nursing home residents received care they didn’t need, which investigators assumed was an effort to be reimbursed at a higher rate by Medicare.


    The Office of Inspector General’s report was based on an examination of medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks during 2009. According to the investigators, the sample population represents approximately 1.1 million patient visits to nursing homes across the United States that year, the most recent year for which data was available. The report not only raises concerns about whether the government is allowing nursing homes to be paid for poor quality services and recommends that the Centers for Medicare and Medicaid Services strengthen its regulations and oversight, but also draws attention to the mistreatment of nursing home residents nationwide. “Once you’re in a nursing home, if things don’t go right, you’re really a prisoner,” said Virginia Fichera, a retired professor with relatives in two New York nursing homes. “As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they’ll be fixed.”

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