In July of 2019, the Office of Inspector General (OIG) published a report entitled “Safeguards Must Be Strengthened To Protect Medicare Hospice Beneficiaries From Harm.” The report is a summary of cases from a review of survey reports of fifty serious deficiencies in 2016. It truly hurts our hearts!
Let’s get the worst out of the way first: a hospice allowed maggots to develop around a beneficiary’s feeding tube! It’s very hard to imagine how this happened and it is truly horrifying.
• A hospice did not treat a beneficiary’s wounds that became gangrenous, which ultimately resulted in the loss of the beneficiary’s leg.
• A hospice did not provide necessary respiratory therapy services for over two months, which caused the patient to have greater difficulty breathing, more fatigue and a “grey color to his skin.”
• A hospice failed to recognize signs of a possible sexual assault of a beneficiary and did not report them as required. Instead, the hospice got an order from a physician to insert a urinary catheter that the staff was unable to insert despite multiple attempts. The patient was transferred to a hospital where the staff recognized the signs of possible sexual assault and notified police.
• A hospice did not intervene when a beneficiary was harmed by his caregiver who would not help the beneficiary get up after falls and would make the beneficiary clean his own soiled briefs.
• A hospice did not take action when a beneficiary was abused by her daughter who used a chain and elastic seatbelt to keep the beneficiary from getting out of bed, left her mother in a wheelchair in the bathroom with the lights off, sprayed her with water when the patient called out for help and refused changes to her mother’s drug regimen because she preferred to keep her Mother sedated.
• A hospice did not address the repeated theft of a beneficiary’s medications by a neighbor, leaving him in emotional and physical distress.
• A hospice mismanaged a patient’s pain control when the hospice medical director refused to order different medications recommended by a consulting pharmacy and insisted on ordering other medications that had made the patient sick in the past.
• A hospice did not provide essential pain management services by failing to make needed medications available to a beneficiary who resided in an assisted living facility (ALF).
• A hospice did not provide care to a patient who was vomiting blood and in pain, and told the patient that there wasn’t much that could be done to help him at home.
• A hospice did not provide necessary wound care for a Stage IV pressure ulcer on a patient’s tailbone for two years. The patient was only given morphine to control the pain.
• A hospice did not properly train its staff about how to safely transfer patients. The staff dropped the patient on the floor and the patient’s right femur was broken.
Now, you may be thinking, “Well, this isn’t about us. It’s only about hospices.” Not so fast! Sadly, similar reports could be compiled about other types of home care providers, as we know from anecdotal reports and Statements of Deficiency issued based on surveys.
You may also be thinking, “It’s not about us. It’s about the provider down the road.” Careful! All providers are only one uncaring, poorly trained and unreliable caregiver away from these types of situations.
It’s very sad indeed. Individual patients suffered. Patients and their families who read about these instances may be more reluctant to receive home care. Referral sources may be less likely to refer. Capable, caring homecare staff members may be mistrusted. The industry is maligned and credibility is lost. Increased vigilance is surely needed by the entire home care industry in the face of this report because it hurts us all.
©2019 Elizabeth E. Hogue, Esq. All rights reserved.