In a recent Kaiser Health investigation, reports show that hundreds of in-home hospice patients and their families have been abandoned by hospice caregivers.
Hospice Patients Abandoned
Hospice care is available through Medicare to critically ill patients whose life expectancy is six months or less and who have agreed to forgo further curative treatments. Hospice care focuses on the terminally-ill patient’s comfort in his/her end-stages of life instead of aggressive medical interventions that prolong the pain, hospital stays, and inevitable death.
There are 759 hospice organizations across the country that serves patients in hospitals and nursing homes, but 86% of hospice patients opt for in-home care provided by hospice doctors, nurses, and caretakers. In recent months, Kaiser Health News analyzed 20,000 in-home hospice inspection records and found 3,200 filed complaints regarding substandard care, neglect, and abuse within the past five years. Common complaints witnessed by elder abuse attorneys included:
- Inaccessible doctors, nurses, and caretakers
- Unanswered phone calls from patients and caretakers
- Missed in-home visits
- Neglected personal care services
- Missed medications
- Missing in-home health care devices
Unlike hospitals and nursing homes, hospices do not face yearly inspections for required certification. With less stringent requirements, elder abuse attorneys often see higher rates of neglect and abuse among in-home patients. Medicare is supposed to supervise hospices, but efforts are falling short. As a result, many in-home hospice patients are being abandoned and left to die alone and in pain.
There are numerous reports of hospices failing to coordinate services, doctors never responding to urgent calls from family members, nurses missing regular visits, denied requests for equipment, and ignored pain medications. In Michigan, a dementia patient was left to endure long waits for pain medications in the last 11 days of life. The hospice caretaker made numerous calls for help to on-call hospice doctors and nurses, with no response.
Hospice is a booming industry, serving about 1.4 million Medicare patients. Hospice agencies receive approximately $15 billion annually in federal Medicare funding, as well as funding by Medicaid, the Department of Veterans Affairs, and private insurance.
To receive Medicare or Medicaid payments, hospice agencies and home-based healthcare services are required to lay out a plan of care for each patient, ensuring proper treatments for the patient’s condition. Hospice agencies are required to be on-call 24/7 to keep terminally-ill patients comfortable, but there is no mandate spelling out how often the hospice staff must show up at the patient’s home.