Hundreds of US hospices have at least one ‘serious deficiency,’ report says

A nurse assists a patient. (Photo: jacoblund / Getty Images)

The majority of hospices in the United States have at least one problem with their care, according to a government watchdog investigation.

More than 80% of the 4,563 hospice centers that provide care to Medicare beneficiaries surveyed nationwide between 2012 and 2016 had at least one deficiency, according to a July report from The Department of Health and Human Services Office of Inspector General. 

“The most common types of deficiencies involve poor care planning, mismanagement of aide services, and inadequate assessments of beneficiaries,” the department said in a news release. “These failings – such as improperly vetting staff and inadequate quality control – can jeopardize beneficiaries’ safety and lead to poor care.”

The report noted problems such the lack of supervision and proper training for staff, the failure to obtain criminal background checks, the failure to monitor medication, the failure to treat severe wounds properly, the failure to stop patients from falling down, the failure to track infections and others. 

Twenty percent of hospice centers surveyed had at least one “serious deficiency,” meaning their “capacity to furnish adequate care was substantially limited, or the health and safety of beneficiaries were in jeopardy,” according to the report.

The number of serious deficiencies nearly quadrupled from 2012 to 2015, then slightly declined the following year.

At one hospice center mentioned in the report, a nurse didn’t tell the physician about a patient’s escalating pain or increasing use of pain medication. The patient, as it turned out, was taking double the dose of fentanyl, a highly addictive drug, than was prescribed.

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A secondary report was also released in July.

“Some beneficiaries have been seriously harmed when hospices provided poor care or failed to take action in cases of abuse,” said the secondary report.

As a result, the Office of the Inspector General suggested that safeguards for patients must be strengthened.

It offered findings to support an existing recommendation that Centers for Medicare and Medicaid Services’ (CMS) should take steps to seek authority in establishing intermediate solutions for poor hospice performance. CMS should have enforcement tools to protect its beneficiaries from harm, the secondary report said.

“Medicare beneficiaries who elect hospice care are an especially vulnerable population. They have the right to be free from abuse, neglect, mistreatment, and misappropriation of patient property,” said the secondary report. “When hospices cause harm or fail to prevent or mitigate harm caused by others, beneficiaries are deprived of these basic rights.”

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