Articles Posted in Medicare
When Hospice Becomes a Barrier to Emergency Care in Nursing Homes and Assisted Living Facilities
At Nursing Home Law Group, we represent individuals and families in cases of neglect and abuse in nursing homes and assisted living facilities throughout California. For more than twenty five years, our practice has focused on protecting vulnerable elders and holding facilities accountable when they fail to provide safe, appropriate care.
For many years, hospice rarely played a role in the cases we handled. That has changed dramatically.
Today, hospice providers are involved in nearly half of our nursing home and assisted living cases. Often they are not named as defendants. But their involvement frequently creates confusion, delays, and missed opportunities to provide life saving care. In some cases, hospice status becomes the very reason a resident does not receive emergency treatment at all.
California Sues Largest Nursing Home Chain in US for Manipulating Medicare Ratings
Brookdale Senior Living, which is the country’s largest chain of senior living communities, is being sued by California prosecutors on the grounds of manipulating the Medicare nursing home ratings system. Becker’s Hospital Review recently published an article highlighting some details of the case. This federal ratings system assigns stars from one (being the worst) to five (being the best) to over 15,000 nursing homes nationwide. The system uses data submitted by nursing homes themselves, to assign stars. Prosecutors are claiming that Brookdale submitted false information in order to win a higher star rating, including exaggerating the number of hours that registered nurses work. This higher rating likely encouraged folks to choose Brookdale, making the chain of homes more money than they would have otherwise. The chain is also being accused of illegally evicting or transferring residents in order to make space for other residents that would bring in more money for the home.
These tactics used by Brookdale Senior Living highlight the manipulative, and often deceptive nature of large for-profit nursing homes and assisted living facilities in the US. The allegations against Brookdale follow a recent Times investigation that found many nursing homes have taken advantage of the starred system to achieve high ratings on false pretenses, leaving issues of care quality not addressed. These allegations are clearly an exaggerated example of some of the wrongdoings that typical nursing homes perform, yet a good reminder of the lengths that homes will go to if their powers are left unchecked. If you feel that a loved one has been subject to negligence or other wrongdoings regarding elderly care at a nursing home or assisted living facility, contact Walton Law Firm today to speak with an elder abuse attorney.
Trumpcare Could Cause a San Clemente Nursing Home Abuse Epidemic
A lack of federal funding for elderly healthcare could cause a nursing home abuse epidemic in San Clemente and across the country, a recent article in The New York Times suggests. While a vote on the Senate health care bill has been delayed, even an amended version of the bill that includes drastic cuts to Medicaid could have serious and even deadly consequences for seniors living in nursing homes and assisted-living facilities. As the article contends, if such a bill passes, introducing “Trumpcare” to California and to the rest of the country, it “is certain to produce drastic upheaval in the landscape of long-term care.” Medicaid is currently “by far the largest source of funding for nursing home stays,” providing the funding for almost two-thirds of all nursing home residents.
If funding ceases, the quality of care is likely to decline, as well. Such a cut to Medicaid would result, at best, in a rise in nursing home neglect cases, the article argues. Could changes to Medicaid funding really produce such damage to elderly nursing home residents’ care?
History of California Nursing Home Abuse and Neglect
Nursing Homes and Federal Reporting Requirements for Elder Abuse
Are nursing homes in California abiding by federal regulations for reporting allegations of elder abuse or neglect? According to a recent report released by the Office of the Inspector General for the Department of Health and Human Services (HHS), not all facilities are reporting incidents of nursing home abuse.
Reporting Requirements and Incr
easing Rates of Elder Abuse
The HHS report emphasized that about five million elderly Americans (or ten percent of the elderly population) sustain injuries from physical abuse, neglect, and financial exploitation. However, these crimes are not always reported.
Northern California Nursing Home Sued for Overmedicating Residents
Nursing homes in California should take note of the negative publicity surrounding elder abuse and assisted-living facilities in our state. A recent article in the Santa Cruz Sentinel described serious nursing home abuse allegations that point to fraudulent Medicare claims and poor patient treatment. In Watsonville, located in Santa Cruz County, the owners of two nursing homes are facing a lawsuit. According to the report, federal prosecutors sued the owners “allegi
ng that leaders made fraudulent Medicare claims” and “persistently and severely overmedicated elderly and vulnerable residents.”
Overmedication and Fraud Allegations
The two nursing homes at issue are Country Villa Watsonville Easy Nursing Center and Country Villa Watsonville West Nursing Center, both in Santa Cruz County. The owners have been linked to serious crimes connected to nursing home abuse and neglect.
Behind the Medicare Star Rating System
History of the Star Rating System
A recent New York Times article discussed the danger of trusting the Medicare star rating system, providing as an example a five-star nursing home facility in California with a history of elder neglect violations. Last week, we discussed the star rating system and the Rosewood nursing home in the Sacramento area. In sum, the rating system is not helping consu
mers in the way it claims. How did this rating system rise to prominence, and why are so many Americans willing to trust it without additional investigation?
According to the article, the five-star rating system began in 2007, when Oregon Senator Ron Wyden posed the following question at a congressional hearing: why is it easier to shop for washing machines than to select a nursing home? Two years later, Medicare officials developed the star rating system, “a move that was applauded by consumer groups, who hope that more transparency would lead to greater accountability.”
The New Financial Side of Hospice Care
Profiting from Bad Hospice Ethics
Last week, we discussed a recent phenomenon in the hospice care industry that’s quickly becoming an elder abuse concern. Specifically, hospice—a form of care designed to allow “patients to die at home or in other familiar surroundings,” according to an article in the Washington Post—has turned into a financially lucrative business. But is it an ethical one? Are hospice companies acting outside the boundaries of the law? And is it possible to take legal action against hospice chains that recruit patients who aren’t suffering from a terminal illness?
First, it’s important to have a clear idea about why hospices are bringing in relatively healthy older adults, and how these companies are profiting from non-terminal patients. How did this start to happen? In short, many hospice care centers have begun recruiting patients with aggressive marketing tactics, and many of those patients aren’t terminal. It’s in the financial interest of a hospice chain to “find patients well before death,” the Washington Post reported. And the reason is simple: “Medicare pays a hospice about $150 a day per patient for routine care, regardless of whether the company sends a nurse or any other worker out that day. That means healthier patients, who generally need less help and live longer, yield more profits.”
Overuse and Misuse of Hospice Care
Have you been urged to place your elderly parent in hospice care despite the fact that he or she is not terminally ill? Hospice care is intended for patients who are terminally ill and for whom there is no cure. So why are healthy older adults ending up in hospice? A recent article in the Washington Post revealed that this phenomenon might be a larger problem than we’d like to think. Indeed, over the 2000s, the newspaper reported that the “number of ‘hospice survivors’ in the United States has risen dramatically.” What’s going on? According to the article, “hospice companies earn more by recruiting patients who aren’t actually dying,” since “healthier patients are more profitable because they require fewer visits and stay enrolled longer.”

If you have been pressured to move a parent into hospice care, your elderly loved one might not receive the kind of treatment she or he needs. For-profit companies shouldn’t be allowed to take advantage of older adults. Indeed, we might think of these actions as another form of elder abuse. It’s important to speak to an experienced elder law attorney about your options.
Hospice Discharge Statistics
Nursing Facility Reaches Settlement in Medicare/Medicaid Fraud Case
A Northern Kentucky nursing home just reached an agreement with the U.S. Attorney’s office to pay a substantial settlement for false Medicare and Medicaid claims filed over the past decade. While this case concerns a nursing facility in Kentucky, it may have a significant impact on nationwide lawsuits under the False Claims Act (FCA) and nursing home issues in California.
According to a local ABC News article, the settlement requires that the owners of the health care facility pay the U.S. Government $350,000 in damages and that they retain an independent compliance consultant to ensure that these crimes are not repeated in the future. Lexington’s local news station, WTVQ, reported that this case represents the first lawsuit in Kentucky accusing a nursing home of violating the FCA by defrauding Medicaid and Medicare.
What is the False Claims Act and How Does it Relate to Nursing Home Abuse?
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