For-Profit Nursing Homes Fuel Rise In Fraud And Abuse Charges

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The rise of for-profit nursing homes is proving tragic for some of the nation's most vulnerable people, resulting in a spike in waste, fraud and abuse charges brought by federal authorities, according to a new report.

An investigation of government data and court filings from Bloomberg News reveals horrifying circumstances at these facilities: A 92-year-old lung cancer patient given physical therapy after spitting up blood. An 80-year-old woman who couldn't support her own head forced into a "standing frame" for over an hour. An unattended 77-year-old patient who choked on her dinner.

The profit motive is having an outsize affect on quality of care, according to Bloomberg, which obtained U.S. government data through Freedom of Information requests. "Thirty per cent of claims sampled from for-profit homes were deemed improper, compared to just 12 percent from non-profits," according to the article.

Seventy percent of nursing homes were operated on a for-profit basis in 2010, according to an audit by the Medicare Payment Advisory Commission, which counsels Congress. For-profit nursing homes perform better financially: Their profit margins from treating Medicare patients were 21 percent in 2010 compared to 10 percent for non-profit nursing home companies, the commission reported.

Cases filed against the firms by law enforcement and by families of patients who died allege that for-profit nursing home companies pressure facility managers to minimize the number of employees and keep down their hours to save costs. At the same time, these firms push for patients to receive services they may not need, according to the allegations cited by Bloomberg.

The companies named in the Bloomberg story, Life Care Centers of America and Skilled Healthcare Group, denied wrongdoing, according to Bloomberg News.

The Bloomberg story details several gruesome incidents alleged by federal prosecutors, states and individuals who filed lawsuits against nursing home operators. In one case, employees at a South Carolina nursing home placed an 80-year-old woman into a standing frame -- a device meant to prevent people who use wheelchairs from sitting all day -- despite the fact that she couldn't hold up her head or open her eyes. A 92-year-old man with lung cancer who coughed up blood was still given two hours of physical, occupational and speech therapy in Florida. Short staffing at a California facility resulted in a 77-year-old woman falling three times, breaking her hip twice, receiving surgery several times and developing bed sores and urinary tract infections. At the same facility, a 77-year-old woman choked to death because she was left alone in the dining hall and patients frequently soiled themselves because there weren't enough employees to help them to the toilet.

In 2009, nursing homes billed $1.5 billion in improper charges, according to a November report by the Office of Inspector General at the Department of Health and Human Services.

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