LIFE CARE CASE A WARNING
Life Care Centers of America agreed Monday to pay the Department of Justice $145 million to settle claims the company overcharged Medicare and TRICARE for services provided to elderly patients, but the company did not have to admit any wrongdoing. We wonder how much it would’ve taken for an apology, too. The Cleveland-based skilled nursing home chain may not have had to admit wrongdoing — and even denied there was any — but the federal government evidently thought there was some.
“Billing federal health care programs for medically unnecessary rehabilitation services not only undermines the viability of those programs,” said Nancy Stallard Harr, U.S. attorney for the Eastern District of Tennessee “it exploits our most vulnerable citizens.”
The exploitation is really at the crux of the matter, not only for Life Care but for so many other elder care facilities that seek to take advantage of patients and their families.
In many cases, the patients themselves don’t have any idea if the services they’re being provided will help them (and may not be able to ask pertinent questions), and their family members can’t be present 100 percent of the time to monitor what is happening.
The situation, which plays out at facilities across the country, is ripe for abuse.
In the Life Care case, according to the government, staffers were ordered to provide therapy to nursing home residents even if it was not needed. And they kept patients in the homes longer than necessary in order to bill Medicare and TRICARE for additional days.
Not only that, but the company set targets for patient billing not related to the patients’ needs, according to the complaint, and distributed bonuses based on how employees and facilities met those targets.
When families entrust someone to any elder care facility, they are placing the care of their loved one into the hands of people who usually do not know them, have many other people to care for and are generally paid little better than minimum wage.
Even where abuse is not alleged, neglect is almost certain — not out of meanness, usually, but out of busyness. To add a layer of intention to that treatment is the height of cruelty.
Fortunately, caring people who go the extra mile can be found at every facility, providing hope for those who have no choice about what to do with their loved one. The whistle-blowers who spurred the federal complaint against Life Care are likely such people.
Going forward, we hope facilities engaging in such abuse notice the settlement against Life Care — the largest with a skilled nursing chain in the department’s history — and end such practices for the sake of both the vulnerable patients and the families who have placed their hearts on the line.