A federal inspector general's report has identified appalling conditions at hospice centers around the country, including particularly bad conditions at one unidentified Missouri center operated by Vitas Healthcare. The kinds of abuse and neglect described in the report would be condemnable under any circumstances, but it's particularly galling that hospice centers collect taxpayer money for their services with far too little oversight to ensure abuses don't happen.
The Washington Post, citing a state inspector in Missouri, identified Vitas as one of the hospice providers with the most severe service deficiencies. It referenced the federal inspector general's reference to a facility in which "a beneficiary developed maggots around his feeding tube insertion site" and required hospitalization for treatment. The Centers for Medicare & Medicaid Services pay hundreds of hospice providers to help ease the suffering when patients with terminal illnesses enter their final six months of life.
The entire idea behind the program is to relieve patient pain and reduce anxiety for their families when a loved one's death is approaching. If hospice providers instead compound the suffering, legal sanctions should be the immediate response available to authorities. But gaps in federal law allow providers to get away largely unscathed, the inspector's report indicated.
In the Vitas case, the provider neither disputed nor agreed with the findings of a 2016 state inspection. The inspector general's report said the Medicare system "cannot impose penalties, other than termination, to hold hospices accountable for harming beneficiaries" because it lacks that authority. Congress can and should fix that gap immediately.
Hospice care is one of those services often ignored by the general public because it is only needed when a loved one is diagnosed with a terminal illness. When the need does arise, though, a good provider with compassionate and attentive staffers can be a godsend. A bad one can only add to the nightmare.
The inspector's report said that from 2012 through 2016, more than 80% of hospices surveyed had at least one deficiency. Most deficiencies were minor, but some were egregious, including the sexual assault of one dying patient and an Alzheimer's sufferer left unattended for so long that the patient's leg had to be amputated. More than 300 hospices were found to have at least one serious deficiency.
Lax sanction authority is only part of the problem. Another is the fact that, since 2018, inspections have been required to be completed only once every three years. Shockingly, that's a big improvement over the previous requirement of once every six years.
Enhanced federal regulation is the only way to protect hospice patients and their grieving families at a time of high vulnerability. The priority must be to ease suffering instead of allowing neglect and malfeasance to make the suffering far worse.
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