The federal Medicare program provides payments to nursing homes in Arizona and across the country for medical care received by eligible home residents.
It's a simple equation: Homes provide care, bill for it, and receive taxpayer-funded payments.
Who do you suspect might be getting the best of that deal?
Of course, there is no winner-versus-loser outcome when there exists a close nexus between payment outlays and needed care that is appropriately priced and received by nursing home residents.
According to a recently issued report that examines home care claims and billings, though, no such nexus exists. In fact, a U.S. Department of Health and Human Services-authored study reveals that many of the claim submissions from nursing homes seem purposefully linked to a strategy aimed at extracting maximum amounts of money from Medicare.
What is especially troubling about that, notes the Inspector General of the Dept of Health and Human Services: Program administrators routinely see billings relating to therapies that do not seem required for given patients.
In other words, there is strong evidence of personnel within the nursing home industry subjecting residents to treatments that are pointless at best, and that might be harming them in some instances, all for the sake of profit.
That is negligent conduct that hardly aligns with the best interests of residents.
Further, it is not disputed by the acting administrator of the Medicare and Medicaid programs, who, in commenting on the report, noted that some homes "provide as much therapy to a resident as that resident can tolerate."
That is egregious conduct, and must be stopped. Family members who believe that a loved one is receiving inappropriate care might want to contact a proven medical malpractice attorney without delay. Experienced legal counsel can provide guidance and, when necessary, aggressive legal representation aimed at protecting that loved one and fully promoting his or her legal interests.