A report recently released by the U.S. Department of Health and Human Services Office of Inspector General (OIG) revealed that Medicare paid $5.1 billion in 2009 to skilled nursing facilities providing inexcusably poor-quality of care to the elderly and other vulnerable populations.
By law, each resident who is covered by Medicare is entitled to a care plan. The care plan should define the resident’s health goals, the type of care services required, who administers the care, and any special needs they may have, such as medical equipment and supplies, or dietary restrictions. An estimated twenty percent of residents investigated had poorly written care plans that did not properly address all of their health problems.
The report found that 37 percent of Medicare patients were admitted to facilities that failed to develop a care plan consistent with the federal minimum standards or failed to execute care according to the plan, putting their residents at risk.
Specific areas of substandard care included wound care, medication management, and therapy.
Despite these deficiencies, these facilities still collected taxpayer dollars for the inferior care they provided.
Senator Bill Nelson (D-FL), chairman of the Special Committee on Aging, responded to the report as follows:
“Spending taxpayers’ money on facilities that provide poor care is unacceptable. The government must do a better job of ensuring Medicare beneficiaries receive the highest quality of care.”
The Centers for Medicare and Medicaid Services (CMS) is the agency responsible for administering the insurance that covers nursing home payments. The OIG recommended the CMS strengthen regulations on care plans, increase the monitoring of facilities, and hold them accountable for deficiencies by linking Medicare payments to proven quality care. It also recommended continued follow up with facilities found to be providing substandard care.