Since the 1960s, the hospice movement has evolved from a constellation of charities, sustained by the goodwill of volunteers, into a 22-billion-dollar industry funded almost entirely by taxpayers. The number of hospices owned by private equity firms has recently tripled. 3/
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Cities like Houston and LA have seen an explosion in new, for-profit hospices that far outstrips their moribund populations. Given the stiff competition, marketers get bounties for each new body they bring in. Some trick patients into believing they're dying when they're not. 4/
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Others enlist family and friends to act as make-believe clients or steal personal information to sign up “phantom patients.” One 29-year-old pregnant woman only learned she'd been enrolled on hospice when she saw her doctor for bloodwork. 5/
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Since going on hospice entails forgoing curative treatments, getting fraudulently signed up can pose serious risks to those who don't need the service, denying them access to transplants, chemotherapy, and mammograms. 6/
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Whistleblowers have sued 7 out of the 10 biggest hospices in the U.S. for fraud.
What follows is the saga of the most bizarre and pivotal trial the end-of-life industry has ever faced. 7/
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The story draws on scores of court documents, medical records, inspection surveys, watchdog reports, licensure data, and conversations with 150+ sources. Thank you to everyone who shared their time with me — and to dream editors Kit Rachlis and Kate Boo.
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Are you looking to learn more about your hospice provider?
Here are some resources to help you examine complaints, reviews, and quality of care scores — (and steer clear of common signs of fraud.)
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Congress and trade groups are calling for reforms, in the wake of a - investigation into hospice fraud.
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The easiest way to understand the hospice boom is to see it for yourself.
In Arizona, Nevada and Texas, the growth since 2018 now accounts for around half of all hospices in each state.
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New: The country's largest end-of-life care trade groups have sent regulators an “unusual and impressive” list of policy recommendations to stop hospice fraud and profiteering.
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CMS is overhauling its entire inspection process for hospices. Inspectors will survey patients from all three levels of care. And consider press reports in their evaluations.
The changes go into effect immediately.
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Until surveyors show up unannounced at patients' homes, ask the patient's or family's permission to observe, and ask questions about how things are going, nothing will change. Hospices will game the system the way long-term care has with "donations."
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Thank you. You did an excellent job exposing the horror of end-of-life care for patients and their families.
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