The Reality Of Nursing Home Abuse and Neglect
Largescale Fraud On The Medicare System
Legal Redress For Fraud And Abuse
Long-term care of the elderly is a massive industry feeding off the accumulated savings of older Americans, Medicare and Medicaid, and private insurance coverage. The elder care industry is also a vast source of fraud against Medicare and Medicaid and sadly of abuse and neglect of the very people it exists to support and care for – the elderly. This week’s Last Week Tonight with John Oliver took a deep look at this complicated, fraud-ridden system. When it comes to the care of the elderly, the bottom line of Oliver’s expose is that our society is not doing a good job except for care of the very wealthy. If you are not wealthy and depend on Medicaid for care, you may end up in an understaffed, underequipped facility or even find yourself thrown out in favor of a private-pay patient. Whether you are rich or poor you (and the government) may be victims of fraud: for the rich by charging for unnecessary services and for the poor payment for services they never receive or receive only at substandard levels. Ingrid M. Evans and the Evans Law Firm, Inc. is a plaintiff’s firm that represents elder victims of abuse and fraud. If you have a senior loved one here in Los Angeles or elsewhere in California who has been a victim of abuse or fraud in a skilled nursing facility or assisted care facility, call us today at (415)441-8669.
John Oliver’s Take
Oliver’s segment on Last Week Tonight shares some alarming statistics of just how bad things are in the American system of elder care:
- 1 million Americans live in skilled nursing facilities.
- 82% of skilled nursing facilities in the U.S. have been cited for violations.
- 42 million Americans take care of older persons at home because for the most part they cannot afford institutionalized care.
- The average annual cost of a private room in a nursing home is over $100,000. Medicare pays only for the first 120 days of skilled nursing care and then the older person is on their own for the bill. Bathing, changes, some staff report having 22 residents to care for.
- 1/3 of all COVID-19 deaths in America were older residents in nursing homes.
The individual interviews and stories shared on the show are even more disturbing. One group of aides reports that each of them is responsible for feeding, bathing, dressing and changing 22 patients each every day. One wheelchair bound resident explains how her calls for help were ignored as she screams in pain. One poor senior tells his story of how he was thrown out of a facility in the middle of the night and ended up in a homeless shelter. The stories are heartbreaking and all too real.
Medicare and Medicaid Fraud
Also all too real is the extent of the Medicare and Medicaid fraud that goes on every year in the long-term care industry. The Centers for Medicare & Medicaid Services (CMS) estimates that improper payments under Medicare and Medicaid total over $68 billion per year. As Oliver points out, fraud exists at both the top and bottom of the long-term care industry. At the tope where Medicare or private health insurance is paying, seniors are prescribed unnecessary medications or services like therapy simply because the government is paying and no one questions the outlay. Oliver tells one illustrative story of how a home billed Medicare for hours of intensive on a terminally ill patient on the very day of his death. At the lower end of the industry, Medicaid may be footing the bill for patients who never receive the care the government is charged for or are placed in a substandard home where the staffing ratios and other care standards fall far below what the government requires but is paying for nonetheless.
You can watch Oliver’s segment here:
If you have firsthand knowledge of Medicare or Medi-Cal fraud or have an elderly loved one who has been the victim of any kind of nursing home or assisted care facility abuse or neglect in Los Angeles or elsewhere in California, call Ingrid M. Evans at Evans Law Firm, Inc. today at (415) 441-8669, or by email to <a href=”mailto:email@example.com”>firstname.lastname@example.org</a>. Ingrid will help you in pursing all available remedies for your senior loved one against all those responsible. You may also have the grounds for a whistleblower action for Medicare or Medicaid fraud and Ingrid can represent you in that kind of case as well. Elder abuse and whistleblower statutes provide enhanced remedies for plaintiffs including recovery of attorneys’ fees and costs incurred in bringing your action.