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Hospitals Referring Patients to Nursing Homes with Low Medicare Ratings & Abuse & Neglect Violations

An NPR station out of Southern California recently featured a story about an 88 year old woman, Elizabeth Fee, who had hip surgery at a reputable California hospital and later died from alleged neglect at a nursing home recommended by and affiliated with the hospital. The piece discussed the family’s lawsuit against the hospital, California Pacific Medical Center, and shone a light on an alarming practice in hospitals: referring patients to nursing homes and rehabilitation facilities who have been cited for violations and who have received low ratings by Medicare.

Hospitals Are Fearful of Violating Medicare/Medicaid Rules
Families such as Fee’s are making major life decisions for their loved ones and are looking to their trusted healthcare team for counsel. Sadly, many hospitals are afraid to violate a Centers for Medicare and Medicaid Services (CMS) regulation that says hospitals should not “specify or otherwise limit” the choice of facility that a patient visits after being discharged from a hospital.  However, most patients and their loved ones would interpret being given a sheet of paper with a list of nursing homes as an endorsement for those facilities listed. While this rule isn’t clearly defined, hospitals tend to shy away from providing information about citations and incidents that have occurred at nursing homes on their list of follow-up care facility suggestions.

Centers for Medicare & Medicaid Services Punishing Hospitals by Reducing Reimbursements
It would seem to be in the best interest of hospitals to come up with a way in which they can share a list of quality facilities without attempting to influence patients. Last year Medicare proposed a plan in which hospitals would be required to give information on the quality of the facilities on the lists they’re distributing to patients and families. While this has not been implemented, there is one way that hospitals are held responsible. CMS has enacted a program called the Readmission Reduction Program, which cuts payments to hospitals who have had what they call “Excess Readmissions” within 30 days of discharge.

If you or a loved one were discharged from a hospital and later injured due to neglect at a hospital-recommended nursing home, rehab center, or other care facility, the experienced nursing home abuse and neglect attorneys at Levin & Perconti can help you navigate the law and determine if you have a case. Please contact us for a free consultation.