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Do Nursing Homes Provide Excessive Rehabilitation Services?

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A new study in the Journal of the American Medical Directors Association, and later reported by the New York Times, indicates that some nursing homes may have found a lucrative new way to make money, through collecting extra funds from Medicare by providing excessive rehabilitation services to patients in their final weeks and days of life.

If this is the case, at least two major concerns are raised: Patients who need hospice and palliative care in their final days are not receiving it, but are rather receiving physical, occupational or speech therapy, and patients in need of rehabilitation services are potentially not receiving the appropriate level of care either, as the influx of rehabilitation patients crowds out therapists’ availability to help those in true need of their services.

The study, which was led by several professors at the University of Rochester Medical Center, found the trend to be more widespread in for-profit, rather than nonprofit, nursing homes.

Predominantly, the authors focused on 647 skilled nursing homes throughout the state of New York between October 2012 and April 2016. Of the 55,700 long-term care residents observed, 7,600 (14 percent) received rehabilitation services within 30 days of their death. Additionally, the study concluded that 2,667 received high to ultrahigh levels of therapy, ranging from 325 minutes a week (high) to 12 hours or more (ultrahigh).

Nursing homes are able to bill Medicare a significant rate for ultrahigh levels of therapy. Between 2012 and 2016, the amount of patients receiving ultrahigh rehabilitation services increased by 65 percent. Of those receiving the ultrahigh care, many were given the intensive services in the last week of their lives.

While the research limited its findings to long-term care facilities in New York, the authors warned that similar practices are likely happening in other states as well, specifically states with fewer policies in place to curtail such behavior.

The U.S. Department of Health and Human Services’ Office of Inspector General and Centers for Medicare and Medicaid Services found similar results in 2015, also claiming nursing homes were billing Medicare for high-level therapy services that were not truly required.

While rehabilitation services are incredibly important and can greatly improve someone’s life, when used inappropriately, they can make residents who should be comfortable in their final days, receiving hospice or palliative care, rather uncomfortable.

The care provided to someone you love, particularly on his or her final days, should never be compromised. If you believe someone you know is receiving inappropriate care at a long-term care facility or is being abused or neglected in other ways, please feel free to contact us for a free consultation or call us at (901) 322-4232. We have years of experience fighting against skilled nursing facility abuse and neglect, and we would be honored to have the chance to fight for you.