This blog is intended to call attention to the way our government fails miserably, to enforce regulations concerning health care . This is some scary stuff considering the situation with Obamacare. Medicare is administered by the government, and almost entirely managed by private contractors. I have reported Medicare fraud, and seen how it is (not) dealt with. The authorities who investigate Medicare fraud, are too busy to actually investigate. What are they to busy doing?
My main focus is on nursing homes and rehabilitation centers. This all started when my Mom died at Hendersonville Health and Rehabilitation, in Hendersonville North Carolina. Sanstone Health and Rehabilitation, operates this facility. It was originally operated by Margret Pardee Memorial Hospital.
Pardee sold the business in 2008, supposedly due to the high cost of operations. Hospitals operating this type of facility, are required to have adequate numbers of staff, to care for the patients. Private companies operating nursing homes, have no staff to patient requirements. This is how they become so profitable, and also why they are so dangerous.
The North Carolina Department of Health and Human Services,(NCDHHS), North Carolina Department of Health Service Regulation (NCDHSR), inspects and licenses these places. They also supposedly investigate complaints filed against these homes. The lack of enforcement is the focus of this blog.
After receiving Mom's medical records, I filed a complaint with the NCDHHS. The records I have are missing required signatures, dated wrong, have the wrong room number, and reflect a pattern of overbilling of Medicare. The initial result of their " investigation " of my complaint, was unsubstantiated.
I met with the Western regional director of the NCDHSR, Gail Maloney, at their Black Mountain office. I produced all the mixed up medical records from Hendersonville Health and Rehabilitation, including a signed notarized statement concerning the night Mom fell. The statement conflicted the nurses notes, which were dated December 1, 2011, a month after Mom died.
My brother and his wife, and my oldest sister were also at the meeting. We had a list of questions that included discrepancies in the pharmacy bill, doctors bill and the bill for a private room, which Mom never had. There was a question as to whether Mom was given Ativan, that was prescribed. The Ativan, was unaccounted for. When I asked Ms. Maloney what happened to the Ativan, she replied, "maybe they put it back". We were told that the NCDHSR would do a review of the complaint, with the information we provided as well.
It took a little more than a month for them to call and say they found no substantiated complaints. Hard to believe, when provided with records, that prove there were reasons to substantiate the complaints. It was becoming more and more obvious, that the NCDHHS was quite friendly with the nursing home owners.
I have since filed through the freedom of information act, the results of their investigation. The day I received the report back, I had to go outside and calm down. The answers given, for the issues we complained about were absurd. There were conflicting reports written by the same person, there were actually three copies of the letter written by the doctor who preformed the review. Each letter had a different story, and none of them was entirely accurate. One of the letters stated that if Mom tried to get out of bed and fell, it was her fault. Another copy says that Dr. Larry Joe Russell had seen Mom the morning after she fell, as he would any patient when he was there. The other version says that Dr. Russell would not have seen her if the nurses evaluation didn't request it. The whole report is full of the same kind of confusion. I wonder if they ever even went into Hendersonville Health and Rehabilitation.
As for the review, it is obvious, that the doctor just sat and wrote letters till he got one close enough to the actual story. Even then, they found no deficiencies. Who is supposed to watch the people who are watching the nursing homes ?
More to come on what agency does, or fails to do.
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