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San Diego Hospice Failed To Report Patient Data To State

— San Diego Hospice failed to comply with a state law requiring disclosure of certain patient information two years in a row.

Aired 3/11/13 on KPBS News.

The troubled San Diego Hospice did not report patient information to the state back in 2009 and 2010 - information that would have indicated how long hospice patients received care.

Special Feature When Does End Of Life Begin

Everyone is familiar with the high-profile and politically charged question, “When does life begin?” But as our friends and family members live longer and survive what once were commonly fatal ailments, another question takes center stage. When does end-of-life begin?

Every year, the Office of Statewide Health Planning and Development requires health care providers, like hospices, to file certain patient information.

San Diego Hospice did not file any of the required data with the state. Not in 2009 or 2010.

Among other things, hospices are required to report how many patients received care for six months or longer before they died or were discharged.

According to the state, the requirement allows for greater scrutiny and helps to set standards.

Failure to report the data could have resulted in a suspension of the hospice’s license, but no action was ever taken.

"CDPH (California Dept. of Public Health) received no complaint about a failure to report data and therefore, we did not investigate," CDPH spokesperson Ralph Montano said.

San Diego Hospice filed for bankruptcy last month, in the wake of a two-year federal investigation, much of it centered on patient eligibility.

A spokesperson for the hospice says the data wasn’t filed with the state because of staff changes. San Diego Hospice also did not supply the missing data to the KPBS/inewsource Investigations Desk despite our request.

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Avatar for user 'Observer_'

Observer_ | March 11, 2013 at 1:21 p.m. ― 4 years ago

While you are absolutely correct in reporting that SDHIPM was remiss in submitting Annual Reports to the CA Office of Statewide Planning and Development, one shouldn't entirely lose sight of the fact Medicare auditors were in house during most of this time, examining many if not all of the charts of patients discharged > 180 days. This doesn't excuse the failure to submit an annual OSHPD report to the state, but it might have a bearing on whether the availability of the data needed to file the report was available under the circumstances. To your credit, your report informs that OSHPD will, upon complaint, pursue state licensed health care providers who neglect to timely file these annual reports.

I'd also like to comment, In the interest of clarification, there is nothing improper per se about a hospice patient receiving service for more than 180 days or receiving Medicare per diem payments as long as reasonable medical documentation exists that the patient's condition is genuinely terminal. What I'm yet to see reported is the number and amount of SDHIPM Medicare payments OIG auditors actually denied. Due process allows the provider the opportunity to appeal retroactive claim denials. In my view, the question that needs to be examined is: Was the decision to close SDHIPM premature? Other recent press reports have cited a similar audit of SDHIPM conducted 14 years ago, in response to which, the former chief medical officer claimed each and every denial was reversed on appeal. One of the questions that can't be ignored is: Was the decision to close this organization premature?

According to OSHPD reports for 2011 another "large" San Diego hospice (for-profit hospice chain branch) reported a higher percentage of patients discharged > 180 days (14.1%). Perhaps under "Sequestration", there are not enough Medicare auditor man-hours available in the budget to investigate these folks.

There is, as I'm sure you know, a wealth of data contained in these reports, and if I may suggest, the story that needs reporting is the jaw-dropping profits many of these hospice agencies realize, particularly in connection with the amount and cost of care they do or do not provide.

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