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( Observer_ )

Comments made by Observer_

Serious Questions About Patient Care At San Diego Hospice

Trying to follow, much less understand this story is like chasing chickens.Your reporting, which initially seemed almost a little strident, This is a remarkable report. Thanks for including useful links, like to the bankruptcy court deposition of the newly-minted hospice Chief Operations Officer. His "analysis" and his advice to the board of directors sounded like a fatal *underdose.*

March 19, 2013 at 4:44 p.m. ( | suggest removal )

San Diego Hospice Failed To Report Patient Data To State

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.

March 11, 2013 at 1:21 p.m. ( | suggest removal )