Most hospitals are profit driven. Employees in large health care systems can face significant pressure to cut costs, increase revenue and improve the numbers that determine their access to Medicare/Medicaid funding and more.
Now HCA Healthcare, the largest hospital chain in the country, is facing disturbing accusations by patients, families and its own doctors. HCA has hospitals in Georgia and throughout the country.
How moving patients into hospice care affects hospital performance metrics
HCA is accused of pushing people to move sick loved ones into hospice care so it could report fewer “in-hospital” deaths (even if the patient remained physically in the hospital) and re-admissions and shorter hospital stays. All of these are important measurements for hospital “performance.” In part, this determines executive pay. If patients are moved to an outside hospice, it frees up beds for more patients.
One woman whose daughter was in a coma and on a ventilator in 2021 says she was urged repeatedly to begin hospice care for her. She says at one point there were at least a half-dozen doctors and nurses in the room telling her she should let her daughter go. She has since recovered fully.
Hospice care involves ending attempts to cure a patient’s disease or make them well. It focuses on keeping them as comfortable as possible in what are typically their final days or weeks.
According to an NBC News investigation, patients were ranked on a “vulnerability index” that measured their risk of mortality. Those with an extremely high number were targeted for hospice care.
NBC News talked to over two dozen doctors at HCA hospitals who said they were urged to get patients into hospice care before they died, and failing to do that was viewed as a “missed hospice opportunity.”
Leading labor union has similar findings
SEIU, the country’s largest health care employee union, has reported the same thing, in part based on Medicare claims data and HCA’s above average hospice transfer rate. HCA is denying the allegations. However, a doctor who spoke to NBC on the record says he’s still being urged to get patients into hospice care before they die.
Deciding to transfer a loved one into hospice care – or even respecting their wishes to end treatment for their condition — is never easy. You must be able to trust the information and advice given by their doctors. If you believe advice was given based on anything other than a patient’s well-being and an accurate diagnosis, it may be wise to determine what kind of legal recourse is available.
