Wait until you see who made out the most.
"Hospice care has become an industry with growing issues; Some doctors also work as directors of the facilities" December 16, 2011|By Peter Waldman, Bloomberg News
SAN FRANCISCO - Janet Stubbs was grateful when the nursing home recommended hospice care for her Aunt Midge. Although Stubbs knew her aunt was not dying, the offer of free, Medicare-paid hospice visits from a nurse and chaplain, plus an extra weekly bath, was too good to pass up.
Stubbs didn’t know that her aunt, Doris Midge Appling, was admitted to Hospice Care of Kansas during the company’s Summer Sizzle promotion drive, which paid employees as much as $100 a head for referrals, according to the Justice Department. Stubbs also said she had no clue that the nursing home doctor who referred her aunt for hospice moonlighted as medical director for the hospice company.
“It doesn’t seem right,’’ said Stubbs, who had Appling’s power of attorney to make medical decisions. “What incentive did the doctor have to put my aunt on hospice? How much was she being paid?’’
Harden Healthcare, the hospice’s current owner, said medical directors received no incentive pay. Appling’s doctor, Donna Ewy, did not return four calls seeking comment.
Hospice care, once chiefly a charitable cause, has become a growth industry, with $14 billion in revenues, 1,800 for-profit providers and a base of Medicare-covered patients that doubled to 1.1 million from 2000 to 2009.
Compensation based on enrollment numbers, pay to nursing-home doctors who double as hospice medical directors and gifts to the nursing facilities have helped fuel the boom, according to an examination of 1,000 pages of court documents and interviews with more than 45 current and former hospice employees, patients, and family members.
“They wanted us to admit, admit, admit,’’ said Joyce White, a former marketer for Vitas Healthcare, a Chemed Corp. unit that is the nation’s largest hospice chain. “All of us competed against each other to make our numbers. You lived or died by your numbers.’’
Publicly traded companies such as Chemed and Gentiva Health Services have created hospice chains through serial takeovers in the last decade. Hospice buyouts and investments by private-equity firms have also led to boosted enrollments.
Funding from Kohlberg Kravis Roberts enabled closely- held Harden’s acquisition of Hospice Care of Kansas’s parent last year. The seller: private-equity investor Apax Partners, of London and New York.
“There was always pressure to get the patient census up, any way we could, to sell the company,’’ said Rae Ann Angelo, a Wichita salesperson for the Kansas hospice from 2003 to 2009, including most of the time when Apax owned it. “You can’t sell unless you show big growth.’’
Other private equity concerns that have been active in the hospice trade include Denver-based KRG Capital Partners. KRG sold Dallas-based Trinity Hospice for $75 million in 2006. The company was liquidated by the buyer, nursing-home operator Sunrise Senior Living, two years later, after $67 million in write-offs and government allegations of ineligible patient enrollments prior to the takeover.
“After KRG came in, it was clear their philosophy was, ‘Put everyone on hospice, don’t ask questions and build!’’’ said Catherine Covington, who worked as a Trinity compliance officer from 2000 to 2004. “They were there to make a buck.’’
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Well, you know what they say: Home I$ Where the Heart I$
"Obama plan raises pay for home health care employees" December 16, 2011|By Sam Hananel, Associated Press
WASHINGTON - Workers in the home health care industry - one of the country’s fastest growing professions - would be guaranteed minimum wage and overtime protections under new rules proposed yesterday by the Obama administration.
The move would boost living standards for nearly 2 million employees who help the elderly and disabled with daily tasks such as taking medication, caring for wounds, or preparing meals. But some health service companies warned that higher pay could also mean higher costs for clients who can least afford it.
Ever notice banks and wars never want for money?
“They deserve to be treated fairly,’’ President Obama said at a White House ceremony attended by more than a dozen home health care workers. “They deserve to be paid fairly for a service that many older Americans couldn’t live without.’’
It was the latest in a series of steps Obama has taken to try to boost the economy or help workers without going through Congress, where his jobs bill has stalled.
Related: "Obama made the centerpiece of the jobs program.... unemployment benefits"
Home health care aides have been exempt from federal wage laws since 1974, when they were considered companions to the elderly and compared with baby sitters. But the number of full-time home care workers has surged, along with the rapid growth of retirees who prefer care at home instead of at institutions.
As the jobs have evolved, home care providers have greater responsibilities helping clients with physical, developmental, and intellectual disabilities and people with chronic or terminal illnesses.
“These are real jobs as part of a huge and growing industry,’’ said Steve Edelstein, national policy director for the Paraprofessional Healthcare Institute in New York. “They deserve the same basic labor protections that other workers enjoy.’’
Unions and advocacy groups say nearly half of all home care workers live at or below the poverty level and receive public benefits such as food stamps and Medicaid. More than 90 percent of home care workers are women. About 30 percent are black, and 12 percent are Hispanic.
GOP lawmakers said Obama’s plan would result in fewer work hours for home care workers and higher costs for taxpayers....
Then tax your rich buddies for once or stop sending aid to Israel; otherwise, shut the f*** up.
Tough working conditions, low wages, and high turnover make it challenging to meet the growing demand for home care for the elderly. With the size of the US population over 65 expected to nearly double in the next 20 years, millions more will rely on longterm health care from in-home workers.
“This proposal will draw more qualified professionals into the in-home caregiving profession, and it will improve the quality of care for our loved ones,’’ said Labor Secretary Hilda Solis.
There is a 60-day period for public comments on the rules before the Labor Department considers them for final approval.
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Don't forget to take your pills:
Medicare's drug coverage gap shrinks
I don't know about you, readers, but all I got from the Globe was the doughnut hole.
See: Medicare Muddle
Also see: US won't define required health care benefits
