The Senate Finance Committee, led by Senators Max Baucus (D-MT) and Charles Grassley (D-IA), has opened an investigation into substandard patient care and deaths at long term care (LTC) facilities after numerous reports of patients being treated horrifically.

Focus on long term care medical centers

Congress’s current investigation into long term care medical centers focuses on the Select Medical Corporation. The for-profit company, founded in 1996, runs 89 long term care hospitals across the nation and has made hundreds of millions of dollars on patient care in the past 15 years – mostly due to Medicare and Medicaid programs which account for 60 percent of its income. Select has been accused of providing substandard care to patients – some of whom have died.

A recent New York Times article provided details on two patients who slipped through the cracks at Select's facilities:

• Kansas medical negligence. A dying patient's heart monitor alarm sounded alerting staff that the patient was in need of emergency assistance. However, nursing home staff ignored the alarm for over an hour and 15 minutes before attending to the patient.
• Oklahoma medical malpractice. A 79 year old woman was injected with ten times the amount of insulin she required. The patient had gone into a coma before staff realized their mistake. However, they waited an hour and a half before contacting her primary care doctor. She died shortly afterward.

Understaffed & underpaid

How can accidents like this happen? Elder care lawyers say that many long term care facilities such as nursing homes, assisted living facility and adult day care center staff are understaffed and underpaid – all to increase the bottom line. And that they do – with the help of government payments.

Medicare and Medicaid programs pay over $5 billion to long term care facilities every year and many facilities know how to work the system. For example, many Select patients were kept at facilities for exactly 25 days because these government programs provide greater reimbursement if they stay for that amount of time. Former Select employees allege that the 25th day is often referred to as the “magic day” because the company can maximize profits and discharge the patient – making room for another.

Long term care practices getting worse

Long term care practices at facilities are only part of the problem Long term insurance companies often deny or delay benefits to long term care insurance policyholders once admitted. Congress is currently investigating regulators and representatives of the industry over their practices – which many say are getting worse as more baby boomer Americans require some type of long term care.

If you've been denied long term care benefits, contact a long term care insurance attorney to discuss your situation. You can fight back.