Recommended Website: Hospice Patients Alliance

Serving:  Hospice patients, family and caregivers, the bereaved and hospice staff

Promoting:  Quality hospice services that respect you as a person

Informing:  YOU!  Knowledge is power…to get the best care

Protecting:  Your rights!
“Serving hospice patients and their families is one of the greatest privileges and trusts a health care professional could ever be granted. Only those staff with great love, sensitivity, and compassion understand the real mission of hospice. Really, it is a “calling.”

“The Constitution of our nation is firmly based upon respect for the sanctity of life, the liberty to live in freedom until a natural death occurs in its own timing.”

~ Ron Panzer, Founder, Hospice Patients Alliance

Source:
HospicePatientsAlliance

NJ Ethics Committess Mediate Crucial End-of-Life Decisions

When a nursing home resident can no longer make decisions, someone else has to make the tough ethical choices. Should the patient’s life be prolonged with a ventilator or feeding tube? Has the time come to remove life support? What would this person have wanted? The family and the nursing home staff can wind up at loggerheads, unable to take the next step.

The state’s ethics committees are helping families and nursing home staff make these tough decisions. The regional panels are made up of trained volunteer professionals with diverse backgrounds, including nursing, social work, long-term care, and clergy. They work under the direction of the state Office of the Ombudsman for the Institutionalized Elderly, which advocates for patients in long-term care facilities.

The ethics committees “are available to people to help them through an extremely difficult and hard time and help them critically think through issues and make decisions that are ultimately resident focused,” said ombudsman James McCracken.

McCracken wants to raise the visibility of these ethics committees and encourage nursing homes to call on them to mediate more often. To do so, he is presenting this month training sessions, “How to Make Ethical Decisions at the Bedside,” taught by clinical ethicist Dr. Helen D. Blank and designed for ethics committee members and nursing home staff.

A new law gives New Jersey residents the final say on their medical care. The planning document, called the “Physician Orders for Life Sustaining Treatment” or POLST, details the individual’s wishes for the quality of life and medical intervention in their final days. The document has the authority of a medical order and follows the patient from one care setting to another, including home, ambulance, hospital, nursing home, and hospice.

POLST is designed to supplement the living will or advanced directive, which individuals typically use to designate a healthcare proxy who will make decisions when they are no longer competent to direct their own medical care. A committee of the New Jersey Hospital Association is expected to create a POLST form to be used throughout the state by the end of the year.

Full Article and Source:
NJ Ethics Committees Mediate Crucial End-Of-Life Decisions

Whistleblower Accuses Hospice Corp. of Medicare Fraud

A former Vitas Healthcare Corp. manager has accused the hospice chain of defrauding the federal government by conspiring with health insurers to enroll Medicare patients who weren’t dying.

Vitas, a unit of Cincinnati-based Chemed Corp. (CHE), is the largest U.S. provider of hospice care, which has attracted government scrutiny as its Medicare-covered patients have doubled to 1.1 million over the last decade.

Chemed fell 15 percent, the most since April 2008, to $49.10 at 10:37 a.m. in New York.

The allegations came in a lawsuit unsealed last week in U.S. District Court in Dallas. Vitas spokeswoman Kal Mistry said the company “cannot comment on pending litigation.”

In the same court, the Department of Justice is seeking internal Vitas documents in an investigation focused on alleged abuses of federal health-insurance programs. The government has told the court it suspects Vitas of “an extensive scheme” to defraud Medicare and Medicaid of “hundreds of millions of dollars” by falsifying records and hospice certifications.

Vitas has “consistently been in compliance with Medicare and Medicaid rules,” Mistry said.

The newly unsealed suit was filed by Michael Rehfeldt, a former branch manager for Vitas in San Antonio, who is seeking damages for the government as a whistleblower under the U.S. False Claims Act, which entitles him to part of any recoveries. Such claims are also called qui tam suits.

“False certifications, fraudulent billing and cost shifting to the United States constitute a widespread, systematic practice endemic to Vitas,” Rehfeldt’s suit alleges.

Full Article and Source:
Whistleblower Accuses Chemed Unit of Medicare HMO Conspiracy

Feds Investigage Hospice Fraud – a $14B Industry

Janet Stubbs was grateful when the nursing home recommended hospice care for her Aunt Midge. Although Stubbs knew that her aunt wasn’t 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.

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, the nation’s largest hospice chain. “All of us competed against each other to make our numbers. You lived or died by your numbers.”

Full Article and Source:
Feds Investigate Fraud in Hospice Care, Which has Ballooned into $14 Billion Industry

Preparing Americans for Death Lets Hospices Neglect End of Life

With his mother wheezing and losing consciousness in a California nursing home, Robert Rogers wanted her moved to a hospital. Vitas Healthcare, her hospice provider, said that wasn’t in the plan.

“Our job is not to prepare them to live,” a Vitas nurse told Rogers on the phone, according to a deposition he gave in April. “Our job is to prepare them to die.”

Rogers called 911. At the hospital, an emergency-room doctor removed 11 maggots from an open wound on his mother’s big toe. Five days later, in September 2008, 91-year-old Thelma Covington died of a sepsis infection brought on by gangrene in her toe and poor circulation, her death certificate said.

Rogers is suing Vitas, a unit of Cincinnati-based Chemed Corp. (CHE), in a California court for alleged elder abuse and wrongful death. Vitas, the biggest company in hospice care, has denied negligence and said that Covington and Rogers knew the risk involved in entering hospice. Ninety-five percent of Vitas care gets positive family ratings in surveys, said Kal Mistry, a company spokeswoman.

As hospice care has evolved from its charitable roots into a $14 billion business run mostly for profit, patients like Covington and their families have paid a steep price, according to lawsuits and federal investigations. Providers have been accused of boosting their revenues with patients who aren’t near death and not eligible for hospice — people healthy enough to live a long time with traditional medical care. In hospices, patients give up their rights to “curative” measures because they are presumed to be futile.

Widespread Neglect

“By admitting these folks to hospice, they are denied access to routine medical and rehabilitative care that they need to extend and improve their lives,” said Cristen Krebs, executive director of Catholic Hospice of Pittsburgh, a non- profit. “A vulnerable and voiceless population is preyed upon for money.”

At the same time, patients are being neglected, according to the claims in the lawsuits, government court filings and interviews with more than 30 people who have worked in the industry or had relatives in hospice. In 2009, a Medicare oversight report found nearly a third of hospice patients were not getting services in care plans that describe the treatment and visits providers promise to give them.

Full Article and Source:

Preparing Americans for Dealth Lets For-Profit Hospices Neglect End of Life

Hospice Worker Accused of Stealing From Dying Patient

A New Jersey hospice worker has been accused of stealing money from a dying patient. Tristan Chang, 23, allegedly used the hospice patient’s ATM card and PIN number to withdraw $700, the full amount the patient had in their account.

Tristan Chang, 23, has been charged with third-degree theft and third-degree hindering apprehension for this particularly heinous form of financial exploitation of the elderly. He faces up to five years in prison and a $15,000 fine.

Full Article and Source:
Hospice Worker Accused of Stealing From Dying Patient

Not a Typical Day in Court

It was a day in court like any other day, or was it?

The Corning Leader’s John Zick and Star Gazette’s Ray Finger reported on the September 17, 2009 Gary Harvey hearing. A hearing that sees a county fighting desperately to hold onto Gary Harvey, though the reasons behind their desperation seems a bit unclear. This is a county, after all, that sought at one point to have Gary starved and dehydrated to death. Though the latter was eventually dismissed, a DNR was placed on him and so it remains.

Sara Harvey, Gary’s wife, has been likewise fighting desperately. She on the other hand has been fighting desperately to save Gary’s life and to get him released from the system prison and back home. Yet, the county attorney keeps trying to paint Sara as the threat and someone to protect Gary from. Interesting that the logic isn’t held up by the facts of the case.

John Zick (Print Edition of the Corning Leader – 9/18/09) reports:

“Shaw also accused the county, represented by Donald Thomson, of withholding documents, an allegation the county denies.

“Shaw is specifically seeking Gary Harvey’s medical records, but Thomson said under normal circumstances, a wife is not privileged to her husband’s records.

“‘Litigation changes everything.’ Shaw countered.”

Sara is trying to save her husband’s life. There is question about the care that Gary Harvey has been receiving. There are questions as to why a so-called ethics committee decided it was right and good to starve and dehydrate Gary to death. Thomson freely throws allegations out there claiming there is cause to protect Gary from Sara. And where is all the so-called proof that Thomson is relying upon? In the very records he refuses to share, conveniently under the HIPPA excuse.

HIPPA? The excuse of all excuses. And the biggest excuses are those who abuse the concept of HIPPA to promote their own agenda.

Sara Harvey is fighting desperately for her husband. Chemung County representatives are fighting desperately to keep Gary under their control for some reason. One sought to have Gary Harvey starved and dehydrated to death. The other fought to save his life.

Full Article and Source:
The Gary Harvey Case Where Obama’s Non-Existent Death Panels Do Exist
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See also:
Wife Seeks Rights to Comatose Husband

The Brainwashing of an Unsuspecting People: Continuing to Deny Death Panels

Behind Closed Doors: The Gary Harvey Story

Follow Up: The Gary Harvey Story

Still Fighting for Her Husband

A Horseheads woman continued her battle Thursday for guardianship of her husband, who has been in a persistent vegetative state since an accident nearly four years ago.

Sara Harvey said she is fighting for legal guardianship of Gary Harvey — who suffered a severe brain injury in a January 2006 accident — so he can get better medical care.

She said her husband is suffering under significantly inadequate care provided by the Chemung County Nursing Facility.

“I see stuff go on with him, and I get no answers,” she told state Supreme Court Judge Judith O’Shea during oral arguments made Thursday by Assistant County Attorney Donald Thomson and Ithaca lawyer William Shaw, who represents Sara Harvey.

Shaw said there had been stonewalling by the county in releasing the medical records that are crucial to his case. Those documents either sustain or refute accusations against Sara Harvey, and he cannot proceed without them, he said.

Thomson said the county opposed the release of Gary Harvey’s medical records because Sara Harvey has no legal right to them.

O’Shea asked about Sara Harvey’s plans for her husband.

Shaw said they include seeking alternative medical services, including Veterans Affairs programs.

Full Article and Source:
Wife Seeks Rights to Comatose Husband
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See also:
The Brainwashing of an Unsuspecting People: Continuing to Deny Death Panels

Behind Closed Doors: The Gary Harvey Story

Follow Up: The Gary Harvey Story

What the End-of-Life Conversation Can Bring

Ed and Catherine Pratt are fierce rivals. Their battlefield is a cribbage board, and competition is in full swing this summer, though Ed is nearing the end of his life. The couple faces off in Ed’s bedroom, on the ground floor of their North Plymouth home, where the Pratts’ daughter and her family live in a second-floor apartment. Most evenings Ed and Catherine listen to the pitter-patter of their 3-year-old granddaughter, Caleigh, running across her living room and down the stairs before she bursts in to ask for chocolate milk.

“I asked the doctor if he could give me a ballpark number,’’ Catherine recalls. “He looked at me and said, ‘Four months. Six if you’re lucky. Let’s get Ed comfortable.’ ’’

With those words Vera initiated what many doctors, patients, and families never get around to having: a conversation about the end of life. The very idea of it is so loaded that a provision of the Obama administration’s health care overhaul to reimburse physicians for advance-care planning consultations with Medicare beneficiaries ignited a furor, with critics predicting the formation of “death panels’’ and the rise of government-backed euthanasia.

“Everybody is afraid of death; it’s part of being a human being. But this regressive thing happens when there’s a big public conversation,’’ said Don Schumacher, president of the National Hospice and Palliative Care Organization. “This legislation is an opportunity to begin. Between 2011 and 2028, 70 million people are going to die. That’s a lot of people to care for, and we need to have these conversations.’’

Full Article and Source:
What the End-of-Life Conversation Can Bring

The Brainwashing of an Unsuspecting People: Continuing to Deny Death Panels

The headlines are amazing, as the denial continues on, suggesting that any claim of a death panel is a myth created by either lying right-wingers or lying special interest groups, who are uninformed or, for selfish reasons, trying to wrongly destroy the health care reform that some think will be a wondrous blessing to all. No, it simply couldn’t be that there is reason for concern.

No matter what they call themselves, or who they work for, there are in fact “death panels” in existence at this very moment and have been for quite some time now. How can anyone dare write, or believe, that “death panels” are merely a myth?

Andrea Clark was sentenced to die under Texas’ Futile Care Law, though she was aware and fighting for her life. She was, after all, deemed by the so-called ethics committee to be hopeless and therefore unworthy of continued effort. Never mind that she was fully aware — it was deemed time to put her down and out of her misery.

In Andrea’s case, her family obtained an attorney and was able to get a stay (delay), while they fought for her. During this period, Andrea did die, but she died because of natural causes and not because she was made to die. There is a very big difference between the two.

The family was not expecting the medical staff to create a miracle that was not within their power to create. All the family wanted was for Andrea to have the chance to survive, if it was possible. She had, after all, been a survivor all her life. Perhaps she would beat the odds again.

Andrea was aware! Andrea was fighting for her life! So what do you call it, when someone decides that in spite of the fact that you are aware and fighting for your life, your life support is going to be removed and you will die? Worse — that you are aware of the decision and that you are going to die because of that very decision and you didn’t even commit a crime beyond becoming ill or injured.

Then we have Gary Harvey from New York, whose wife is fighting both for his life and the right to take him home.

“This is a case where a 55 year old man had a heart attack, fell down the basement stairs, and ended up severely brain damaged. It is a case where still another so-called ethics committee felt it had some sort of god-like wisdom and right to determine life or death for a stranger. It is a case where a so-called ethics committee decided, behind closed doors, that it was perfectly okay to starve and dehydrate this man — Gary Harvey — to death by termination of his Total Parenteral Nutrition (TPN) feeding tube.”

Thankfully the request has been dismissed for now, but just what title should be given to those, who wished to starve and dehydrate Gary Harvey to death?

Full Article and Source:
The Brainwashing of an Unsuspecting People: Continuing to Deny Death Panels

See also:
Behind Closed Doors: The Gary Harvey Story

Follow Up: The Gary Harvey Story