WEBVTT	#Elemental Media Engine(TM) 2.17.0.603489

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The hospice industry has

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been booming all across the

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nation.

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It's actually a multi-billion dollar

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business that is dominated by

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for profit operators.

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Well, now an L.A.

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Times investigation has found

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the epicenter of this

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explosive growth is right

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here in L.A. County, which has seen

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a wave of fraud and in

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some cases poor care

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for those in their final days of

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life.

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L.A. Times investigative reporters

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Kim Christensen and Ben Poston

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joined us with more on

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their big investigation.

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Hey, Kim, I'm going to start with

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you. Remind everybody what hospice

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care is a little bit about its

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history.

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Hospice care is conceived

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as end of life care for people

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who have six months

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or less to live.

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Terminally ill people.

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It started in the United

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States in the in the

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early to mid 1970s,

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mostly as a nonprofit

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venture by charitable

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groups and community groups

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and churches.

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And then in the

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early 1980s, Medicare began

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to fund it. And that sparked

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a

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what's been a long running growth

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climate for

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it's now a 19-billion

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dollar a year industry.

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Ben, tell me about the growth

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of the industry here in Southern

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California, how it compares with the

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rest of the country.

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Yeah, we've seen here in L.A.

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County a

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six-fold increase over the last

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decade in the number of hospices,

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that's compared to like a fourfold

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increase in California and less than

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a 50 percent increase across the

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nation.

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And then when you drill down on L.A.

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County, San Fernando Valley has

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become the epicenter of growth.

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And you have places like Van Nuys,

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North Hollywood, Burbank, that

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all have some of the highest per

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capita rates in the country.

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And we found on a one mile stretch

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of Victory Boulevard in the valley,

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there were more than two dozen

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hospices.

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And in one office complex

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alone, there was 50.

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And there's a lot of money at stake,

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right, Kim?

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The daily rate paid by

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Medicare for hospice coverage ranges

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from about 150 dollars

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to about 1400 dollars.

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And that has spawned

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a fair amount of sort

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of a cottage industry of fraud,

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people trying to get those Medicare

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dollars.

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Talk to me about Kim, the

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tactics they're using to recruit

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people who are not at the

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end of their life, and yet

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they sign up for hospice care.

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Yeah, typically what

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happens is some of the unscrupulous

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hospices, and we should mention that

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generally hospice has been a godsend

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for millions of people.

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So when it's done right, it's

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it's great.

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But the unscrupulous

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operators

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generally use

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recruiters and marketers, and

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they will send these folks out to

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senior citizen centers

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and other places to

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basically recruit

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patients, many of whom are

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terminally ill.

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And they do this by offering them

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medical equipment,

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housecleaning services, any number

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of things that are

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disguised as something other than

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what they are.

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Well yeah, people who were signing

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these papers not really clear on

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what they were signing up for,

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thought, oh, I'm just going to get a

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mobility scooter or I'm just going

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to get housecleaning or

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somebody to help me with my

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groceries.

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And were shocked to later learn that

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they've lost their coverage

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because they signed up for this

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service that they don't even need.

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Right. Hospice provides

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only palliative care,

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not curative care.

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So if you sign up for hospice, you

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lose,

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you know, your regular medical

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coverage. And in one case, a woman

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lost her place on a

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on a transplant waiting

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list. So it has real

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ramifications.

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Tell us about a couple of people,

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Peter Craig and Nicolas Tuparan.

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Well, Mr. Tuparan was in his

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late eighties and he was in

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hospice care, but living in a

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nursing home in Pasadena and

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he was being fed his breakfast one

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morning and choked,

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couldn't breathe and

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lost consciousness and

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basically slipped into a coma

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and was being fed by

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a hospice nurse.

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But she did not perform

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CPR

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because she said it was against the

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hospice's policy to do that.

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And as a result of that, even

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though his family had expressly

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asked that that be performed

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if necessary, so that

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the effect for him was that he

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suffered severe brain damage,

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had to be intubated and put on

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a ventilator and died

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a couple of months later had a

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pretty miserable last couple

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of months of his life.

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Peter Craig was

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in the end stages of cancer

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and had been cared

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for by his family.

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And they turned to hospice

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because they wanted somebody there

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with them in his final

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hours. He was in a lot of pain and

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they felt they needed help

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administering his pain medication

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so they enrolled him in hospice.

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And they say the hospice

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promised them that they

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would have a nurse at his side

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in his final hours.

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But when his final

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hours came, the hospice

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didn't send anybody.

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The hospice contends that it was a

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miscommunication.

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Ben, tell us how difficult it is

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to find the data

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on these places

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and how someone will know

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if they're putting their loved one

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in an accredited facility.

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Yeah, we we found, you know,

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limited information available

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online. If you're searching for

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a hospice for your parent or

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grandparent,

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a simple web search doesn't really

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give you that much information?

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If you go to the Medicare's compare

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site, you can look up

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at specific hospice, but

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there's very limited information on

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there about quality of care.

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The State Department of Health

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website does have a searchable

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database, which, you

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know, in some cases provides

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detailed reports.

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But we found some serious violations

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in our reporting

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that were not available on the state

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health website.

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So there's just really no central

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place for consumers to find this

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information.

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And we hope that our story helps

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sort of move the ball

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a little bit.

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Kim, I'll finish with you.

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Let's talk about accountability.

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Well, the difference between

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hospices and nursing homes, for

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example, is that

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state regulators, in the case of

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nursing homes can impose

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fines or

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suspensions when they find

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bad actors.

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But in the case of hospices,

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basically what happens is

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a corrective action plan

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is written by the hospice and

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then they

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just continue on in most cases.

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And at the federal level,

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the only sanction by Medicare

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against hospices is to boot

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them from the program.

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And that happens rarely

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in person.

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Ben Poston and Kim Christensen for

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the L.A. Times, thank you so much

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for this investigative report.

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Thank you.

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Thank you.