First, here is a line so grotesque in its nature and what it says of our nature that I want to weep…or vomit:
A number of hospice providers said ethical and legal constraints would
prevent them from discharging patients who outlived their profit
That is from a NYT article on the “catastrophic financial consequence” to hospice care facilities of patients living longer than expected resulting in the “federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.”
The charges are assessed retrospectively, so in most cases the money
has long since been spent on salaries, medicine and supplies. After
absorbing huge assessments for several years, often by borrowing at
high rates, a number of hospice providers are bracing for a new round
that they fear may shut their doors.
One is Hometown Hospice,
which has been providing care here since 2003 to some of the most
destitute residents of Wilcox County, the poorest place in Alabama.
locally owned, for-profit agency, which serves about 60 patients,
mostly in their homes, had to repay the government $900,000, or 27
percent of its revenues, from its first two years of operation, said
Tanya O. Walker-Butts, a co-owner. Its profits were wiped out in the
time it took to open the demand letters, Ms. Walker-Butts said.
paid its first assessment with a bank loan. When the bank declined
credit for the second year, the hospice structured a five-year payment
plan with the Centers for Medicare and Medicaid Services, the federal agency that administers the program, at 12.5 percent interest.
The next bill is expected any day.
“If they hit us with a number in the several hundred-thousand range, I
just don’t see how we can survive,” said Gaines C. McCorquodale,
Hometown’s other owner.