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New Report Says Medicare Paid Over $5 Billion to Nursing Homes that Offered Poor Care

An alarming report just released by the Inspector General of the Department of Health and Human Services says that in 2009, Medicare paid about $5.1 billion for patients that stayed in skilled nursing facilities that failed to meet federal quality of care rules.

According to an article by the Associated Press, nursing homes by law must write up care plans for each resident. But investigators estimate that in one out of five stays, the patient’s health problems weren’t addressed in the care plan. In some cases, residents got therapy that they didn’t need. The report said this was in the nursing homes’ financial interest because they would be reimbursed at a higher rate by Medicare. In another case, there were no plans made to monitor a patient’s use of two anti-psychotic drugs and one depression medication, even though the medication had serious side effects.

The Office of Inspector General’s Report was based on medical records from 190 patient visits to nursing homes in 42 states. The sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, which was the most recent year when data was available.

According to the article, the report brings up the question that the system could allow homes to be paid for poor quality services that could harm residents. It suggests that the Centers for Medicare & Medicaid Services instead tie payments to facilities that are able to meet basic care requirements, as well as strengthen regulations and oversight.

In the article, Medicare spokesman Brian Cook told the Associated Press, “Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care. We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to.”


These findings come at a time when cost and quality of health care are becoming a concern for the nation, especially with the possibility of sweeping changes in funding. But what’s most important is to make sure that your loved one who is in a nursing facility is getting the care they require and deserve. If you believe there is neglect, contact the nursing home neglect attorneys at Michael J. O’Connor & Associates for a free review of your case.