Hospice: Dallas Facility Busted for Ordering Staff to Increase Drug Doses

Hospice: Dallas Facility Busted for Ordering Staff to Increase Drug Doses

Living Trusts are an important part of our business, and many topics related to estate planning and end-of-life care are relevant for us. Discussions about hospice care frequently surface in our offices for a good reason—there is a lot of confusion surrounding hospice.

Hospice: a boom industry, largely unregulated and growing

Hospice is a booming business and, at least for now, a mostly unregulated one. The growth in recent years—largely from the for-profit sector—has been dramatic. Expansion has been driven in large part by investors, including private equity firms, hedge funds and entrepreneurs because there’s a lot of money to be made. Aging baby boomers represent a huge market with nearly unlimited potential needs.

FBI intervention for Dallas-area hospice

A recent article from a Dallas newspaper shows how the lack of regulation allows hospice care to spiral out of control. For those of us facing decisions about elder care for our own family members, it’s a warning to be very careful in not only selecting a facility but monitoring the care that our loved ones are receiving. An FBI agent investigating this case was working with investigators from the Department of Health and Human Services’ inspector general’s office. They eventually busted this Dallas-area hospice facility, but the scenario is chilling.

Hospice care owner orders staff to increase drug doses to hasten death

Accountant Brad Harris founded Novus Health Care Services Inc., in July 2012. Harris, who has no medical training or licenses, ordered nurses to increase drug dosages for patients to speed their deaths and maximize profits. He ordered higher dosages for at least four patients, though it’s unclear whether any deaths resulted from overdoses of drugs, including morphine.

In a warrant authorizing an FBI raid on the hospice, it alleged that the Harris sent text messages to workers with this kind of messaging: “You need to make this patient go bye-bye.” and “Find patients who will die within 24 hours.”

Hospice: short stays translate to bigger profits

The warrant explained that the longer a patient receives care, the greater the chance that federal reimbursements will diminish. A provider eventually can be forced to return federal payments. According to the FBI, hospices are subject to an “aggregator cap,” which limits Medicare and Medicaid payments based on the yearly average hospice stay. If patients live longer than that, the provider can be forced to pay back part of their payments to the government. Hospice providers have an incentive to enroll patients whose hospice stays will be short relative to the cap. It’s not unusual for hospice facilities to ask patients to leave if they have not died within an expected period of time.

While this is a particularly egregious example of abuse, the level of care from one hospice facility to another remains inconsistent. We recently wrote several blogs on this topic:

  • For-Profit vs Nonprofit Hospice: the Controversy Continues
  • End-of-Life Preparations Brings up Confusion About Hospice

Planning for end-of-life care is an important part of our comprehensive Living Trust package. Contact California Document Preparers at one of our three Bay Area locations and schedule an appointment today!