Long-Term Care Hospitals Lacking Oversight

According to Medicare officials, long-term care hospitals have sprouted up all over the country in the past 30 years, when hardly any such facilities existed in the early 80s. Perhaps the repaid growth of long-term hospitals can be attributed to Medicare rules that offer high payments for hospitals that treat patients for 25 days or longer. While it isn’t at all wrong for a patient to stay in the hospital for a longer period of time, what is problematic is that many long-term hospitals are private, publicly traded companies—many of which lack the proper oversight to prevent serious medical problems in the patients that utilize their services.

Select Specialty Hospital of Kansas City is a particularly potent example of the types of problems experienced in long-term care facilities. In fact, lawsuits, state inspection reports, and federal reports found that in 2007 and 2008 Select’s hospitals were cited in violation of Medicare rules almost four times more often than regular hospitals. One such incidence occurred in 2007, when Ms. Bell- Jackman, a 46-year-old with diabetes was hospitalized at Select for five weeks. Ms. Bell-Jackman became increasingly agitated, but could not speak because of a surgical hole in her throat. Although Ms. Bell-Jackman was supposed to be supervised, her sitter left at 8 p.m. on June 26, 2007 without notifying hospital staff. Around 9:30 p.m. Ms. Bell-Jackman tried to get out of bed and walk around and hospital staff responded by tying her down with wrist restraints. Then, around 12:15 a.m., nurses sedated her to further calm her down. No one bothered to notice that Ms. Bell-Jackman was dying. Perhaps if an attending physician was on staff that night, her death could’ve been prevented. However, most long-term hospitals don’t have doctors on staff.

Many patients at long-term care facilities are critically or chronically ill. While they are usually in stable condition, many still require consistent care including dialysis, attention to wounds that won’t heal, or breathing help on a ventilator. Despite Select’s poor history of attending to patients, they maintain that they “quality patient care”. Unfortunately, this may not have been the case with Ms. Bell-Jackman. After receiving the sedative injection at 12:15 a.m., Bell-Jackman seemed to relax. However, the leads on her chest connecting her to the heart monitor came loose around 12:42 a.m. and an alarm sounded—no one noticed. When the nurse that was supposed to be watching her overnight finally came to check on her, Ms. Bell-Jackman was found unconscious and attempts to revive her were unsuccessful. Ms. Bell-Jackman’s family filed suit against Select in January 2008 and received an $800,000 settlement for her death. Nevertheless, Select still denies wrongdoing.