The hospice industry has been booming across the nation. It is a multi-billion dollar business dominated by for-profit operators. Now, an LA Times investigation has found the epicenter of this explosive growth is here in Los Angeles County, which has seen a wave of fraud and, in some cases, inadequate care for those in their final days of life.
LA Times investigative reporters Kim Christensen and Ben Poston joined us with more on their big investigation.
Hospice care is conceived as an end-of-life option for terminally ill patients. It provides palliative care and prescription drugs, nursing services, medical equipment, supplies, and spiritual counseling for those diagnosed with six months or less to live.
"It started in the United States in the early to mid-1970s, mostly as a nonprofit venture by charitable groups, community groups, and churches. And in the early 1980s, Medicare began to fund it, and that sparked what's been a long-running growth for this now $19-billion-a year industry," said Christensen.
Compared to the rest of the country, Los Angeles County has seen significant growth in the hospice industry.
"Here in L.A. County, we've seen a sixfold increase over the last decade of the number of hospices. That's compared to a fourfold increase in California and less than a 50% increase across the nation. Then, when you drill down on L.A. County, the San Fernando Valley has become this epicenter of growth. You have places like Van Nuys, North Hollywood, and Burbank that have some of the highest per-capita rates in the country. We found on a one-mile stretch of Victory Boulevard in the valley, there were more than two dozen hospices in one office complex alone," said Poston.
There are several tactics used to recruit patients who are not terminally ill.
"The unscrupulous operators generally send recruiters to places like senior citizen centers to recruit patients by offering them medical equipment, housecleaning services —any number of things that are disguised as something other than what they are," added Christensen.
One patient named Peter Craig was in the end-stages of cancer and was cared for by his family, but they turned to hospice because they wanted somebody there with him.
"In his final hours, he was in a lot of pain, and his family needed help administrating his pain medication. So, they enrolled him in a hospice, and they said the hospice promised them that they would have a nurse at his side in his final hours. But when his final hours came, the hospice didn't send anybody. The hospice contends that it was a miscommunication," said Christensen.
When searching for a hospice for a loved one, a simple web search does not provide much information on the facilities.
"If you go to Medicare's compare site, you can look up a specific hospice, but there's very limited information on there about the quality of care. The state department of health's website has a searchable database, which, in some cases, provides detailed reports, but, we found some serious violations in our reporting that were not available on the state health website. So, there's really no central place for consumers to find this information, and we hope our story helps move the ball a little bit," added Poston.