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For-Profit Elder Care Hospitals Subject of Investigation

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Tulsa, OKLast month the New York Times published an in-depth exposé of elder abuse at many US care facilities. The story prompted the Senate Finance Committee to launch an investigation into patient deaths and allegations of substandard treatment.


According to the New York Times report, the Senate investigation will focus on Select Medical Corporation, which operates 89 long-term for-profit care hospitals across the US and boasts more facilities than any other company.

The Times detailed an incident that allegedly occurred at a Select facility in Kansas, in which a dying patient's heart alarm sounded for more than an hour before help arrived. By the time nursing staff finally responded, the patient had been in distress for 77 minutes.

On March 8, Senators Max Baucus (D-Montana, the committee's chairman) and Charles E. Grassley (R-Iowa), the panel's senior Republican, demanded that Select provide more information about the allegations. Select Medical indicates it would cooperate fully with the inquiry, although a spokeswoman claimed that Select viewed the Times article as misleading and inaccurate.

Other complaints lodged against Select and subject to investigation come from former employees of the company, who have detailed a discharge policy that seems to put profit ahead of patient well-being.

Under Medicare rules, hospitals that treat patients for 25 days or longer earn higher Medicare payments. Former Select employees allege that the company presses to keep patients for 25 days, then tries to discharge them almost immediately in an effort to maximize profitability. At some Select hospitals, the New York Times reported, the twenty-fifth day is known as the "magic day."

In a lawsuit concerning the death of 79-year-old Ruth Tanner, a patient in a Select hospital in Tulsa, Oklahoma, a doctor provided a deposition claiming that nurses at the facility injected the "relatively-healthy" Tanner with 10 times the appropriate level of insulin, then waited 90 minutes after the woman had slipped into a coma before notifying her doctor. Tanner never regained consciousness, according to medical records and the lawsuit. She died in early 2009, a month after the incident.

The owners of Select have earned $400 million since founding the company in 1996. Recent company announcements revealed that profit margins had risen 19 percent in 2009, compared to 16 percent the year before. Cash flow increased by $54 million.

The Government Accountability Office has been asked to examine federal and state oversight of all long-term care hospitals.

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READER COMMENTS

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Its very clear, as a former employee of Select, that pt. safety has never been a priority. I have witnessed first hand, the unsafe situations that, Select has put it's patients and staff in daily. Select takes admits directly from the ICU units of local hospitals. The only difference between the ICU and Select, is that the nurses would often times have 4 to 5 patients where as the ICU units nurses never had more than 1-2 patients due to their high level of acuity. They would call these patients "stable", which often times would be the farthest thing from the truth. These patients were often times still being diagnosed and treated for acute illness. IF they would become unstable and needed critical drips the patients were often times kept at our hospital instead of being transfered back to a ICU unit because the patients length of stay would not be met. The worse part about keeping these patients on drips, was that we often times had no ICU trained nurses to take care of the patient. I also witnessed, a CEO tell another manger, that we needed to keep a patient alive for another day, even though the family had made the decision to take the patient off life support. The hospital stood to loose 10,000, due to not meeting the length of stay, so the family was told that we had to slowly take him off the machine, which in reality was the farthest thing from the truth. Ultimately the patient and family suffered another day all in the name of profit! I also, over heard several conversation of case mangers with doctors about, "Finding a reason to buy a few more days for the patient to stay." Often time these patients had absolutely no reason to be at a acute hospital. I think it's an absolute travisty the way these patients are cared for all in the name of profit, not only do these patients have substandard care , due to poor staffing because of controlled acuity systems , they have untrained , unqualified staff caring for them. The sad part about it, families are unaware of the substandard care until an event takes place.

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