Consumers may take comfort in recognizable brand names or chains. That rationale may also apply in the context of health care providers.
Yet with familiarity comes an expectation of consistent performance. Unfortunately, a lawsuit against ManorCare, a nursing home chain, suggests that patient expectations were not met. In fact, the allegations include negligent care that resulted in personal injuries.
According to the complaint, ManorCare prescribed unnecessary therapies in order to capitalize on Medicare reimbursements. To be sure, a bad outcome is not always sufficient proof of medical malpractice. There may be risks associated with a procedure or treatment, yet a patient gave informed consent in conjunction with the recommendation of his or her doctor because the potential benefits outweighed those risks.
However, the allegations in this case suggest therapies prescribed for financial reasons, rather than patient health needs. In one example, an 85-year-old patient’s medical records indicated hospice care and another therapist noted that the man was medically fragile. Instead of hospice care, however, the ManorCare facility where the man was staying subjected him to 100 days of therapy. Notably, 100 days was also the limit of the man’s Medicare coverage for therapy treatments. Only after those 100 days were up did the facility put the man into hospice care.
In the above example, the 100-day period seems more than just coincidental. Yet gathering and presenting evidence of substandard medical care to a jury involves more than allegations or suspicious coincidences. Generally, the testimony of other doctors or experts will be needed to establish the applicable standard of care and to highlight how the treatment at issue in a particular case fell short of that standard.
It is true that health care costs are rising. However, financial considerations have no place in the medical diagnostic arena. A doctor’s recommendations should be made with a patient’s interests in mind, not potential Medicare reimbursements.
Source: Associated Press, “US intervenes in whistleblower cases against nursing homes,” Matthew Barakat, April 21, 2015