List date(s) this work was published or aired.
22-Jul-11
Provide a brief synopsis of the story or stories, including any significant findings.
The article showed how allegations of patient neglect and Medicare fraud have tracked hospice care’s change from a largely charitable cause into a for-profit business, dominated by large corporations. It also showed how patients who are not dying are being admitted to hospices and — having given up their rights to curative care — are being subjected to neglect at the most vulnerable times of their lives, sometimes to the point of death. Shares in Chemed Corp., which owns the largest U.S. hospice chain fell in the weeks after Waldman’s story and were down substantially for the year.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Waldman used public records requests to obtain corporate registry, survey and regulatory documents from five states and plumbed more than 1,000 pages of court records in state and federal courthouses in 16 states. He also obtained voluminous patient medical records from family members. The state and federal data revealed how hospice costs, profit margins and patient lengths of stay have soared in the last decade to become much higher at for-profits versus non-profits. The data helped undergird experts’ and prosecutors’ assertions that hospices are using sales incentives and other inducements to target the most profitable patients who aren’t dying, and scrimping on care expenses.
Explain types of human sources used.
Waldman interviewed more than 60 doctors, hospice employees, patients and family members to build a portrait of a noble calling gone awry. The doctors, chaplains, nurses and marketers he interviewed revealed the job pressures — and bonus pay — motivating hospice employees to target old and vulnerable patients who were not dying. Family members told their loved ones’ stories.
Results:
Waldman’s work has been closely followed within the U.S. Department of Health and Human Services, which is considering new regulations and reimbursement schemes for hospice care. Roberta Baskin, of the Office of Inspector General with HHS, called his work “great investigative reporting.” Medpac, the advisory panel to Congress on Medicare, has been working with Waldman’s article in recommending reforms.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No corrections or clarifications.
Advice to other journalists planning a similar story or project.
Get public records requests in early to federal and state FOIA officers, because often the best stuff takes months to arrive. Never hesitate to call or email people blind, through LinkedIn or other social media, which are a gold mine for sourcing. Always aim to put everyone on the record, which takes coaxing and cajoling. Work with medical professionals and others to abide by the very strict privacy restrictions by ensuring the requisite patient waivers are in place to allow them to share experiences.