JUDY WOODRUFF: Now: There
are 4,000 hospice agencies
around the country.

And a new report has
some disturbing findings
showing neglect for
too many patients and

their families.

John Yang has the story.

JOHN YANG: In-home hospice
care promises 24/7 support
for a dying patient's
physical, emotional

and spiritual needs,
allowing them to spend
their final days at home.

But a new investigation has
found that calls for help in
times of crisis have sometimes

been met by delays, no-shows
and unanswered calls.

Here to talk about this
is one of the reporters
who conducted the
investigation, JoNel Aleccia,

a reporter for Kaiser Health
News, which is an independent
service not associated with

Kaiser Permanente.

JoNel, thanks so
much for joining us.

You worked on this with your
colleague Melissa Bailey.

Tell us what you found, sort of
the magnitude of what you found.

JONEL ALECCIA, Kaiser
Health News: Yes, we did.

You know, we took a look at
about 20,000 hospice inspection
record from Medicare, and those

included about 3,200 complaints.

And of those, more than
700 were confirmed and
found to have problems.

We looked at those, and more
than half of the inspection
reports and the complaints

with problems were from
people who had missed visits,

no-shows and other kinds
of services that they were
promised that were missed.

JOHN YANG: And an example of
this, we have got -- you folks
at Kaiser Health News produced

a video part of this report.

This is Patricia Martin
of Wasilla, Alaska,
talking about her struggle
to get pain medication

for her husband as
he died of cancer.

PATRICIA MARTIN, Alaska:
So, I called them.

And I said, we didn't
get the pain medication.

And they said, oh, well, we
can't get ahold of the doctor,
because he is sleeping because

he works at night at the
hospital on Saturday.

He said to me, "I thought I
was going to get pain relief"
when we got into hospice.

JOHN YANG: The Alaska Department
of Health and Social Services
concluded in that case

that the hospice failed
to properly coordinate
services for the Martins.

How typical was that
-- is this example?

JONEL ALECCIA: You know, Pat
Martin's situation was, sadly,
really typical of the situations

that we found in those
complaint records.

We combed through them and
were able to track down people
through death records and other

public records.

But Pat's case was,
sadly, very common.

We had other people where they
delivered boxes of medication
without telling them how to

use it.

They had nurses that they would
call in the middle of the night.

One nurse that we reported
about, her cell phone was on
silent, and she missed 16 calls

for help as this woman's
husband was dying.

JOHN YANG: What was the industry
response to what you found?

JONEL ALECCIA: You know,
what the industry said is, no
situation like that is tolerable

or appropriate.

But they emphasize that most
people who enroll in hospice
are happy with the experience.

And they said that these cases
are a small minority of the
typical cases that you will

find in hospice.

JOHN YANG: In your report,
you pointed out that a lot of
this was paid for by Medicare

and that hospice gets -- the
hospice services are paid for
by about $16 billion a year in

Medicare funds.

These are taxpayer funds.

What sort of oversight
does Medicare have
over these services?

JONEL ALECCIA: Well, Medicare
-- you know, Medicare is
responsible for oversight of the

hospices.

But, you know, what is not often
known is that these hospices
aren't inspected as frequently

as nursing homes
are, for instance.

They don't have to be
inspected every year.

You know, they just changed the
rules, and starting in 2018,
they will have to be inspected

every three years.

So, Medicare is responsible for
oversight of these hospices,
but it doesn't appear to

be enough.

JOHN YANG: In -- we have got
less than a minute to go.

What can families do to try
to avoid these problems?

JONEL ALECCIA: Families
can ask questions about
how people respond to
patients in emergencies.

If they have time, they can
ask their local state -- the
state health department for the

inspection records at the
hospice that they plan to use.

But, mostly, they need
to ask questions about
what happens late in the
night and when patients

are at their worst.

JOHN YANG: JoNel Aleccia Kaiser
Health News, thank you so
much for telling us about this

really startling report.

JONEL ALECCIA:
Thanks for having me.

JOHN YANG: And you can
read the full Kaiser Health
News report on our Web
site, PBS.org/NewsHour.