WEBVTT 00:02.000 --> 00:04.800 align:left position:10%,start line:77% size:80% JUDY WOODRUFF: Now: There are 4,000 hospice agencies around the country. 00:04.800 --> 00:09.800 align:left position:20%,start line:71% size:70% And a new report has some disturbing findings showing neglect for too many patients and 00:10.400 --> 00:11.366 align:left position:30%,start line:89% size:60% their families. 00:11.366 --> 00:13.933 align:left position:20%,start line:89% size:70% John Yang has the story. 00:13.933 --> 00:17.866 align:left position:10%,start line:71% size:80% JOHN YANG: In-home hospice care promises 24/7 support for a dying patient's physical, emotional 00:19.800 --> 00:24.033 align:left position:10%,start line:77% size:80% and spiritual needs, allowing them to spend their final days at home. 00:24.033 --> 00:29.033 align:left position:10%,start line:77% size:80% But a new investigation has found that calls for help in times of crisis have sometimes 00:30.400 --> 00:33.833 align:left position:10%,start line:83% size:80% been met by delays, no-shows and unanswered calls. 00:33.833 --> 00:38.533 align:left position:10%,start line:71% size:80% Here to talk about this is one of the reporters who conducted the investigation, JoNel Aleccia, 00:38.533 --> 00:43.533 align:left position:10%,start line:77% size:80% a reporter for Kaiser Health News, which is an independent service not associated with 00:44.300 --> 00:45.533 align:left position:20%,start line:89% size:70% Kaiser Permanente. 00:45.533 --> 00:47.266 align:left position:20%,start line:83% size:70% JoNel, thanks so much for joining us. 00:47.266 --> 00:51.500 align:left position:10%,start line:83% size:80% You worked on this with your colleague Melissa Bailey. 00:51.500 --> 00:54.366 align:left position:10%,start line:83% size:80% Tell us what you found, sort of the magnitude of what you found. 00:54.366 --> 00:56.700 align:left position:10%,start line:83% size:80% JONEL ALECCIA, Kaiser Health News: Yes, we did. 00:56.700 --> 01:01.700 align:left position:10%,start line:77% size:80% You know, we took a look at about 20,000 hospice inspection record from Medicare, and those 01:05.100 --> 01:08.333 align:left position:10%,start line:89% size:80% included about 3,200 complaints. 01:08.333 --> 01:13.333 align:left position:20%,start line:77% size:70% And of those, more than 700 were confirmed and found to have problems. 01:15.366 --> 01:19.066 align:left position:10%,start line:77% size:80% We looked at those, and more than half of the inspection reports and the complaints 01:19.066 --> 01:23.200 align:left position:10%,start line:83% size:80% with problems were from people who had missed visits, 01:23.200 --> 01:27.166 align:left position:10%,start line:77% size:80% no-shows and other kinds of services that they were promised that were missed. 01:27.166 --> 01:31.900 align:left position:10%,start line:77% size:80% JOHN YANG: And an example of this, we have got -- you folks at Kaiser Health News produced 01:31.900 --> 01:34.500 align:left position:10%,start line:89% size:80% a video part of this report. 01:34.500 --> 01:39.500 align:left position:10%,start line:71% size:80% This is Patricia Martin of Wasilla, Alaska, talking about her struggle to get pain medication 01:40.733 --> 01:42.900 align:left position:20%,start line:83% size:70% for her husband as he died of cancer. 01:42.900 --> 01:45.433 align:left position:20%,start line:83% size:70% PATRICIA MARTIN, Alaska: So, I called them. 01:45.433 --> 01:50.000 align:left position:20%,start line:83% size:70% And I said, we didn't get the pain medication. 01:50.000 --> 01:55.000 align:left position:10%,start line:77% size:80% And they said, oh, well, we can't get ahold of the doctor, because he is sleeping because 01:56.466 --> 02:01.466 align:left position:20%,start line:83% size:70% he works at night at the hospital on Saturday. 02:03.433 --> 02:07.800 align:left position:10%,start line:77% size:80% He said to me, "I thought I was going to get pain relief" when we got into hospice. 02:11.433 --> 02:16.000 align:left position:10%,start line:77% size:80% JOHN YANG: The Alaska Department of Health and Social Services concluded in that case 02:16.000 --> 02:21.000 align:left position:10%,start line:77% size:80% that the hospice failed to properly coordinate services for the Martins. 02:22.200 --> 02:24.233 align:left position:20%,start line:83% size:70% How typical was that -- is this example? 02:24.233 --> 02:29.000 align:left position:10%,start line:77% size:80% JONEL ALECCIA: You know, Pat Martin's situation was, sadly, really typical of the situations 02:32.333 --> 02:35.366 align:left position:20%,start line:83% size:70% that we found in those complaint records. 02:35.366 --> 02:39.833 align:left position:10%,start line:77% size:80% We combed through them and were able to track down people through death records and other 02:39.833 --> 02:41.866 align:left position:30%,start line:89% size:60% public records. 02:41.866 --> 02:44.900 align:left position:20%,start line:83% size:70% But Pat's case was, sadly, very common. 02:44.900 --> 02:49.733 align:left position:10%,start line:77% size:80% We had other people where they delivered boxes of medication without telling them how to 02:49.733 --> 02:51.533 align:left position:40%,start line:89% size:50% use it. 02:51.533 --> 02:55.300 align:left position:10%,start line:83% size:80% They had nurses that they would call in the middle of the night. 02:55.300 --> 03:00.133 align:left position:10%,start line:77% size:80% One nurse that we reported about, her cell phone was on silent, and she missed 16 calls 03:00.133 --> 03:04.033 align:left position:20%,start line:83% size:70% for help as this woman's husband was dying. 03:04.033 --> 03:07.633 align:left position:10%,start line:83% size:80% JOHN YANG: What was the industry response to what you found? 03:07.633 --> 03:12.633 align:left position:10%,start line:77% size:80% JONEL ALECCIA: You know, what the industry said is, no situation like that is tolerable 03:15.100 --> 03:17.166 align:left position:30%,start line:89% size:60% or appropriate. 03:17.166 --> 03:21.100 align:left position:10%,start line:77% size:80% But they emphasize that most people who enroll in hospice are happy with the experience. 03:23.566 --> 03:28.566 align:left position:10%,start line:77% size:80% And they said that these cases are a small minority of the typical cases that you will 03:30.066 --> 03:32.133 align:left position:30%,start line:89% size:60% find in hospice. 03:32.133 --> 03:35.366 align:left position:10%,start line:77% size:80% JOHN YANG: In your report, you pointed out that a lot of this was paid for by Medicare 03:35.366 --> 03:40.366 align:left position:10%,start line:77% size:80% and that hospice gets -- the hospice services are paid for by about $16 billion a year in 03:43.933 --> 03:45.166 align:left position:30%,start line:89% size:60% Medicare funds. 03:45.166 --> 03:47.133 align:left position:10%,start line:89% size:80% These are taxpayer funds. 03:47.133 --> 03:50.833 align:left position:20%,start line:77% size:70% What sort of oversight does Medicare have over these services? 03:50.833 --> 03:55.833 align:left position:10%,start line:77% size:80% JONEL ALECCIA: Well, Medicare -- you know, Medicare is responsible for oversight of the 03:56.466 --> 03:58.533 align:left position:30%,start line:89% size:60% hospices. 03:58.533 --> 04:02.000 align:left position:10%,start line:77% size:80% But, you know, what is not often known is that these hospices aren't inspected as frequently 04:03.166 --> 04:06.166 align:left position:20%,start line:83% size:70% as nursing homes are, for instance. 04:06.166 --> 04:09.633 align:left position:20%,start line:83% size:70% They don't have to be inspected every year. 04:09.633 --> 04:14.566 align:left position:10%,start line:77% size:80% You know, they just changed the rules, and starting in 2018, they will have to be inspected 04:14.566 --> 04:16.500 align:left position:20%,start line:89% size:70% every three years. 04:16.500 --> 04:20.966 align:left position:10%,start line:77% size:80% So, Medicare is responsible for oversight of these hospices, but it doesn't appear to 04:21.633 --> 04:23.133 align:left position:30%,start line:89% size:60% be enough. 04:23.133 --> 04:25.833 align:left position:10%,start line:83% size:80% JOHN YANG: In -- we have got less than a minute to go. 04:25.833 --> 04:29.000 align:left position:10%,start line:83% size:80% What can families do to try to avoid these problems? 04:29.000 --> 04:34.000 align:left position:20%,start line:71% size:70% JONEL ALECCIA: Families can ask questions about how people respond to patients in emergencies. 04:36.600 --> 04:41.600 align:left position:10%,start line:77% size:80% If they have time, they can ask their local state -- the state health department for the 04:44.000 --> 04:47.466 align:left position:10%,start line:83% size:80% inspection records at the hospice that they plan to use. 04:47.466 --> 04:52.466 align:left position:20%,start line:71% size:70% But, mostly, they need to ask questions about what happens late in the night and when patients 04:54.433 --> 04:56.866 align:left position:20%,start line:89% size:70% are at their worst. 04:56.866 --> 05:01.000 align:left position:10%,start line:77% size:80% JOHN YANG: JoNel Aleccia Kaiser Health News, thank you so much for telling us about this 05:01.000 --> 05:02.666 align:left position:20%,start line:89% size:70% really startling report. 05:02.666 --> 05:05.133 align:left position:20%,start line:83% size:70% JONEL ALECCIA: Thanks for having me. 05:05.133 --> 05:09.266 align:left position:10%,start line:71% size:80% JOHN YANG: And you can read the full Kaiser Health News report on our Web site, PBS.org/NewsHour.