By Molly Corbett, President & CEO of Livingston Memorial Visiting Nurse Association
Not long ago, a Ventura County family called Livingston for help. Their loved one was enrolled with another hospice but had not received a visit from one of its nurses in more than three weeks.
Consider what those weeks must have felt like. The family had made one of the most difficult decisions it would ever face. Instead of focusing on their loved one, they were left wondering when help would come and whether anyone was paying attention.
That’s the human cost of hospice fraud and neglect. It’s not only money improperly billed to Medicare. It’s pain that may go unmanaged, calls that go unanswered and precious time consumed by fear and frustration.
For most families, hospice is unfamiliar territory they may navigate only once or twice. The decision often comes amid fear, exhaustion and anticipatory grief. People at that moment should be met with honesty and compassion, not treated as billing opportunities.
At its best, hospice can be a gift. It provides comfort, dignity and symptom management while helping patients live as fully as possible. It supports families, too, giving them more time and space to be present with the person they love.
I believe that’s what makes the growing evidence of hospice fraud particularly heartbreaking.
Federal officials recently suspended payments to approximately 800 hospices and home health agencies suspected of fraud in Los Angeles alone. Those providers accounted for $1.4 billion in Medicare spending last year, according to the Centers for Medicare & Medicaid Services. In May, the agency also temporarily paused new Medicare enrollment for hospices and home health agencies nationwide while it investigates suspicious providers and removes bad actors.
The moratorium does not prevent established hospices from accepting eligible patients, and families should not delay needed care because of it. But the scale of the enforcement action should prompt every family to ask questions before choosing a provider.
This is not a distant problem. Agencies based outside Ventura County solicit patients here, and dishonest operators can evade detection by shifting their operations across county lines. They do not limit themselves to one community or demographic. They exploit people at one of the most vulnerable times in their lives.
Fraud can take several forms. A provider may enroll someone who is not terminally ill, bill for services never delivered or accept a patient and then provide little or no care. Some people do not realize they have been enrolled in hospice until they seek other medical treatment.
No family should be pressured to sign hospice paperwork. If you’re uncertain whether your loved one qualifies, pause and speak with a trusted physician. Ask where the hospice’s office and clinicians are located. Find out who its medical director is, how quickly a nurse can reach your home and what support is available at night and on weekends. A trustworthy hospice will answer those questions without hesitation.
Use Medicare’s Care Compare https://www.medicare.gov/care-compare/?providerType=Hospice to confirm that the hospice participates in Medicare and review its available quality information. A lack of public data does not automatically indicate wrongdoing, but it should prompt more questions.
Families also have rights. Patients may change hospice providers or end hospice care. Review Medicare statements to ensure every listed service was received. Report unfamiliar charges or an enrollment you did not authorize to Medicare.
I’ve seen how deeply fraud harms people who are already vulnerable. One man told a clinician on our palliative care team that he felt bullied into enrolling with a hospice he did not want and he was not even eligible for hospice per Medicare’s guidelines. We also hear from families whose hospice stopped answering calls, disconnected its telephone or simply disappeared.
The harm extends beyond those directly affected. These experiences can erode trust in hospice altogether, causing families to miss care that could bring comfort, dignity and support.
At Livingston Memorial Visiting Nurse Association, we’ve served this community since 1947, and we believe quality care and careful compliance are inseparably linked. As a nonprofit, we answer to our community, not shareholders.
*Putting patients before profits is not a slogan, it’s an obligation to our neighbors, friends and families. Our history is more than a point of pride. It’s a promise that we’ll be here when families call.
We’re not alone. Ventura County has several established hospices providing trusted, compassionate care. Ask questions. Take your time. Expect transparency. Choose a provider with qualified local clinicians and demonstrated commitment to patients and families.
Hospice fraud is real, and we must confront it. So is the extraordinary good that trustworthy hospice teams provide every day. With stronger oversight and families who have good information, we can protect that care and ensure hospice remains what it was always meant to be: comfort, dignity and help when people need it most.