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Elderly Have Few Care Options

December 16, 1997

WASHINGTON (AP) _ Many elderly Americans who are referred to home health care agencies or nursing homes by hospitals that own them are offered no alternative, according to government regulators.

``We found that many Medicare beneficiaries do not have full choice in selecting a home health agency or nursing home,″ said June Gibbs Brown, inspector general for the Health and Human Services Department, in a report released Tuesday.

Brown said a survey of 651 Medicare patients and a review of their hospital discharge records justify new rules included in this year’s balanced budget act requiring hospitals to disclose which follow-up care companies they own and inform the elderly of available choices. She recommended that Medicare officials publicize the new requirement.

Among the elderly on Medicare who got home care from hospital-owned companies, 38 percent told federal inspectors the hospital ``just sent home care people to them″ after they were discharged.

Likewise, a quarter of those referred to hospital-owned nursing homes said they had ``no say″ about which nursing home they went to.

More than 60 percent who got home health care after a stay at a hospital owning a home care company ended up with that company, records showed. Hospitals that owned nursing homes discharged Medicare patients there, rather than to independent homes, 40 percent of the time.

Elderly people placed in hospital-owned follow-up care reported feeling more certain they were discharged from the hospital at the right time, and having a better understanding of the services they would receive, than those going to independent care-givers.

But recovery took longer when patients got care from hospital-owned companies, inspectors found.

Although hospital stays were an average of two days shorter, nursing home stays averaged eight days longer when a Medicare patient was sent to a home owned by the hospital rather than an independent home. For patients discharged to hospital-owned home health agencies, home care lasted on average 12 days longer.

Medicare pays flat rates for hospital treatment of any given illness _ no matter how long it takes _ but pays daily fees once patients move on to a nursing home or home health care. Hospital discharge practices have come under increased federal scrutiny as the number of big health care conglomerates that also own follow-up care companies has grown.

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