Long-term care hospitals, which have grown rapidly in the last 25 years, are cited as having almost twice the number of Medicare violations as standard hospitals, and also have higher incidents of bedsores and infections. But according to the New York Times, such facilities--there are more than 400 nationwide now, up from only about 10 in the 1980s--face less scrutiny than standard hospitals.
These hospitals are defined by the fact that they keep patients longer than standard hospitals. Despite the rapid growth, Medicare has not closely examined care, and does not penalize the hospital if it does not submit quality data. The federal agency has few ways to discipline long-term care hospitals, or any hospitals for that matter. Hospitals must submit plans to correct the problems, but CMS cannot impose fines or reduce payments.
"It is typically only when the deficiencies are chronic or serious, such as when they directly affect patient care, that Medicare will take the unusual step of threatening decertification," said Robert L. Roth, who was a senior lawyer for Medicare.