Senate Committee Requests Investigation of Long-Term Care Hospitals

Janice Simmons, March 10, 2010

A Senate panel is looking into allegations that some Medicare beneficiaries receiving care in long-term care hospitals "are being exposed to an unreasonable risk of harm."

Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Minority member Charles Grassley (R-IA) said Tuesday that they are asking the General Accountability Office (GAO) to investigate problems related to care and safety at the facilities that treat patients for an average of 25 days or more.

They also sent a letter to Select Medical Corp., a publicly traded Pennsylvania company that runs 89 long term hospitals across the country. Twelve of the company's hospitals were reported in a story last month in the New York Times to have incurred 22 violations during the last three years.

If uncorrected, Medicare could ban those hospitals from admitting Medicare patients, the Times reported.

The 22 violations represent an estimated 2% of the serious violations that Medicare found nationally—even though Select operates less than half a percent of the nation's hospital beds. In an analysis of 2007 and 2008 data, Select's hospitals were cited at a rate almost four times that of regular hospitals for serious violations of Medicare rules.

In the letter, Baucus and Grassley said they were concerned about allegations related to:

  • Unusually high rates of violations of Medicare requirements
  • Poor healthcare quality
  • Inadequate staffing in terms of the type and number of practitioners
  • High staff turnover rates
  • Inadequate patient monitoring

More than 400 similar facilities, called long term acute care hospitals, have opened nationally in the last 25 years, according to The Times. Many of the other long term care hospitals were found to have been cited for violations at a rate about twice that of regular hospitals. Overall, long term care hospitals currently treat about 200,000 patients a year, including 130,000 Medicare patients at a projected cost of $4.8 billion to the government, up from $400 million in 1993.

In a statement, Select Medical said that it looked "forward to providing the [Finance] Committee with accurate facts untainted by plaintiffs' lawyers' pleadings that make plain that Select Medical provides high quality care to thousands of high risk and fragile patients each year."

It added that it "received full accreditation in every one of [its] 21 Joint Commission reviews" and that it "looked forward to documenting our true history for the Finance Committee."

According to the Times, Select is partly owned by a private equity firm, and it sold shares to the public in September. Its top two executives, a father and son—Rocco and Robert Ortenzio—made about $200 million from salary, benefits, and share sales since founding the company in November 1996. The Ortenzios, who previously working in the for-profit hospital industry, still own about 10% of the company, worth around $200 million, according to the Times.

Janice Simmons Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at
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