Medicaid fraud is a widespread problem within the health care industry in Florida and nationwide. The issue is especially pervasive when it comes to elderly, and nursing home patients in particular.
The reason is because these individuals often lack the ability to discern or report what is happening to them. This can involve patients undergoing procedures that are unnecessary or not in their best health interest, as well as their accounts being billed for services or medications that were never rendered. In any case, it is patients who suffer this harm.
Recently in Sunrise, a 48-year-old dentist became the subject of a search warrant in a Medicaid fraud case in which it was alleged he fraudulently billed Medicaid for dentures in patients who either never received them or didn’t need them. During the search of his computers, federal agents allegedly found evidence of child pornography as well.
The investigation is ongoing, and the dentist in question has not as of this writing been formally charged. However, the clinic’s billing practices have been the focus of an inquiry by the Florida Attorney General’s Office too, which is analyzing records dating back at least five years.
According to the Sun-Sentinel, court records don’t indicate how much may have been allegedly bilked from Medicaid, but there are several anecdotal examples provided. Among those was that of a 99-year-old dementia patient, long restricted to a liquid diet and unable to communicate, was given a full set of false teeth.
Part of the reason the criminal probe is taking so long is that many of the patients involved are either unable to be interviewed due to their disabilities, or they are now deceased. Some could not remember if they even had dentures or, if they did, who provided those services.
Although this type of situation is by no means unique to dental work, we do know based on a 2013 report from The New York Times that poor dental hygiene within nursing homes is “epidemic.” Many residents are plagued by gum disease, cracked teeth and cavities – and most often because their mouths simply aren’t kept clean.
Even though policies regarding dental care have been much improved in many facilities, many offices are sorely understaffed and can’t keep up with the need. Patients have to be fed, helped to the toilet, hydrated, or repositioned in their beds to help prevent pressure sores. That often means teeth brushing falls low on the totem pole of things to do.
Even when this type of care is available, not many staff members are properly trained in how to deliver routine dental hygiene to patients with dementia who may resist it, sometimes violently.
Beyond just having bad breath or a cavity, this can lead to serious health problems, including horrible pain, deadly infections and even pneumonia – which is one of the top causes of death among elderly nursing home patients.
In a study of 1,100 residents in two dozen nursing homes in Wisconsin, nearly one-third had teeth that were broken to the gums, meaning their roots were visible. Another one-third had “substantial” oral debris on their teeth or in their mouths. Another study in 2006 of five facilities in New York found that only 16 patients received any oral hygiene assistance at all. Of those, the average length of time spent brushing their teeth: 16 seconds. Some facilities didn’t even have tooth brushes.
At Freeman Injury Law, our nursing home abuse lawyers know that this lack of care is unacceptable and can lead to serious pain and other medical complications for vulnerable patients. If you have concerns about the care your loved one is receiving, contact us today to learn more about how we can help.
Call Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights. Now serving Orlando, West Palm Beach, Port St. Lucie and Fort Lauderdale.
Fraud investigation into dental office uncovers child porn, warrant says, Nov. 27, 2015, By Tonya Alanez, Sun Sentinel
More Blog Entries:
Study: 10 Percent of Older Americans Are Victims of Abuse, Nov. 28, 2015, Fort Lauderdale Nursing Home Abuse Attorney Blog