How to Avoid Healthcare Fraud and Abuse

By Staff Writer

When a person is so sick that they need constant attention by a healthcare provider, the best place for them to be is in an assisted living facility. While, in most cases, the patient receives all of the care they need without incident, there are instances where those with the power (i.e. the caregivers and/or those running the facilities) take advantage of those in their care.

How to identify healthcare fraud and abuse

Examples of healthcare fraud and abuse

• Charging for services but not providing them
• Charging more for care/services than agreed upon
• Getting kickbacks for referrals to other providers or for prescribing certain drugs
• Over- or under-medicating
• Recommending incorrect treatment
• Medicaid fraud

Examples of Physical abuse

• Signs of injury such as bruises, welts, or scars
• Broken bones, sprains, or dislocations
• Drug overdose or not taking medication regularly
• Broken eyeglasses or frames
• Signs of being restrained
• Family not allowed to see patient alone

Risks that Can Lead to Caregiver Abuse

Although many people —everyone from spouses, children, relatives and even professional caregivers— can find the act of taking care of someone who is sick or elderly an enriching endeavor, even the most motivated can fold under pressure. This can be a result of or escalated if the patient’s condition worsens.

If severe enough, the stress of being a caregiver can lead to mental and/or physical health problems – thus, leading to the caregiver becoming burnt out or impatient. Signs that a caregiver may eventually burn out and lash out at their patient(s) include:

• Inability to cope with stress
• Depression
• If a relative is providing care, lack of support from other caregivers
• A perception that taking care of the elder is burdensome and without psychological reward
• Substance abuse

This is by no means a comprehensive list. However, watching for these warning signs —especially if the patient is being taken care of by a family member— may help to lessen the chance of abuse. This story from Greeneville is just one of many examples where a caregiver has abused their patient.

Healthcare fraud and abuse is not limited to family members. Employees at an institutional setting can also experience the stress of taking care of patients, leading to abuse. For example, nursing home staff can be prone to elder abuse if they lack training, have too many responsibilities given to them, if they are unsuited to being a caregiver and/or if they work under poor conditions.

If you believe you or your family member has been a victim of healthcare fraud or abuse, please schedule a free consultation with Tennessee medical malpractice attorneys at Gilreath & Associates today. For more information about healthcare fraud, medical malpractice, abuse or other related issues, continue browsing our blog and knowledge center.

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