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Hostility Against Hospitals Raged During COVID; Long COVID Patients Lack Safety Net

— This past week in healthcare investigations

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INVESTIGATIVE ROUNDUP over an image of two people looking at computer screens.

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Hostility Against Hospitals Raged During COVID

As hospitals continue to treat COVID-19 patients, they are also experiencing hostility that has "flourished during the pandemic, encouraged by misinformation campaigns, anti-vaccine activists, and conspiracy theorists," the .

Such was the case at Valley Regional Hospital, a small community hospital in Claremont, New Hampshire. One day in December, callers began overwhelming the hospital, demanding it treat a COVID patient in its care with the anti-parasitic drug ivermectin, the Post reported. The calls and emails spiraled out of control, even threatening a "military extraction" of the patient from the hospital. And then came the bomb threat.

"No matter what, when things heat up at work, we can't just close up shop and go home," Jocelyn Caple, MD, MBA, who became chief executive of Valley Regional Hospital in 2020, told the Post. "I was angry that anyone would endeavor to make my staff's jobs any harder or more stressful than they already are."

Sadly, Caple and her staff are not alone.

"While doctors and nurses say they're accustomed to encountering anger from patients and their relatives, the level of distrust surrounding COVID and its treatment represents a new and disturbing phenomenon," the Post wrote. "It's an environment in which some families view clinical decisions with suspicion, leading to threats and lawsuits."

The mistrust has given way to "spiraling tensions between hospitals and families of COVID patients," the Post reported. That has been especially common when it comes to ivermectin, which has been embraced as a COVID cure by those skeptical of vaccines, despite a lack of evidence that it works.

In the case of Valley Regional Hospital, after the bomb threat -- the first in the hospital's history -- medical practices remained closed for days, the Post reported. Caple brought in counseling to help her staff, and many broke down in tears.

"There was fear, but anger, too, at outsiders who would issue threats as staff risked their own well-being to care for COVID patients," the Post wrote.

No Safety Net for Long COVID Patients

As an untold number of Americans struggle with lingering symptoms after their acute COVID infection subsides, an uncovered "critical gaps in the existing assistance programs."

Two taxpayer-funded programs -- unemployment insurance and long-term disability insurance -- are in place to safeguard workers against lost income, NBC reported. However, neither program is an option for most people with long COVID because they may be too sick to work but not ready to depart the workforce altogether.

"Long Covid cases fall into the huge middle ground between 'I have a cold' and 'I have stage four pancreatic cancer,'" Kathleen Romig, director of Social Security and disability policy at the Center on Budget and Policy Priorities," told NBC. "That's where we really have a huge gap in this country."

NBC reported that interviews with more than three dozen individuals across medical fields, government agencies, and disability law practices revealed that large numbers of Americans are failing to get the financial assistance they seek while battling lingering symptoms.

"If my employer knew the shape I am actually in, I wouldn't have a job," one home healthcare worker in Pennsylvania, told NBC. The worker added that she has over $10,000 in medical debt, and is trying to conceal her neurological issues from her employer, even as she cares for patients with severe disabilities.

All the while, efforts to spur government action have largely gone unanswered, NBC reported.

"The system is gearing itself against individuals with long Covid," David Putrino, PT, PhD, director of rehabilitation innovation for Mount Sinai Health System in New York, told NBC. "And that makes them sicker and sicker over time ... causing them so much stress and exertion as they're trying to get care that it actually makes the condition worse."

Investigation Reveals Rampant Hospice Fraud

Dozens of patients who were supposed to be near death and in need of end-of-life care were "unwitting pawns" in an alleged Medicare fraud scheme that saw two Southern California couples rake in more than $4.2 million in federal reimbursements, .

State prosecutors said the couples ran two hospice businesses and paid doctors for "bogus diagnoses or illegal kickbacks for patient referrals," the Times reported, noting the accusations "mirror the type of widespread hospice fraud" previously detailed in its own 2020 investigation of the industry. In all, 16 people face multiple felony counts, including conspiracy to commit insurance fraud, insurance fraud, and grand theft.

"Decades of unchecked growth came to a halt Jan. 1, when a moratorium on new state hospice licenses took effect along with reforms aimed at curbing widespread fraud in end-of-life care," the Times wrote. "The measures were largely spurred by the Times investigation, lawmakers said."

The Times investigation had found that "explosive growth" in hospice providers had changed end-of-life care from a space of charities and religious groups to a multibillion-dollar industry. "The rapid expansion spawned widespread fraud, negligence, and mistreatment of some of California's most vulnerable residents," the Times wrote of its findings.

Defendants in the latest prosecution include Ralph Canales and Rochell Paragados Canales, and Giovanni Ibale and Maureen Ibale, who together operated New Hope Hospice Inc. and Sterling Hospice Care Inc. in San Bernardino County, the Times reported, citing court documents.

An examination by the state auditor is also underway, the Times reported, in order to identify deficiencies and recommend improvements when it comes to hospice licensing and oversight.

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    Jennifer Henderson joined 51˶ as an enterprise and investigative writer in Jan. 2021. She has covered the healthcare industry in NYC, life sciences and the business of law, among other areas.