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In traditional hospitals, patients have an attending physician or doctors on staff to treat them in the event that their condition worsens. Unfortunately, Medicare loopholes have created an industry of so-called "long-term hospitals" where extended-stay patients are transferred to from traditional hospitals. There are over 400 of these long-term care hospitals across the U.S. One company, Select Medical Corporation, alone has eight locations throughout Florida. These "hospitals" usually do not have an overnight physician on staff. And in the event of an emergency, physicians are called from outside the hospital.

While some long-term hospitals are not-for-profit, most are. The previously mentioned Select Medical Corporation is a for-profit, publically traded company specializing in long-term care hospital management. While Select's profits soar, whistleblowers within the company expose the management's lack of adequate training and quality standards. A recent New York Times investigation reports countless examples of downright gross negligence by Select. It's a widespread problem, with reports showing Select Medical Care has committed four times the national average of Medicare violations on a per-bed basis.

Proponents of long-term care hospitals say while traditional hospitals help patients survive acute illness, they are not equipped for long-term care. Discharging the patients to long-term care hospitals, they say, would be more appropriate. But the reality is, the motive is profit. Under Medicare payment rules, normal hospitals have a financial disincentive to keep patients for long periods of time because Medicare begins paying the hospital less money after 25 days. Meanwhile, long-term facilities have a financial incentive to take these patients, and are subject to less Medicare oversight due to their nature as a "specialized" care facility. The normal hospital frees up a bed for a new patient (which Medicare would pay more for), while Medicare pays the long-term care facility receiving the patient an average of $40,000 for patient care. This amounts to a staggering burden on the Medicare system, projected to be $4.8 billion dollars this year alone.

The long-term care hospital market was founded based on loopholes in the Medicare rules and has been exploited to an alarming level. Medicare reform is long overdue, and absolutely must address the issue of long-term care hospitals. It's vital that the legislature continue to close the loopholes which allow these companies to skirt the rules and severely jeopardize patient lives only to increase profit margins slightly.

If someone you know has been admitted to a long term care facility, research the company as much as you can before placing a loved one. By doing so, you'll probably know more about it than Medicare administrators.