Hospice care facilities provide comfort to terminally ill patients near death. But a shocking new investigation revealed that hundreds of these facilities across the country have serious deficiencies, some of which have put patients in harm’s way.

The probe, undertaken by the Department of Health and Human Services (HHS) Office of Inspector General (IG) and obtained by NBC News, found that of the 4,563 hospice care facilities across the country that receive reimbursements from the Centers for Medicare and Medicaid Services (CMS), more than 300 surveyed between 2012 and 2016 were flagged as poor performers.

Some of the more extreme cases involved maggots developing around a patient’s feeding tube and another patient’s wounds not being properly treated resulting in the patient developing gangrene and having his leg amputated.

The investigation also turned up several cases of Medicare fraud, including a $60 million scheme in North Texas in which nurses admitted to over-medicating patients to hasten their deaths and ratchet up Medicare payments. In that case, 16 people were indicted, of whom seven pleaded guilty and nine are set to stand trial later this year.

Other deficiencies noted in the report included facilities enrolling patients who were not terminally ill, billing for services that were never provided, inadequately training staff, not monitoring medications, failing to run background checks on staff, and providing fewer services for patients than what was required.

Erin Bliss, assistant inspector general at HHS, told NBC News that the number of hospice facilities with serious deficiencies was “surprising and, frankly, they’re unacceptable.”

“Hospice patients and their families are some of the most vulnerable. We’re talking about people that are dealing with a terminal illness for themselves or their loved ones,” she said. “And so we think that Medicare should make it as easy as possible for them to get good information about their hospice options and the track records of those providers and how to make complaints in the event that they do run into a problem or are concerned about their hospice provider.”

CMS issued a statement saying it has “zero tolerance for abuse and mistreatment of any patient.” Facilities that receive reimbursements are required by meet basic federal health and safety standards, the agency said, adding that it issued new guidance for surveyors earlier this year in an effort to more quickly identify and address facilities with the most dire patient safety situations.

The IG’s office is also reaching out to consumers, encouraging anyone who experiences or witnesses abuse, neglect, poor care or financial abuse in a hospice care facility to contact the administrator, the state department of health, the police, or the Medicare hotline at 1-800-Medicare.

Beasley Allen lawyer Alyssa Baskam handles cases of abuse and neglect at nursing homes and other health care facilities. We have a brochure that provides more information about these types of cases and what people can look for to identify potential abuse or neglect. Request a free brochure.

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