UnitedHealthcare Accused of Incentivizing Nursing Homes Not to Transfer Residents to Hospitals

Was your loved one insured by UnitedHealthcare (UHC) while receiving care at a nursing home? If they suffered a medical emergency but were not transferred to a hospital, resulting in injury or death, you may have a claim for legal action. Burg Simpson can explore your right to bring a UnitedHealthcare nursing home lawsuit.

The Guardian recently released a report revealing that UnitedHealthcare allegedly provided secret financial incentives to nursing homes not to transfer critically ill residents to hospitals for emergency care. At least one resident suffered permanent brain damage due to alleged interference on the part of UHC.

UnitedHealthcare covers more seniors with Medicare Advantage than any other health insurance company. According to The Guardian, the scheme to minimize hospital transfers from nursing homes and assisted living facilities has saved the company millions of dollars in costs of caring for elderly patients.

Companies need to be held accountable when they put profits ahead of people. Our nursing home neglect attorneys are prepared to fight for justice on behalf of nursing home residents and their families. To find out if you have a UnitedHealthcare nursing home lawsuit, call Burg Simpson at 888-895-2080 today. Your initial case evaluation is FREE and 100% confidential.

Do I Have a Claim?

Both UnitedHealthcare and the facility responsible for providing care to your family member may be held liable for conspiring to prevent or delay necessary medical treatment. The evidence needs to show that the delay or failure to provide care caused your loved one harm.

Potential examples of situations where a claim may be filed for nursing home neglect include:

• Delayed treatment of a stroke, resulting in brain injury
• Failure to treat a heart attack, leading to damage of the heart muscle or heart failure
• Not transferring residents with pre-existing conditions to a hospital if their symptoms worsen
• Avoidable complications from pneumonia or other infections due to a lack of treatment
• Failure to hospitalize a patient exhibiting signs of mental deterioration
• Lack of treatment for a fall or other serious injury, potentially resulting in complications
• Coercion of residents to change their code status to “do not resuscitate”

Nursing home residents are susceptible to a number of serious health issues. This can make it difficult to determine whether the facility’s negligence and/or the malfeasance of an insurance company contributed to their decline in health or, even worse, death.

Burg Simpson has the experience and resources to investigate nursing home neglect. We waste no time collecting the evidence needed to prove that the defendants’ actions harmed your loved one and that you and your family are entitled to compensation.

What Evidence Do I Need for a UnitedHealthcare Nursing Home Lawsuit?

The controversy surrounding UnitedHealthcare’s alleged incentives to limit the number of nursing home residents being transferred to a hospital represents a novel legal challenge. Ultimately, our lawyers will need to prove that UHC and the nursing home conspired to deprive your loved one of necessary medical care.

Evidence that may help to establish wrongdoing on the part of the defendants includes:

Admission Agreement

This contract specifies the care and services the nursing home is required to deliver. It also contains your loved one’s wishes pertaining to medical decisions. Ideally, you will have a copy of the original agreement so we can identify any questionable changes.

Medical Records

It is important to provide a complete picture of your loved one’s health both before and after the incident. This includes medical records from the nursing home, as well as records held by other medical providers.

Insurance Paperwork

People with elderly family members covered by UHC should thoroughly review their insurance policy. The Nursing Home Plan specifies the insurer’s obligations and your relative’s rights.

Witness Statements

Residents (particularly those close to your loved one) may be able to provide testimony on your relative’s condition. Testimony from caregivers and other staff may support a claim against the nursing home, the insurer, or both.

It may be difficult to get witnesses to come forward in a nursing home neglect case. Attorneys at Burg Simpson can pursue various legal means of obtaining witness testimony.

Expert Witness Testimony

We enlist medical experts, authorities on nursing home regulations, and other professionals to support your case. This is critical for proving liability, establishing the damages you and your family are due, and more.

Autopsy Report (If Applicable)

Delays in medical care may prove fatal for vulnerable seniors. Unfortunately, autopsies are rarely performed on elderly patients. If your loved one passed away because a nursing home failed to transfer them to the hospital, it is crucial to request an autopsy. A report by a pathologist establishing the case of death is essential for any wrongful death claim.

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Communications between nursing home staff and UHC or another insurer may also prove vital. Such evidence would obviously be a closely kept secret, but Burg Simpson can take steps to acquire internal records and communications when preparing your case.

Are You Entitled to Compensation?

Both residents and their families may be entitled to significant compensation for losses due to nursing home neglect. This may include damages such as:

• Medical expenses, including therapy and rehabilitation
• Relocation costs for moving your loved one to your home or another facility
• The cost of medical equipment, household medical care, etc.
• Pain and suffering
• Emotional anguish
• Loss of enjoyment of life
• Burial or cremation expenses, the cost of a funeral, and other wrongful death damages

In some jurisdictions, punitive damages may be awarded if the court finds that the defendant engaged in fraud or malicious conduct. Plaintiffs in a UnitedHealthcare nursing home lawsuit may be entitled to additional compensation if the evidence confirms what The Guardian reported: that UHC pressured nursing homes to hold off on transferring residents to the hospital, suggesting that the insurer and the facility knowingly endangered their health.

Contact Burg Simpson Today

Approximately 20% of Medicare beneficiaries have plans through UnitedHealthcare. Your loved one may be at risk if they have UHC nursing home coverage and suffer an injury or illness.

If your elderly relative lives or lived in a nursing home and did not receive hospital care when they needed it, a nursing home neglect lawyer at Burg Simpson can review your case and discuss your legal options. Our unique combination of local clout and national strength means we are client- and community-focused while providing superior representation in complex claims.

Call 888-895-2080 for immediate assistance or fill out our confidential online form to schedule a FREE case evaluation. We are a nationwide law firm with offices in multiple states.