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A state inspector in Missouri documented the grim details: a deep, poorly treated pressure wound on the patient’s tailbone, apparent pain that caused grimacing and — in a crisis requiring a trip to the emergency room — a “maggot infestation’’ where the feeding tube entered his abdomen.

The official cited Vitas Healthcare, the nation’s largest hospice chain, for putting the patient in “immediate jeopardy,” the most severe category of violation. The inspector found that Vitas staffers had skipped home visits and failed to assess the amount of pain the patient endured.

The case is among the most severe of a dozen examples of patient suffering cited in a strongly worded inspector-general report on the hospice industry released Tuesday. The report takes Medicare to task for what it describes as weak oversight and enforcement of the growing ranks of hospice providers and recommends stronger safeguards “to protect Medicare hospice beneficiaries from harm.’’

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The Washington Post

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