Is this OK or is this fraud?

Dear Nurse Beth,

Our Physical Therapist is on vacation for several weeks. We continue to admit rehab patients to our Swing Beds. Nursing is expected to do the physical therapy based on an initial assessment done by a therapist. Is this allowed, or our we not meeting our Swing bed requirements without a trained therapist working with the patients?

Dear Meeting Requirements,

Swing beds are beds in an acute care hospital that can be designated as sub-acute beds (for example, Rehab) if needed, often in rural or critical access facilities.

The provider will order therapy for the patient needing sub-acute care and placement. Therapy may include occupational therapy, physical therapy, respiratory therapy, skilled nursing care, and so on. The therapy must be delivered or supervised directly by a qualified therapist, in this case, a Physical Therapist.

An assistant or a nurse can deliver some of this care, but the Physical Therapist needs to make the initial evaluation and prescribe treatment. Nurses can assist with transfers and mobility, but a nurse is not qualified to independently provide physical therapy,

The question that comes to mind is billing and services. I'm not sure how the facility can bill Medicare for physical therapy when there was no Physical Therapist. Also the patients who needed professional physical therapy did not receive it, which seems unethical.

My knowledge of Rehab is meager, but I'm sure there are nurses here on site who will have plenty of great insight to your question.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!