Fraudulent visits - yes I brought it up! - page 4

I'm a DON at a HHA. I have an LPN who we've caught a few times and has been accused many times of fraudulent visits. She's on probation with the BON for the same thing in the past. Every time I... Read More

  1. by   nurseprnRN
    If your agency issues a laptop or tablet for her on-site documentation, (and you certainly should), entries can be electronically timed AND you can have a GPS chip in it to track where it goes. Consider that. You can also buy free-standing very inexpensive GPS-tracking gadgets to attach to, say, staff name pins, which are then downloadable to show where they've been that day and when. They use them around here to track snow plow contractors to verify their billing. Big Brother-ish? You betcha. How much do you want to avoid being called out for Medicare/Medicaid fraud? Do the risk-benefit analysis and I'd go for the tracking.
  2. by   KelRN215
    I do not see how anyone could possibly believe that this nurse is doing 26 visits in a day. I did six today and it took me the whole day.
  3. by   BabaLouRN
    Maybe she had 26 patients visit her at her house!! LOL
  4. by   Isabelle49
    It would be in your best interest to document, document, document what is happening. If an audit is done and visits prove to be fraudulent, you could very well be pulled into the middle of this mess and it won't be pretty. We had a nurse fake her visits and when she was caught, our DON didn't want to fire her. I suspect it is because she did not want to let Medicare know about it as the missing visits may have resulted in a much lower pay rate. She was fired and sadly not much longer afterward she died in her sleep.
  5. by   Bubbles
    So the question remains what do we do when we know there is Medicare fraud? The situation as described does not seem to even need to be proved given that actually doing that number of visits is not humanly possible! Do we want to keep hospice as a Medicare benefit? Do we want Medicare to survive such insults? I recently read an article on this site about being a 'whistle blower' and the need for the person sounding the alarm to protect themselves by seeking the assistance of a nurse attorney. Just last evening I saw on the news where six employees were fired because they blew the whistle for being required to 'rubber stamp' physicians to the state medical board who did not meet the qualifictions. For not wanting to harm the general public these employees were all fired and now they are on the news. And don't you just want to know the names of the doctors who should not have been licensed in my state?
  6. by   MikeFNPC
    It’s not possible to do that many visits in one day, at least not consistently. I’m currently transitioning into an FNP role after over 15 years in home health. Most agencies have some form of sign in process for each visit in addition to a log that’s kept in the home. The agency I’m at now pulls the home log at the discharge visit for quality control. Additionally, LVN’s where I’m at are required to have ride-along visits once a year. You could ride with her on one of those 26 visit days just to see what she’s doing; although I couldn’t imagine doing that.
  7. by   Libby1987
    Man, am I ever naive. These kind of things are pretty much responsible for the insane amount of documentation the rest of us legit agencies have to comply with.

    I've worked with a lot of contract staff who have worked for different agencies and there has been some cross over with another local legit agency, I've never heard anyone share anything remotely close to what has been described here.

    And I would have to have starving children before I'd be within 10 miles of such a practice.

    Amd TID visits? I haven't seen that since we were paid FFS pre reform, how is that a financial benefit for the company with PPS?