Opinions, Is this illegal?

I'm glad I saw this thread. I was going to apply there. Not now.

One of the big advantages of this site is to have access to the opinions and experiences of other nurses.

Thanks Caliotter for pointing out that indeed that is what these are... opinions. I work for Amedisys, as a RN case manager. I am not a cheerleader for Amedisys , however, the office I work for is excellent and our DOO is a caring and medicare conscious person. She has encouraged me to use MY nursing judgement in answering the oasis questions, and we are never encouraged to admit patient's who do not meet the homebound status. I would like to clarify a theme that I am picking up here in this thread, and if I am wrong, please enlighten me. Is it the majority opinion that in order to be homebound that one has to be dying and cannot leave their home for any reason?? I have been taught that a person can leave to shop for groceries,go to medical appoinments, church, or even the hair salon, as long as it is infrequent and it must be a taxing effort in order for them to do so. I do not intend to be fraudulent to medicare, if I have it wrong, I need to know.

http://questions.cms.hhs.gov/cgi-bin...ted=1207329475

This is CMS guidance on the homebound status of a Medicare HHC patient.

In case of an audit, if Medicare determines the patient is not homebound, they take the money back from the agency.

Owner/administrators can be charged with fraud, but these cases are very rare and take years to prepare.

The cases are extremely rare in light of the amount of fraud that is happening. RAC (recovery audit contractors) will be looking through agency records soon and will take money back when they find something that does not qualify for reimbursement.

This process can potentially close some agencies due to financial losses.

I worked for a company in Arizona, 32 hours per week. I met my par on Thursday morning, first visit, so I made plans on Friday afternoon. I ended up with 30 visits (at 32 hours I was suppose to have 20-24 modified units/wk). I was called at 2 pm on Friday for a SOC that had to be done immediately and when I said no I had plans for that afternoon, my boss asked me if I met par, I told her yes, I had met it Thursday morning, and she stated, we own you from 8 am to 5 pm. I told her I was part time, and worked 5 days a week. that I worked this job because it was flexible. She told me again, we own you from 8-5 M-F and she would have to talk to me about this. I went in and told her my contract I signed said nothing about working 8-5 M-F, it only specified 20-24 modified units per week. She tried to tell me that it was not a contract, just an agreement. I laughed and told her I was part time, and I would not work 5 days a week and be available from 8-5. Now I work for the same company in California, and have not been told that once. I work 4 days a week 32 hours. Maybe it is branch to branch specific. This office I work for has been great so far. Good luck. I would find a company that fits your needs, and doesn't commit fraud.

is it me, or does the "we own you" phrase make others' skin crawl?

It makes my skin crawl too, but I've used it myself a lot and heard it used a lot in certain contexts. Not a desirable way to refer to oneself or other employees.

just did a google search "amedisys medicare fraud"----very interesting.!!!

Thanks for the tip, could use some interesting reading.

Ha! What's interesting is when you're on the other side - being paid for 8hrs, and they try to tell you that you should not be paid for the full 8hr day, when some of the patients were no-shows, or cancelled, etc. I guess we should all demand things in writing before accepting the job - and to be on the safe side, have your attorney look over the contract!