Published Jul 6, 2016
Hhcna
12 Posts
So I am a home health aide, and I love it most of the time, but I'm having an issue. This has been happening a lot lately, say I am scheduled for a pt 8 to 12 I get a majority of the things done for them within an hour sometimes two and the rest is purely down time. I've had patients who are of sound mind and body and or family members who are there who tell me I can leave if I want that they are satisfied with the work and that I can go and put 8 to 12 on my paperwork. I have an issue because I do not want to do that, because it is dishonest, medicare fraud (I think), and could getme in trouble. Though my agency refuses to believe that patients tell aides they can leave early because all the other aides don't say anything about it they just put it down and leave. I also understand the major issue that if something bad were to happen during my scheduled time and I was not there i would be held liable and I'm sure that I would lose my certification amongst other repercussions. However, I did not become a cna to twiddle my thumbs on someone's couch for two hours watching TV with them, ready to poke my own eyes out. What should I do?
AutumnApple
482 Posts
The remedy to your delima is simple really. You already pointed out that you understand reporting the hours as worked after you left is the wrong way to go. Good, at least we don't have to talk about that.
I do though see your problem differently than you. According to what you wrote, you are being told you may go but to mark your time sheet as having let later. You don't want to sit around doing nothing either.
Why wouldn't leaving and marking the time properly not be an option?
The thing I see differently, the thing you didn't mention is: What if the family truly wants you to be done and leave, but you don't?
If they say you can leave, treat this comment as if you are being told to. Inform your company that the work is done, the family is happy but you are being told you can now leave. They will follow up.
You don't want to get into a situation where the family feels you were told to leave and you didn't comply. Documenting well and informing your company of what is going on, keeping them updated, will avoid this.
When they say "You can go", do so. But do it with the hours you were there reported correctly.
caliotter3
38,333 Posts
You are correct in your assumption about medicaid fraud and what could happen if you are caught when an untoward event occurs when you have reported that you were on duty. The consequences are far reaching and permanent for you. What I do in similar circumstances is to report on my time sheet and care note the actual time of departure, including a statement that the client asked me to leave at that time. I also make a written report to the agency that the client has asked me to falsify my time sheets. That way you are in the clear, although you should still be prepared for negative consequences. Expect that you may need to find a new employer even though you acted in a lawful manner.
lifelearningrn, BSN, RN
2,622 Posts
I worked as a HHA in the late 90s/early 2000s and I never, ever billed for hours I wasn't in the home. I often would finish my duties within a couple of hours- part of the job I loved were the hours I could just sit and visit with the patient and her family. I still have fond memories of the time I spent with my patient just 'visiting'.
I should add I wasn't a CNA (just an aide) and I worked three days a week (6 hour shifts) with the same patient for nearly 3 years. Companionship was part of the job description, so I didn't feel like I was 'twiddling my thumbs', though I tried to make sure I did some of my housekeeping duties while she was watching her favorite 'novella', since I didn't understand a word of it. :) I actually loved talking with her, she grew up during the depression and had some amazing stories and wisdom to share.
nursel56
7,098 Posts
I'll keep this short. Don't do it. It really doesn't matter if you're bored, or if someone calls you Little Goody Two-Shoes to make themselves feel better about engaging in fraudulent activities. You'll pray for boredom if the S hits the F.
Neats, BSN
682 Posts
As a seasoned RN and Administrator and experience as a utilization manager with an insurance company I would get a feel for the patient and their needs. If the time truly is decreased from what was originally asked for there should be no problem. Document and speak to your supervisor about the time. If they want you to "lie" about the time this is fraud and it can come back and hurt not only you but your company. Not only fraud but the the skilled nurse visit or home health aide visit time is billed to the insurance company. The insurance company requires documentation. When the bill is paid this money comes from the company your patient/significant other works for and the patient has to pay a portion too (think deductible or co-pay). Some only offer limited skilled nurse/Home Health aid visits. Most people think the insurance company gets to keep the monies, they do not. What the insurance company does is manage the pool of money the company has for their employee medical benefits. When you are not truthful about time it hurts all involved. If your time has decreased and your company is afraid they will not get reimbursed if your patient needs future extra time all your company needs to do is request extra time with supporting documentation.
All medical professionals who are able to document in a patients medical record should document what they observed, what they did for the patient in true fashion. All medical records no matter how you think they are not important are legal records.
If I was the patient and found out you were staying extra time just because... and it was costing me extra monies I would be upset.
I know home health agencies employees want to do what is right for their patients and to provide excellent cares in a timely manner.