Specialties Home Health
Published Apr 26, 2003
hotwheels
7 Posts
Hi I am also new to the board and thought this would be the place to find answers to a whole lot of questions I have. I have been in home health for 7 years and I am hospital based. Home health is probably the only area of the hospital that is making money according to finance statments they send to us. Anyway, what determines medicare/medicaid fraud? Myself and several nurses I work with feel that many of our daily patients are being seen just to make money. There is no reason for these patients to be seen daily. I thought the whole thing behind a good home health nurse was that a patient or someone else was able to learn to do the care and for us to not stay in a home for months much less years!!!
gwenith, BSN, RN
3,755 Posts
Any time you have a portion of health care making money it is open to exploitation. "overservicing" is an easy area to fudge. Who actually funds this service? Who reviews the patients requirements for ongoing care?
Many otherwise honest people will not question a situation like this in case the cut-backs that inevitably come affect thier jobs.
hoolahan, ASN, RN
1 Article; 1,721 Posts
If we give someone daily visits, we practically have to sign in the blood of our first-born that there is no other possible way to instruct the pt or the family in the care.
Are you talking about wound care? You need to read the HHM-11, the manual of Medicare, you will find a link here http://www.cms.gov
Hard to believe you have enough staff to provide so much daily visits. I smell a rat. It is pretty unusual for a HHAgency to make so much money, you are usually making money on some cases, and losing some on others, so break even. If it is Medicare, they are utilizing their PPS budget unwisely IMHO.
HH is the part of the hospital making the most money? More than surgery? That is unusual I would think. You are smart to question it.
renerian, BSN, RN
5,693 Posts
Hoolahan that is the gospel truth what you said...........LOL. Made me smile.
renerian