Homebound but working?

i think first it depends on the payor source, tho i do not agree with it, some payors say the patient does not need to be homebound,,,,also i did not think that labs was considered a skill anymore,,,but it may come down to the payor source.

Sorry, I forgot to make myself clear! The patient is Medicare! I know most insurances will allow home health if needed and the patient can still go to work. But under MC I have never had nor heard of seeing a patient that is able to go to work, even if they are disabled. Taxing effort doesn't apply for this. If it did we would all be homebound! Luckily I didn't have to see him today, couldn't contact him. But, unless I'm wrong, isn't this fraud? And, no, MC doesn't pay for any type of labs, in or out of the home.

I think whoever drives him to work should swing him by his lab and have them draw his labs or his md should order him his own INR meter so he could do it himself, we don't do any blooddraws period, wouldn't be an issue for me, but I agree, he's not ( anywhere near) homebound, I wouldn't want to be involved with that case

But, unless I'm wrong, isn't this fraud? And, no, MC doesn't pay for any type of labs, in or out of the home.

Yes, it is fraud.

i agree, i have read and re-read this post------MEDICARE FRAUD!!!!

I'd agree with the fraud aspect due to not being homebound, but not with the labs per se. If you have a patient on anticoagulant therapy, your skill should be teaching the patient about the therapy. You also have a three-week window for skilled assesment based on acute changes, assuming that the anticoag therapy is new. If your DoN cannot give you an adequate explanation for "overlooking" the homebound guidelines, then I'd say you should be looking for another company. (Some Medicare HMOs do not require homebound status, only an acute change in condition.)

Thank you all for your thoughts. The pt's been on service since Feb this year, not an HMO, straight MC. Yes, I agree, it's definitely fraud and I just can't believe how obvious it is! I have already decided to find another agency ASAP. This is just some of the icing on the cake, too much to go into here. Just trying to decide when to notify MC of all the problems with them. Guess I will after I leave.

That's what I figured, too. Plus I think I'm the only one there who hasn't actually seen this pt. The other nurses there act like it's no big deal that he works. Not sure what background they have for HH but don't think they understand the rules. Can't wait to get out of there!

Thanks. I'm usually pretty diplomatic about other employers/agencies when talking to potentials. As far as employers being worried about their own misdeeds, if they follow the MC guidelines then they shouldn't have any fears. Or misdeeds at all. I'm not necessarily a "do gooder" but I've worked too hard over the years for the knowledge I have now and my license means more to me than someone else's stupidity. I too can turn a blind eye when appropriate and doesn't affect a pt's care but blatant fraud is not that time. And, of course, I would never make it a topic of conversation at an interview.