I worked in HR & forced to change charting

[Lutzka1121]

Hello!

Up until two two weeks ago I worked at a home health agency as the HR person and this was my first time working in the healthcare field.

About 7 months into my job the owner approached me and asked me to assist with correcting (her term) charting for the CNAs. I agreed. Basically I had two different tasks. Every week I was suppose to find the CNAs who didn't chart at a clients and plug in charting for them. I was instructed to use the care plan or a previous visit to find which codes and tasks to chart. My second task was to audit charting and correct any mistakes ( again her terms).

Basically I was review every single visit for the past 4 months and moving forward and make sure they CNAs were not making mistakes and document if they were missing requires tasks or had charting something not of the plan of care. If I found a mistake I was to instructed to remove it if it wasn't supposed to be on there and add it something required for as missing.

The owner had a LPN at the time who was auditing but refused to make changes as I was instructed. She was "laid off" short after this but we all knew it was because she refused to do the changing. When I was assigned the task the owner told me the LPN felt it was wrong to change which is why she was asking me help and her justification was that it's not like it didn't happen they just didn't chart or mark

correctly and we are just fixing it.

I was scared to lose my job so I kept doing the work until I explained to my husband one day what what I was doing and he freaked and said I was falsifying medical documents and I needed to stop. I started questioning to my coworkers if they was really that bad and none of them really gave me a straight answer. But I continued to do it because again didn't want to lose my job.

Flash forward to two weeks ago I was "laid off" with the explanation of not needing a FT HR person and because I complained about auditing the charting. When I asked for a time of when I complained the owner couldn't give me an example. I can only assume one of my coworkers said something to the owner. I was offered two weeks severance and unemployment.

I just need a straight answer if what I was doing was wrong or not. Is this a normal practice? It seems so wrong as I have no clue what the aide did at the clients and if they weren't doing a tasks for weeks at a time and I plugged in that they did that is wrong!

Also how this could come back to haunt me if it's found out. Should I report to the DOH even though I could get in trouble? I refuse to accept the severance because I have to sign saying I won't sue in the future but I'm really scared this could affect me. Thanks for any feedback!

[caliotter3]

Move on and find another job. In the future don't falsify documentation. If you don't want to sign the release from liability in order to get the severance, then don't do so. It would be good to keep that employer wondering if and when you are going to deal with them on this issue. Meanwhile, find a new employer that has higher standards.

[caliotter3]

BTW, a more appropriate way to deal with the situation would have been to have each employee come in to fix their own paperwork after their audit. I've seen that happen with licensed nurses. Then you would have been doing your job of auditing without doing something wrong.

[JKL33]

When I was assigned the task the owner told me the LPN felt it was wrong to change which is why she was asking me help and her justification was that it's not like it didn't happen they just didn't chart or mark

correctly and we are just fixing it.

I was scared to lose my job so I kept doing the work until I explained to my husband one day what what I was doing and he freaked and said I was falsifying medical documents and I needed to stop. ...

No this is not normal practice and yes this is a big problem. It's likely fraudulent billing on the part of that HH agency, since there's absolutely no way that owner knows what work was or wasn't done. You have no idea what the job-specific training or the expectations of the CNAs are, and you certainly have no knowledge of what they are doing at their visits. The ageny wants certain things charted, amongst other reasons, to be able to bill for them. And yes, it is also falsification of medical records.

My guess is there is just blatant falsification and fraudulent billing - - otherwise why not enforce CNA charting policies with the CNAs and make them chart their work properly? The reason to make someone else do the charting is to tell that person to chart more than what was done since they don't know any different.

Find a new job pronto. Don't sign the agreement. Not sure about the specific steps of reporting this, maybe someone else will know.

[Davey Do]

This would be a really good topic for RiskManager. He was just on AN.com yesterday and I tried to send him a PM, but his account isn't accepting PMs.

So I sent him a Friend request instead. Maybe he'll look me up?

Welcome to AN.com, Lutzka1121! Hopefully, we are and/or will be able to help you out.

[HyzenthlayLPN]

It sounds to me as though you are potential whistle blower for a Medicare and/or Medicaid fraud case. I found the number for Medicare online and copy/pasted it below. Call them and tell them who you worked for and what they had you doing.

Call us at 1-800-MEDICARE (1-800-633-4227). Report it online to the Office of the Inspector General. Call the Office of the Inspector General at 1‑800‑HHS‑TIPS (1‑800‑447‑8477). TTY: 1‑800‑377‑4950.

[Lutzka1121]

Thanks for the info! We were private pay and didn't accept Medicare only LTC insurance. The owner was obsessed with the possibility of getting audited by the state and wanted everything to be PERFECT. The RN case managers couldn't get the aides to chart correctly or all the time despite conversations and training. So the owners solution was to have me audit and "correct" thier errors and chart on behalf of the HHA if they missed charting on a shift. If I audited and found they hadn't been charting hydration even though it was on the care plan I was expected to go back and add it the charting for all visits missing this item. Sometimes this was every single visit. Simply because she didn't want to get dinged on this during a state audit. She is a seriously neurotic human being. I mean seriously an insane micro manager and unpleasant person.

[Julius Seizure]

Thanks for the info! We were private pay and didn't accept Medicare only LTC insurance. The owner was obsessed with the possibility of getting audited by the state and wanted everything to be PERFECT. The RN case managers couldn't get the aides to chart correctly or all the time despite conversations and training. So the owners solution was to have me audit and "correct" thier errors and chart on behalf of the HHA if they missed charting on a shift. If I audited and found they hadn't been charting hydration even though it was on the care plan I was expected to go back and add it the charting for all visits missing this item. Sometimes this was every single visit. Simply because she didn't want to get dinged on this during a state audit. She is a seriously neurotic human being. I mean seriously an insane micro manager and unpleasant person.

That's odd that the aides that weren't charting correctly despite training were not "laid off" for not satisfactorily completing their job duties. Was there any concern that they weren't actually doing other parts of their job, either?

As far as getting dinged on a state audit, what does the owner think happens if the state auditor notices that an HR person has been retroactively editing the documentation?

OP, I would seriously consider letting the people that do the state auditing know what is going on. That owner seems to be more worried about money than about staff doing their jobs correctly, and that is concerning.

[Ambersmom, BSN, RN]

Considering you were asked to chart and correct cna's mistakes... How do you know they were mistakes? Did you see the patients? If you didnt see the patient you CANNOT chart for someone else period.

[Ambersmom, BSN, RN]

OP, I would seriously consider letting the people that do the state auditing know what is going on. That owner seems to be more worried about money than about staff doing their jobs correctly, and that is concerning.

Yup, I would be calling the state as well.

[Ambersmom, BSN, RN]

Also how this could come back to haunt me if it's found out. Should I report to the DOH even though I could get in trouble? I refuse to accept the severance because I have to sign saying I won't sue in the future but I'm really scared this could affect me. Thanks for any feedback!

If the company is audited and your name can be traced to any of those "corrected" charts you could be held accountable for the alleged fraud. I reported an agency years ago for blatant fraud and heinous patient care, I was asked to change my honest assessments to ones that fit the agencies agenda profit margin, I refused. When I realized the extent of fraud I called CMS, and asked what would happen if my name were associated with these charts (this place had your computer password so they could even log on as you) anyway, cms said I could lose my license, and be barred from participating in medicare and/or fined and jailed. I then asked what would happen if I reported it? They said well, nothing because you reported it. I waited a week, made sure I was absolutely correct in what I suspected, then reported it and gave notice. So, OP, you can do what you want but to limit damage to yourself, I would report it, because eventually someone will. Good luck.

[Lutzka1121]

Thank you all again! I reported them to the DOH who was interested in my story. Per the attorney I spoke with he said the best thing I could was report it with out implicating myself if I could so I never said I was the one doing it I was just reporting and was let go for questioning it. My only defense would be I worked in HR what reason would I have to change anything unless I was forced too by the owner who didn't want to risk her RN and LPN licenses if they go caught. All of this was electronic charting so not sure if my login is linked to it somehow.

I KNEW she was in the wrong! She is still trying to have my old coworkers reach out to me trying to convince me it wasn't wrong. I know it's her typing on the other end so I have since ceased contact with everyone there and deleted their contacts. Her latest quote which kills me is "if what you corrected what can be proven to be correct how do you consider that falsification of documentation" I wish I could post a screenshot of the whole thing. She is seriously nuts.

Again thanks for your advice!