Opinions, Is this illegal?

Specialties Home Health

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ok fellow homecare nurses--- does this seem wrong to you?

i was hired as a 40 hour per week salaried employee.... recently, our company was bought out and we are now paid per visit.. our census has plummetted and i have had appx. 12-15 revisits per week (for the past two months). in the past, our 40 hour salary was based on 30 revisits, which is fulltime, and of course 12-15 is hardly even part time pay. however, administration has told the full-time employees that although we are paid per visit, we were told- verbatim--, ' we own you for 8 hours a day regardless of the fact that you are only getting paid per visit."

so basically, i have 2-3 revisits per day but im sitting around from 8-430 monday thru friday because 'those are the rules.'

is this illegal? i have to be 'available' to them for 8 hours per day when im getting paid for 2 hours?? its not like we are even making on-call pay!! help!!??!!?

I am not a full-time employee at Amedisys. I do not get benifits. I work Mon-Fri and I get paid per visit. I was told that if I sign-up to work it is from 8 am to 5 pm. I even do call and work week ends just like a full-timer but they are not going to hire anybody full-time except the LPN. That is what I and the other part-time RN was told each and every time we asked about full time work. We had 3 full-time RN's in the past 6 months. They leave pretty quickly. I really liked the job when I first started but it is getting to be too much.

sounds like this amedisys company is committing medicare fraud right and left. it's companies like this that make me really angry.

please- report this company!

amedisys reaffirms 2008 guidance, strong cash collections and reduced day's sales outstanding

"baton rouge, louisiana (november 20, 2008) - amedisys, inc. (nasdaq: "amed", "we", "our"), one of america's leading home health nursing companies, today announced that we have reaffirmed our previously stated 2008 guidance that net service revenue is anticipated to be in the range of $1.150 billion to $1.175 billion, excluding the effects of future acquisitions, if they are made. 2008 diluted earnings per share is expected to be in the range of $3.20-$3.25 based on an estimated 26.9 million shares outstanding, after adding back tlc integration costs and also excluding the effects of future acquisitions, if they are..."

http://www.amedisys.com/press_release.cfm?do=view&id=177

Specializes in Hemodialysis, Home Health.

WOW... interesting. :stone

Our nurses are all ppv as well, and while we have PLENTY of pts, (we average 6-8 visits per day.. or more), we DO have to be available to the agency until 4:30 pm.. even if you have completed your visits for the day. That's so if another admission comes in, or a prn visit needs to be made.. so I understand that and have never had a problem with it.

But your agency/company.. sheesh ! Marla is right.. sounds like they are really pushing the envelope. And what they do, affects us all in the long run.

We discharge our pts as soon as they are no longer homebound.. and we do NOT admit them if they are not truly homebound. We always tell them up front, that if they are able to drive and go out, then we are not permitted to sign them up, as it is against medicare rules.

Medicare has changed so many of their "billable/not billable" policies, that it is hard to keep anyone for any length of time, even those poor pts. who could really benefit from us staying with them a while longer. Indeed, a blood draw is not even considered a "skill" anymore, so for our poor elderly patients, who have no way to get to their MD office and need weekly or monthly PT/INRS drawn.. and no family or neighbors who can take them... what about them? It's really sad, the way it's getting more and more difficult to keep some of these needy patients. And then you have agencies such as yours who commit the ultimate fraud, and why medicare keeps changing their rules......... :madface:

:nono:

Hello:

I am new to this forum but a friend of mine sent this to me because I work for Amedisys. I am very worried because on more than one occassion I have admitted pt's to home health services that are not home bound......when I complained for being sent to a home of a non-home bound pt and wasting my time I was told that I am not a team player and that I do not promote the company. I admitted a pt today who was busy all day preparing a dinner for her Son and his family and a few others. I think there were 15 total people coming to her home for dinner. She was not even aware that she was being admitted for home health. She had seen her Dr about 3 weeks ago and our sales rep talked to him about getting her onto home health services. We are seeing her husband too for something that he is also not home bound for...he went out to the grocery store while I was there so she could make her world famous eggplant cassarole. They are a nice couple and they are both scratching their heads as to why we are coming to there home for these services. He wanted to go to the local out-pt clinic for PT and Anodyne therapy. The part on the 485 that states why the pt is home bound is filled out with the following statement: "Pt is not able to leave home without a taxing effort." What a crock!!!

They do pay well but I sure don't want any part of this anymore...I have been sucked-in enough. I would guess that at least 1/3 of our pt's are not really home bound. It's all about numbers and quotas. I was told that this pt today must be admitted so that we can make our quota and be on the "Presidents List" yet again. We even have a nurse who sits in the office and makes "sunshine calls" to previous pt's and if they say they don't feel well she calls their Dr and gets orders for home health services. How many times can we teach diabetic care or what HTN is or CHF, COPD???? Is there not a cut off for how many times a pt can have physical therapy or education from a home health service??? Needless to say I am looking for another job. I just hope I don't go to jail first. I am afraid that the current Directer will give me a bad reference if I complain more...so I am keeping it cool until I get the heck out of there.

How many of you out there remember the ABC scandal? They were caught doing some similar abuses and it resulted in a lot of the oversight/paranoia that we are living with now. Still, there are questionable practices that continue out there. It hurts us all in the long run, because it drives up health care costs and results in innocent agencies being punished for the bad ones.

Unfortunately you are pretty much powerless in these situations, which I learned the hard way. I worked for such a company in a middle management position and when I tried to make changes and questioned things too much I was fired. It ruined my life. I should have listened to my gut instinct but I wanted to get a year in and was just starting to look for another job when they let me go. How do you explain that to other employers? Who in their right mind would believe that fraud and abuse is still alive and well?

You can report the company to Medicare, and they will take a closer look, but it is hard to prove these things if they are very good at crossing t's and dotting i's. They know how to make things look good. Remember too that some insurances do not require homebound status, only medical necessity. Sunshine calls are not illegal, but it turns my stomach to hear that they are so desperate for referrals that they do this. It reminds me of credit card companies constantly calling me to see if they can transfer balances or sign me up for the latest plan.

My advice is to look for a non-profit agency and do your research before you accept such a job. You will be the one who gets in trouble for fraud if the going gets tough. Your employer will never back you up. They will claim innocence and fire you to make it look like they are correcting the problem.

You will be the one who gets in trouble for fraud if the going gets tough. Your employer will never back you up. They will claim innocence and fire you to make it look like they are correcting the problem.

How true. The person who reports wrongdoing will always be the one who suffers, and yet we are mandated to report.

I used to work for Amedisys and quit for this reason! You must be available to work 40 hrs and also do endless reduntant paperwork that is micromanaged and non regulated - BUT you only get paid per visit. In the end, as a medical professional you are making less than the Mc Donald's employee! Check out indeed dot com for more eye opening experiences!:flmngmd:

Specializes in Community Health,Pediatric, School nursi.

If you are providing home care service to Medicare patients (for whatever company) who you KNOW are not homebound, then YOU are participating in fraud. Get out now and report them.

I had a similar situation working per diem for a momandpop HHA last year. Having had MC skilled visit experience, I knew I could not justify recerting at least 2 of the pts., and they called me up when I was about to d/c the patient, and told me that the pt's spouse was not very well, and I should keep visiting the patient. (just for assessment). Also another that had more social services problems, and had NO skilled services needs - (she'd been recerted like 4 times already). I left soon after, thankfully, for another job - I could just see myself having to testify in a fraud case in court! - RUN!

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

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.

Specializes in LTC, HH, clinic.
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/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=9070&p_created=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.

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