Patient family blatently lied to me, ugh!!

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Specializes in Pulmonary, Lung Transplant, Med/Surg.

Found out today patient and family were trying to hide the fact that patient was going to outpatient cardiopulmonary rehab...as I dug deeper the over involved daughter actually said to me, "They told us not to tell you guys because you wouldn't come anymore..." So lying to us and trying to con Medicare is the logical solution??

You can bet your behind I had a nice chat with that transplant coordinator. Ugh!!! Thankfully I just opened him Saturday but still, unbelievable.

Does this happen to anybody else?!

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Sorry to hear you were lied to.

You may want to double check on the need for discharge though. Our home health agency does not discharge for outpt cardiac rehab. It is not a duplication of services because our agency does not offer cardiac rehab and this is approved by Medicare. It may still be a difficult and taxing effort for the patient to leave home.

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Specializes in Pulmonary, Lung Transplant, Med/Surg.
Sorry to hear you were lied to.

You may want to double check on the need for discharge though. Our home health agency does not discharge for outpt cardiac rehab. It is not a duplication of services because our agency does not offer cardiac rehab and this is approved by Medicare. It may still be a difficult and taxing effort for the patient to leave home.

Medicare is fairly strict. As far as they're concerned if you are well enough to participate in cardiopulmonary rehab you are too well for home care. It's been a well oiled machine between myself and the lung transplant center since I've started with home care. This patient, however, was 5 years out of their transplant, they were back for CHF/rejection issues.

Nonetheless, they were d/c'd today per the transplant team.

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Our Director advised us to continue services if a patient still meets homebound guidelines.

I think patients don't understand the homebound criteria. They think it is a choice verses how their medical conditions impair them to leave the home. If they know home care will have to discharge if they are not homebound, they try to tell you why they think they should still get services. I've had patients say to me "I won't go to church on Sunday so you nurses can visit me"... or "how do I get fast food if I can't leave the home?"

It's sometimes amusing and often difficult to explain to patients what a difficult and taxing effort is.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

If primary home care diagnosis is cardiac + client is able to get out the door to outpatient Cardiac Rehab -- also providing CP instruction, then homecare needs to discharge as duplication of services = Medicare fraud. If your are providing home care for wound care as primary diagnosis,then home care can stay in.

You do not want your name attached to chart when you know duplication services occurring and Feds get wind of agency fraud..

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Specializes in Pulmonary, Lung Transplant, Med/Surg.
If primary home care diagnosis is cardiac + client is able to get out the door to outpatient Cardiac Rehab -- also providing CP instruction, then homecare needs to discharge as duplication of services = Medicare fraud. If your are providing home care for wound care as primary diagnosis,then home care can stay in.

You do not want your name attached to chart when you know duplication services occurring and Feds get wind of agency fraud..

Absolutely. I don't need my name anywhere near that!!!

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