I have an ethical dilemma on my hands. I started working in Case Management for a small-ish hospital system (formerly a Tenet facility, bought out by 2 physicians), about 2 months ago. My specific function is Discharge Planning.
I really like the job, I like the hours, I like my co-workers. I really enjoy working in this department and, best of all, the pay for this job is outstanding! I mean really, really good. I was pretty shocked when I was told the salary, so of course, this is icing on the cake.
OK, here's the bad part.....now that I'm fully on board, been on my own the last few weeks, and am into the job, this is what is going on.
There are certain doctors, at this facility, who also own or are Medical Directors of SNF's, or that own Home Health companies, or DME companies, etc. When their patient is getting discharged, these docs are writing orders like "Discharge to "XYZ SNF", or "D/C home w/XYZ Home Health for Nursing/PT". It is so bad that these certain docs are arranging for the SNF placement w/their own facility prior to d/c, completely bypassing the CM dept. The SNF intake/admissions co-ordinators are coming onto the units, going throught the patient's charts, making copies of records, etc!
To make matters even worse...there is one doc,in particular, who is referring patients to the SNF, even when they don't need/want SNF placement, when they have family/caregivers at home who do not want SNF placement. Even after, myself, as the DCP has assessed for pt. needs and determined that SNF placement is not indicated.
I have had 2 incidents in the last week, where the doc tried to "coerce" the pt/family into SNF placement, saying the pt "had to go, they had no choice, they were being trransferred to another hospital", and trying to send them to his facility! :angryfire Also, this MD id of a certain ethnicity, his pt's are, majority, the same ethnicity, and generally non-English speaking. He basically scares these pt's into placement by telling them they "might die" if they just go home!! :angryfire
I have been able to prevent these last 2 pt's from SNF placement by telling them and their families that they do have a choice and no, they cannot be forced into this placement. This doc was not a happy camper. In fact, w/the last pt, he said "then he has to sign out AMA, I'm not going to d/c him, and no, I will not give him his d/c prescriptions, oh and you better tell him he could die from an exacerbation if he goes home!"
There is more, but that is the gist of it.....oh, did I mention he has his "reps" from his companies calling us (DCP's/CM'S), approaching us (individually) outside of the hospital and handing us bags, that when opened turn out to be expensive items like Louis Vuitton bags??!!!
I really, really like this job, like I said, and the pay is, well, it will be hard to give that up....but I feel like I need to leave here....I don't trust anyone in management, or HR, I feel like the whole culture here is corrupt....even calling their internal compliance line would be a crap-shoot...
What to do? Who can I report this to? CMS, Medicare/Medicaid?