copperkettle

Unions are a two-edged sword. I've been on both sides of it. With the current administration in Washington wanting to take over all of health care, we can bet that SEIU will either be knocking on your door soon, or trying to co-opt any other nursing organizations. They will collect your union dues and cause uproar in the workplace. Some workplaces NEED to have a little uproar created, but the presence of a union forever changes any good management/employee relationships. I also believe it is a mistake to believe union members have any say in what the union does. In my experience, that's a joke. Be very careful.

Wow. I don't want to sound like a Pollyanna here, but I've worked for this agency connected to a hospital for a few years. Our bosses are absolute sticklers about compliance and documentation. Most of the kinds of fraud mentioned in the previous posts, I have never even thought of happening. We are very aware of when a skilled need exists or does not; we teach patients and families and caregivers to do simple wound care, injections, what to look for and report, with the goal of them being as independent as is safe for their situation. We are in the midwest; people here seem much more willing to do this. We discharge as soon as they are safely able to get out for outpatient care or do it themselves. We can always readmit later if they change. I'm sorry to hear of so much fraud. Frankly, I'd encourage anyone knowing about intentional fraud, not just mistakes, to report them to Medicare. It is our collective honor and reputation at stake. If it's wrong, stop enabling.

If your system is organized so you can easily communicate with the nurses doing the visits, it will make your life much easier if you can see in advance when a recert or discharge is coming up, and ask the nurses who have seen the patients to provide you with the summary of info you need, including DATES of ER visits or admissions, and other specific events the OASIS will ask you about. If your agency does not use Case Managers who should be able to give you this info, maybe you could encourage some kind of sequential event journal system on each patient for such information. I say this because I sometimes have to do a recert or discharge on a patient I have never seen, and have to dig back through every visit to find out when they were in the hospital, or to get enough of the picture to construct a "summary" of what has taken place in the past 2 months. It has often taken me several hours to do an accurate recert or discharge, when it would have taken the Case Manager less than one, because they have the info in their head or personal notes. Good luck in your new position. Keep us posted on how it's going for you. I love doing Home Health. The individual patients I get to know make the "paperwork" bearable. (Isn't it funny we still call it "paperwork" when we're mostly using computers???)

I've worked with Horizon at our agency for the past few years. We have current high quality laptops and our IT dept keeps things updated. My opinion -- while McKesson may cover the Medicare requirements well, the user interface continues to look like something from the early 90's. Unnecessarily cumbersome, time consuming, frustrating. The medications and orders processes are confusing and complex. The interface requires many, many more keystrokes and mouse moves than necessary. I do not understand why a big company like McKesson maintains this amateur user interface. Even with touch screens on our laptops, it is a real pain.