So frustrated !! One of the places I work has a administrator who is really pushing the lmits of Medicare.. this goes beyone Ruging for Dollars, way into me thinking... "if this chart gets pulled for review Medicare will take back every last cent"... Nurses notes are lacking or the same old , v/s stable no signs of infection, etc... this administrator is having me cover individuals who RUG out at PA1... ( he/she was in a psych hosp with a 3 day stay ), PD2 (he/she went out for mental status changes, pulled out the IV, had po abt and RUG out at PD20, therapy ended 2 weeks ago and we are mointoring them to be sure they don't decline... on and on and on...I feel as if this is fraud, not even pushing the limits, myself and other nurses, therapists are feeling the same way, we rool and eyes and whisper under our breath, oh my god, how are we going to justify this ? :argue::argue:Everytime we review this with the administrator, he indicates this is all coverable and appropriate under Medicare Part A for skilled observation, and I am reeling, what are we skilling for ?!?!? I'm so glad that all I do is complete the MDs and not be held liable for the decision to keep the person on, I'm okay , right ? I am not making the medicare decision, of course this is documented no where, should I worry if Medicare comes looking ? I am doing the MDS correctly, if nothing happend in the hospital stay or look back period, than nothing happened... but , this is all making me very very ill...thoughts please , no , I cannot quit, and no, I can't go above the adminstrator, been there done that all I had was negative outcomes for me...
One of the places I work has a administrator who is really pushing the lmits of Medicare.. this goes beyone Ruging for Dollars, way into me thinking... "if this chart gets pulled for review Medicare will take back every last cent"...
Nurses notes are lacking or the same old , v/s stable no signs of infection, etc... this administrator is having me cover individuals who RUG out at PA1... ( he/she was in a psych hosp with a 3 day stay ), PD2 (he/she went out for mental status changes, pulled out the IV, had po abt and RUG out at PD20, therapy ended 2 weeks ago and we are mointoring them to be sure they don't decline... on and on and on...I feel as if this is fraud, not even pushing the limits, myself and other nurses, therapists are feeling the same way, we rool and eyes and whisper under our breath, oh my god, how are we going to justify this ? :argue::argue:Everytime we review this with the administrator, he indicates this is all coverable and appropriate under Medicare Part A for skilled observation, and I am reeling, what are we skilling for ?!?!? I'm so glad that all I do is complete the MDs and not be held liable for the decision to keep the person on, I'm okay , right ? I am not making the medicare decision, of course this is documented no where, should I worry if Medicare comes looking ? I am doing the MDS correctly, if nothing happend in the hospital stay or look back period, than nothing happened... but , this is all making me very very ill...thoughts please , no , I cannot quit, and no, I can't go above the adminstrator, been there done that all I had was negative outcomes for me... 