Vent: Medicare Fraud

[love-d-OR]

About a month and half ago, I applied to a home health agency that stated on their ad that "they would train new grads" From the start the owner new I was only interested on something part-time as I had a full time job (The full time job did not begin until the begining of this month and I needed work while I waited)

Anyway, my "trianing" was going over the paper work (OASIS, recerts) on the same day I had my interview. I asked if I would be able to spend at least an 8hr day with an RN on the field, and was assured that I would, but that never happened. I was given patients without a formal orientation, it scared me but I figured I would do a visit and assess my comfort level. I felt comfortable with my assessments skills, so I went ahead and did the assignments. However, when I returned with my charts, I was told I had to change my pain scale assessment from indicating a 2 to 8! I was told that the higher the score the more money they would get from medicare. I was also told to always state patients had multiple problems with ADL's. One of my patients did not have an indication for skilled nursing. She had a caregiver, was slightly demented and hard of hearing. Why did she need home health?

I told my manager (owner) I would not change my assessment but if she wanted to make changes, she was more than welcome to do so herself (I should have left then, but I really needed the money). Anyway, I quit yesterday after I had a conversation over the phone with the owner. The work place was very unprofessional.

I heard some people have gone to jail for medicare fraud. I don't know how prominent this is, but its really sad. I'm glad I don't depend on that job to pay my bills, cause that would have been horrible. I hope all home health jobs are not like this one, cause I enjoyed teahing patients and would not mind doing it again for a professional company in the future.

[horsepoor]

they need to be turned in for Medicare fraud. Some of their money is coming out of all our pockets.

[HmarieD]

Whoa...

Never allow someone to change your documentation, that is your license and professional reputation on the line.

This is definitely fraud. They should be turned in.

[lossforimagination]

Speaking of fraud....I've worked for an agency where the owner's motto was "a good nurse will always find a reason to recertify a patient".

I've had clients tell me they felt like they were ripping off medicare because they were on home health so long when they didn't need it. One patient told me she wanted to be discharged, not recertified. I advised my supervisor; and would you believe she called the client and asked her if we could come for just 5 more visits (so they could bill)? Unbelievable!..... I don't work for these people anymore. I wish I had turned them in for fraud.

[love-d-OR]

That's why good social programs turn into failures...