Would you report this?

[JPKToxicWaste]

I am a private duty nurse, and I am having issues with a coworker. I have been on this particular case for about 5 years, and she started about 6 months ago. She seems nice, and their parents adore her, but here are my problems:

First, she is always late. I don't mean 15 or 20 minutes, I mean like 2-3 HOURS. We both work days, and I only know this because the parents complain about it to me. The night nurses were getting upset at her lateness, so she changed her start time with scheduling to 7:30 am, so now the night nurses just give report to the parents.

we attend school with the patient, and one day earlier this year, the patient missed school because the nurse wasn't there by the time the bus came.... At 9:45 am!

The parents aren't going to complain, because they think she's absolutely wonderful, and she covers 4 day shifts a week, but she's involving them in her fraud by having them sign her sheet stating a fraudulent start time. I tried to bring this up to them, but they got defensive and refused to discuss it.

She also hides her nursing notes. We keep all the notes in a box in the home (current and recent carbon copies) so that nurses and parents can review them. She puts hers somewhere else, I suspect because she's documenting care and assessments at a time when she isn't even in the home. Recently the patient was in distress, and I couldn't review her notes for the past 3 days because they were nowhere to be found.

I've given a lot of thought as to whether I should just continue to mind my own business, or whether I should say something to the agency. Ordinarily, I wouldn't, but I'm thinking of dropping this case, and I know my supervisor will want to know why I'm leaving after all this time. I'm just sick of her BS. She blatantly disregards orders to follow the parents wishes (giving vitamins, changing feedings, even giving ABT eye drops the patient had left over from a previous infection because she thought the patient needed them, but didn't notify anyone but the parents) so of course when I refuse to do what she's been doing until I can get an order, the parents get very upset with me.

I tried to discuss this with her, but she continues these behaviors. I'm not risking my license for this case anymore, and I want to be honest with the agency when I leave. I have mentioned these incidents to our previous clinical manager, but she never did anything about it (as far as I know; she certainly may have addressed it, but there was no change in this nurses behaviors) and the clinical manager recently quit.

what would you do?

[LeChien, BSN, RN]

I was going to say leave it be until you mentioned disregarding orders.

If you plan on staying with the case, put it in writing and bring it to the case manager. You are all supposed to be a team to take care of this child. Once it is out of your hands I would leave it be.

[Nurse tobe]

In this case... I would give one final complaint about it, make sure it's documented, and if it still persists, then leave the case. She is putting the patients health at risk. Were something to happen and the pt was taken to the ER, no one would know what to do and the last nurse would be probably be the one in trouble. My sister had a nurse come in to look after my father when he was ill (he was one of those patients who wanted to be waited on hand and foot because he was sick. He was, but his attitude and everything made my sister not want to be with him. She threatened to put him in a nursing home if he didn't shape up). She would often show up late, but made out her time sheet to where she had been there on time. My dad liked her and all but my sister and brother in law were fed up with it. One day they called the agency to see where she was at and the agency stated that she was there. My sister told them she was not. I do believe she was fired for it and they sent someone else to replace her. Thing is, who knows what this other nurse is doing, but she is jeopardizing the health of said patient. Doing things against dr's order in order to placate the parents is not in the best interest of the patient.

Just my .02.

[Anonymous865]

You state that the nurse is getting the parents to sign her timesheet showing a start time that is wrong. I assume you mean the nurse is being paid for hours she did not work.

Unless the parents are paying for the services themselves, the parents, nurse, and the agency are committing health care fraud. This is a federal crime. People go to jail for up to 5 years for EACH OFFENSE. They can be fined up to $10,000 for EACH OFFENSE.

If the agency is billing Medicare/Medicaid for hours the nurse did NOT work, then they can be banned from providing services for Medicare/Medicaid. I doubt they could stay in business if they are banned from Medicare/Medicaid.

If you suspect the parents and this nurse are committing fraud, notify the agency in writing.

If the agency does not address this, report it yourself

Reporting fraud | Medicare.gov

You can get up to $1000 reward for reporting Medicare/Medicaid fraud.

Insurance fraud costs all of us in increased premiums, reduced benefits, increased taxes, etc.

[Kitiger, RN]

The parents aren't going to complain, because they think she's absolutely wonderful, and she covers 4 day shifts a week, but she's involving them in her fraud by having them sign her sheet stating a fraudulent start time. I tried to bring this up to them, but they got defensive and refused to discuss it.

This is Medicaid fraud, and you must report her. My agency also states that you can also be held liable (fines and/or prison) if it is shown that you knew about it and did nothing, but I haven't confirmed this independently.

False Claims Act - Wikipedia, the free encyclopedia

[JustBeachyNurse, LPN]

Your agency should have a compliance officer to report fraud to. They are legally obligated to act & investigate

[caliotter3]

She is committing fraud and you are aware of it. Report your concerns in writing. Did you inform the parents that their complicity has the potential for negative consequences for them as well as the patient? If your employer is anything like the one I reported the same type of info to, you will find yourself reconsidering your continued association with the employer.