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Odilia:

You need to schedule a private meeting with your supervisor and let him/her

know all of the details, along with the fact that you have had other patient

complaints regarding the same issue with the same therapist. At the very least,

it is unethical. This type of therapist is the kind that needs to be weeded out

of our profession....your manager should take the appropriate steps to remove

them from the homecare setting.

Pike, PT

Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last week

to tell them I was coming out to the house and she informed me that another

therapist had called that they were on their way out as well. I told her it

would take me 20 minutes to get there, and that I could do some paperwork if

needed if the other therapist had not finished yet. I arrived 25 minutes later

to find that the therapist had already come and gone for the eval. I arrived at

the patient house at 12:50. Today I noticed that the therapist had written on

his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice and

the therapist is lying to the agency about how long he is with the patient. I

actually had a different patient complaining to me before that this therapist

was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let me

know from an employee side what I need to do next.

Odilia

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An agency I work for has an internal hotline for compliance. While it may

seem " right " to start at top (go to therapist.go to supervisor.etc.) this

may not be practical in the real world politics. It is a tough call you are

facing. If you only go to the therapist. you may find a simple explanation

but you may also just hide the problem. If you go to local management, you

may cause hurt feelings if complaint is unjustified and it gets back to

therapist.

I really think the overall problem is billing-staffing policies creeping up

in most HH agencies. They prefer to pay per visit for simplicity in their

tracking and to encourage the therapist to see huge number of patients.

Therapists and managers are so happy to see 12+ HH patients a day but this

is simply not possible if you have excess travel and patient issues. The

agency can turn a blind-eye to the practice and leave it up to the therapist

professional ability but this is avoids the agencies (?) legal and (?)

ethical responsibility with billing. If we went back to pay-per-hour, I am

sure efficiency would drop . cannot be sure the problem would not occur but

it would be less supported by the agency process.

Steve Passmore PT, MS

Healthy Recruiting Tools

spass@...

Phone:

Fax:

" What We Did For You Yesterday Is History. What Can We Do For You Today "

Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card

Design ~ Recruiting Software

From: PTManager [mailto:PTManager ] On Behalf

Of odiliahome

Sent: Friday, February 04, 2011 9:42 PM

To: PTManager

Subject: Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last

week to tell them I was coming out to the house and she informed me that

another therapist had called that they were on their way out as well. I told

her it would take me 20 minutes to get there, and that I could do some

paperwork if needed if the other therapist had not finished yet. I arrived

25 minutes later to find that the therapist had already come and gone for

the eval. I arrived at the patient house at 12:50. Today I noticed that the

therapist had written on his eval that he was there from 5:18 to 6 PM, which

is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice

and the therapist is lying to the agency about how long he is with the

patient. I actually had a different patient complaining to me before that

this therapist was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let

me know from an employee side what I need to do next.

Odilia

Link to comment
Share on other sites

An agency I work for has an internal hotline for compliance. While it may

seem " right " to start at top (go to therapist.go to supervisor.etc.) this

may not be practical in the real world politics. It is a tough call you are

facing. If you only go to the therapist. you may find a simple explanation

but you may also just hide the problem. If you go to local management, you

may cause hurt feelings if complaint is unjustified and it gets back to

therapist.

I really think the overall problem is billing-staffing policies creeping up

in most HH agencies. They prefer to pay per visit for simplicity in their

tracking and to encourage the therapist to see huge number of patients.

Therapists and managers are so happy to see 12+ HH patients a day but this

is simply not possible if you have excess travel and patient issues. The

agency can turn a blind-eye to the practice and leave it up to the therapist

professional ability but this is avoids the agencies (?) legal and (?)

ethical responsibility with billing. If we went back to pay-per-hour, I am

sure efficiency would drop . cannot be sure the problem would not occur but

it would be less supported by the agency process.

Steve Passmore PT, MS

Healthy Recruiting Tools

spass@...

Phone:

Fax:

" What We Did For You Yesterday Is History. What Can We Do For You Today "

Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card

Design ~ Recruiting Software

From: PTManager [mailto:PTManager ] On Behalf

Of odiliahome

Sent: Friday, February 04, 2011 9:42 PM

To: PTManager

Subject: Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last

week to tell them I was coming out to the house and she informed me that

another therapist had called that they were on their way out as well. I told

her it would take me 20 minutes to get there, and that I could do some

paperwork if needed if the other therapist had not finished yet. I arrived

25 minutes later to find that the therapist had already come and gone for

the eval. I arrived at the patient house at 12:50. Today I noticed that the

therapist had written on his eval that he was there from 5:18 to 6 PM, which

is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice

and the therapist is lying to the agency about how long he is with the

patient. I actually had a different patient complaining to me before that

this therapist was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let

me know from an employee side what I need to do next.

Odilia

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Share on other sites

Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week!

My heart goes out to you in your dilemma, just as it did to our colleague,

Marcey.

Without knowing which state you are in, you are saying that the other

therapist claimed a 45 minute visit during the 25 minutes you were en route.

If you were in Florida, you would be subject to FL-456, the law which

enables FL-486, the practice act. FL 456 clearly says that we are " mandated

reporters " of such activities. You may want to check with your state PT

Association office to see whether you are subject to a similar law.

Dr. Dick Hillyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of pikede@...

Sent: Saturday, February 05, 2011 7:40 AM

To: PTManager

Subject: Re: Help, what to do?

Odilia:

You need to schedule a private meeting with your supervisor and let him/her

know all of the details, along with the fact that you have had other patient

complaints regarding the same issue with the same therapist. At the very

least, it is unethical. This type of therapist is the kind that needs to be

weeded out of our profession....your manager should take the appropriate

steps to remove them from the homecare setting.

Pike, PT

Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last

week to tell them I was coming out to the house and she informed me that

another therapist had called that they were on their way out as well. I told

her it would take me 20 minutes to get there, and that I could do some

paperwork if needed if the other therapist had not finished yet. I arrived

25 minutes later to find that the therapist had already come and gone for

the eval. I arrived at the patient house at 12:50. Today I noticed that the

therapist had written on his eval that he was there from 5:18 to 6 PM, which

is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice

and the therapist is lying to the agency about how long he is with the

patient. I actually had a different patient complaining to me before that

this therapist was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let

me know from an employee side what I need to do next.

Odilia

Link to comment
Share on other sites

I do feel that there must be some caution taken in what the patient reports

as the times. I can understand that if there is a repeated pattern of

complaints, it should be followed through.

I was reported to a referring Dr. as only spending 15 minutes per session

with the patient throughout the 5 weeks of treatment which was far from the

truth. The patient's daughter was upset that I was discharging her mother

from treatment and thus was trying to get an additional referral to another

therapist or agency when the patient had clearly reached their maximum

potential.

I believe that caution has to be taken in accusing someone of wrongful

reporting of times.

, PT

Florida

>

>

> Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week!

> My heart goes out to you in your dilemma, just as it did to our colleague,

> Marcey.

>

> Without knowing which state you are in, you are saying that the other

> therapist claimed a 45 minute visit during the 25 minutes you were en

> route.

> If you were in Florida, you would be subject to FL-456, the law which

> enables FL-486, the practice act. FL 456 clearly says that we are " mandated

> reporters " of such activities. You may want to check with your state PT

> Association office to see whether you are subject to a similar law.

>

> Dr. Dick Hillyer, PT,DPT,MBA,MSM

>

>

> _____

>

> From: PTManager [mailto:PTManager ] On

> Behalf

> Of pikede@...

> Sent: Saturday, February 05, 2011 7:40 AM

> To: PTManager

> Subject: Re: Help, what to do?

>

> Odilia:

> You need to schedule a private meeting with your supervisor and let him/her

> know all of the details, along with the fact that you have had other

> patient

> complaints regarding the same issue with the same therapist. At the very

> least, it is unethical. This type of therapist is the kind that needs to be

> weeded out of our profession....your manager should take the appropriate

> steps to remove them from the homecare setting.

> Pike, PT

>

> Help, what to do?

>

> Group,

>

> I am not sure what to do and need some advice.

>

> I am a contract therapy for a home health agency. I called a patient last

> week to tell them I was coming out to the house and she informed me that

> another therapist had called that they were on their way out as well. I

> told

> her it would take me 20 minutes to get there, and that I could do some

> paperwork if needed if the other therapist had not finished yet. I arrived

> 25 minutes later to find that the therapist had already come and gone for

> the eval. I arrived at the patient house at 12:50. Today I noticed that the

> therapist had written on his eval that he was there from 5:18 to 6 PM,

> which

> is a lie (or fraud?)

>

> So my question is: is this considered fraud under medicare, the therapist

> is

> paid per visit, not sure how the agency is paid and if medicare requires a

> minimum per visit, but at the very least the patient was done a disservice

> and the therapist is lying to the agency about how long he is with the

> patient. I actually had a different patient complaining to me before that

> this therapist was never staying more than 5 minutes.

>

> So where do I go from here?

>

> Appreciate any input. Remember I am a therapist there not a manager, so let

> me know from an employee side what I need to do next.

>

> Odilia

>

>

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Share on other sites

I do feel that there must be some caution taken in what the patient reports

as the times. I can understand that if there is a repeated pattern of

complaints, it should be followed through.

I was reported to a referring Dr. as only spending 15 minutes per session

with the patient throughout the 5 weeks of treatment which was far from the

truth. The patient's daughter was upset that I was discharging her mother

from treatment and thus was trying to get an additional referral to another

therapist or agency when the patient had clearly reached their maximum

potential.

I believe that caution has to be taken in accusing someone of wrongful

reporting of times.

, PT

Florida

>

>

> Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week!

> My heart goes out to you in your dilemma, just as it did to our colleague,

> Marcey.

>

> Without knowing which state you are in, you are saying that the other

> therapist claimed a 45 minute visit during the 25 minutes you were en

> route.

> If you were in Florida, you would be subject to FL-456, the law which

> enables FL-486, the practice act. FL 456 clearly says that we are " mandated

> reporters " of such activities. You may want to check with your state PT

> Association office to see whether you are subject to a similar law.

>

> Dr. Dick Hillyer, PT,DPT,MBA,MSM

>

>

> _____

>

> From: PTManager [mailto:PTManager ] On

> Behalf

> Of pikede@...

> Sent: Saturday, February 05, 2011 7:40 AM

> To: PTManager

> Subject: Re: Help, what to do?

>

> Odilia:

> You need to schedule a private meeting with your supervisor and let him/her

> know all of the details, along with the fact that you have had other

> patient

> complaints regarding the same issue with the same therapist. At the very

> least, it is unethical. This type of therapist is the kind that needs to be

> weeded out of our profession....your manager should take the appropriate

> steps to remove them from the homecare setting.

> Pike, PT

>

> Help, what to do?

>

> Group,

>

> I am not sure what to do and need some advice.

>

> I am a contract therapy for a home health agency. I called a patient last

> week to tell them I was coming out to the house and she informed me that

> another therapist had called that they were on their way out as well. I

> told

> her it would take me 20 minutes to get there, and that I could do some

> paperwork if needed if the other therapist had not finished yet. I arrived

> 25 minutes later to find that the therapist had already come and gone for

> the eval. I arrived at the patient house at 12:50. Today I noticed that the

> therapist had written on his eval that he was there from 5:18 to 6 PM,

> which

> is a lie (or fraud?)

>

> So my question is: is this considered fraud under medicare, the therapist

> is

> paid per visit, not sure how the agency is paid and if medicare requires a

> minimum per visit, but at the very least the patient was done a disservice

> and the therapist is lying to the agency about how long he is with the

> patient. I actually had a different patient complaining to me before that

> this therapist was never staying more than 5 minutes.

>

> So where do I go from here?

>

> Appreciate any input. Remember I am a therapist there not a manager, so let

> me know from an employee side what I need to do next.

>

> Odilia

>

>

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Share on other sites

-

Excellent point! We all need to be certain we've documented accurately

for what we've done.

Dr. Dick Hilyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Goodger

Sent: Sunday, February 06, 2011 1:28 PM

To: PTManager

Subject: Re: Help, what to do?

I do feel that there must be some caution taken in what the patient reports

as the times. I can understand that if there is a repeated pattern of

complaints, it should be followed through.

I was reported to a referring Dr. as only spending 15 minutes per session

with the patient throughout the 5 weeks of treatment which was far from the

truth. The patient's daughter was upset that I was discharging her mother

from treatment and thus was trying to get an additional referral to another

therapist or agency when the patient had clearly reached their maximum

potential.

I believe that caution has to be taken in accusing someone of wrongful

reporting of times.

, PT

Florida

On Sat, Feb 5, 2011 at 6:53 PM, Dick Hillyer <RHillyer@...

<mailto:RHillyer%40comcast.net> > wrote:

>

>

> Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week!

> My heart goes out to you in your dilemma, just as it did to our colleague,

> Marcey.

>

> Without knowing which state you are in, you are saying that the other

> therapist claimed a 45 minute visit during the 25 minutes you were en

> route.

> If you were in Florida, you would be subject to FL-456, the law which

> enables FL-486, the practice act. FL 456 clearly says that we are

" mandated

> reporters " of such activities. You may want to check with your state PT

> Association office to see whether you are subject to a similar law.

>

> Dr. Dick Hillyer, PT,DPT,MBA,MSM

>

>

> _____

>

> From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

> Behalf

> Of pikede@... <mailto:pikede%40lakeshore.net>

> Sent: Saturday, February 05, 2011 7:40 AM

> To: PTManager <mailto:PTManager%40yahoogroups.com>

> Subject: Re: Help, what to do?

>

> Odilia:

> You need to schedule a private meeting with your supervisor and let

him/her

> know all of the details, along with the fact that you have had other

> patient

> complaints regarding the same issue with the same therapist. At the very

> least, it is unethical. This type of therapist is the kind that needs to

be

> weeded out of our profession....your manager should take the appropriate

> steps to remove them from the homecare setting.

> Pike, PT

>

> Help, what to do?

>

> Group,

>

> I am not sure what to do and need some advice.

>

> I am a contract therapy for a home health agency. I called a patient last

> week to tell them I was coming out to the house and she informed me that

> another therapist had called that they were on their way out as well. I

> told

> her it would take me 20 minutes to get there, and that I could do some

> paperwork if needed if the other therapist had not finished yet. I arrived

> 25 minutes later to find that the therapist had already come and gone for

> the eval. I arrived at the patient house at 12:50. Today I noticed that

the

> therapist had written on his eval that he was there from 5:18 to 6 PM,

> which

> is a lie (or fraud?)

>

> So my question is: is this considered fraud under medicare, the therapist

> is

> paid per visit, not sure how the agency is paid and if medicare requires a

> minimum per visit, but at the very least the patient was done a disservice

> and the therapist is lying to the agency about how long he is with the

> patient. I actually had a different patient complaining to me before that

> this therapist was never staying more than 5 minutes.

>

> So where do I go from here?

>

> Appreciate any input. Remember I am a therapist there not a manager, so

let

> me know from an employee side what I need to do next.

>

> Odilia

>

>

Link to comment
Share on other sites

-

Excellent point! We all need to be certain we've documented accurately

for what we've done.

Dr. Dick Hilyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Goodger

Sent: Sunday, February 06, 2011 1:28 PM

To: PTManager

Subject: Re: Help, what to do?

I do feel that there must be some caution taken in what the patient reports

as the times. I can understand that if there is a repeated pattern of

complaints, it should be followed through.

I was reported to a referring Dr. as only spending 15 minutes per session

with the patient throughout the 5 weeks of treatment which was far from the

truth. The patient's daughter was upset that I was discharging her mother

from treatment and thus was trying to get an additional referral to another

therapist or agency when the patient had clearly reached their maximum

potential.

I believe that caution has to be taken in accusing someone of wrongful

reporting of times.

, PT

Florida

On Sat, Feb 5, 2011 at 6:53 PM, Dick Hillyer <RHillyer@...

<mailto:RHillyer%40comcast.net> > wrote:

>

>

> Gee Odilia, I feel like I'm stuck in the role of " Bogeyman " this week!

> My heart goes out to you in your dilemma, just as it did to our colleague,

> Marcey.

>

> Without knowing which state you are in, you are saying that the other

> therapist claimed a 45 minute visit during the 25 minutes you were en

> route.

> If you were in Florida, you would be subject to FL-456, the law which

> enables FL-486, the practice act. FL 456 clearly says that we are

" mandated

> reporters " of such activities. You may want to check with your state PT

> Association office to see whether you are subject to a similar law.

>

> Dr. Dick Hillyer, PT,DPT,MBA,MSM

>

>

> _____

>

> From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

> Behalf

> Of pikede@... <mailto:pikede%40lakeshore.net>

> Sent: Saturday, February 05, 2011 7:40 AM

> To: PTManager <mailto:PTManager%40yahoogroups.com>

> Subject: Re: Help, what to do?

>

> Odilia:

> You need to schedule a private meeting with your supervisor and let

him/her

> know all of the details, along with the fact that you have had other

> patient

> complaints regarding the same issue with the same therapist. At the very

> least, it is unethical. This type of therapist is the kind that needs to

be

> weeded out of our profession....your manager should take the appropriate

> steps to remove them from the homecare setting.

> Pike, PT

>

> Help, what to do?

>

> Group,

>

> I am not sure what to do and need some advice.

>

> I am a contract therapy for a home health agency. I called a patient last

> week to tell them I was coming out to the house and she informed me that

> another therapist had called that they were on their way out as well. I

> told

> her it would take me 20 minutes to get there, and that I could do some

> paperwork if needed if the other therapist had not finished yet. I arrived

> 25 minutes later to find that the therapist had already come and gone for

> the eval. I arrived at the patient house at 12:50. Today I noticed that

the

> therapist had written on his eval that he was there from 5:18 to 6 PM,

> which

> is a lie (or fraud?)

>

> So my question is: is this considered fraud under medicare, the therapist

> is

> paid per visit, not sure how the agency is paid and if medicare requires a

> minimum per visit, but at the very least the patient was done a disservice

> and the therapist is lying to the agency about how long he is with the

> patient. I actually had a different patient complaining to me before that

> this therapist was never staying more than 5 minutes.

>

> So where do I go from here?

>

> Appreciate any input. Remember I am a therapist there not a manager, so

let

> me know from an employee side what I need to do next.

>

> Odilia

>

>

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Share on other sites

Odilia,

I am not really familiar with home health computer documentation, but I wonder

if the time the therapist was in the home may have been documented much later

after all of that therapists visits were completed for that day and he then did

his computer documentation: hence the " 6:00 pm " time instead of the 12:25-12:50

time he was actually there. I am not sure if home health is like I am in

outpatient, and I document any time I get a chance, which may be after I am done

for the day at 6:00 or 7:00 pm. Just a thought. Seems like an awfully short

eval and treat for a patient though.

Matt Dvorak, PT

Yankton, SD

________________________________

From: PTManager on behalf of odiliahome

Sent: Fri 2/4/2011 9:42 PM

To: PTManager

Subject: Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last week

to tell them I was coming out to the house and she informed me that another

therapist had called that they were on their way out as well. I told her it

would take me 20 minutes to get there, and that I could do some paperwork if

needed if the other therapist had not finished yet. I arrived 25 minutes later

to find that the therapist had already come and gone for the eval. I arrived at

the patient house at 12:50. Today I noticed that the therapist had written on

his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice and

the therapist is lying to the agency about how long he is with the patient. I

actually had a different patient complaining to me before that this therapist

was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let me

know from an employee side what I need to do next.

Odilia

Link to comment
Share on other sites

Odilia,

I am not really familiar with home health computer documentation, but I wonder

if the time the therapist was in the home may have been documented much later

after all of that therapists visits were completed for that day and he then did

his computer documentation: hence the " 6:00 pm " time instead of the 12:25-12:50

time he was actually there. I am not sure if home health is like I am in

outpatient, and I document any time I get a chance, which may be after I am done

for the day at 6:00 or 7:00 pm. Just a thought. Seems like an awfully short

eval and treat for a patient though.

Matt Dvorak, PT

Yankton, SD

________________________________

From: PTManager on behalf of odiliahome

Sent: Fri 2/4/2011 9:42 PM

To: PTManager

Subject: Help, what to do?

Group,

I am not sure what to do and need some advice.

I am a contract therapy for a home health agency. I called a patient last week

to tell them I was coming out to the house and she informed me that another

therapist had called that they were on their way out as well. I told her it

would take me 20 minutes to get there, and that I could do some paperwork if

needed if the other therapist had not finished yet. I arrived 25 minutes later

to find that the therapist had already come and gone for the eval. I arrived at

the patient house at 12:50. Today I noticed that the therapist had written on

his eval that he was there from 5:18 to 6 PM, which is a lie (or fraud?)

So my question is: is this considered fraud under medicare, the therapist is

paid per visit, not sure how the agency is paid and if medicare requires a

minimum per visit, but at the very least the patient was done a disservice and

the therapist is lying to the agency about how long he is with the patient. I

actually had a different patient complaining to me before that this therapist

was never staying more than 5 minutes.

So where do I go from here?

Appreciate any input. Remember I am a therapist there not a manager, so let me

know from an employee side what I need to do next.

Odilia

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