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F Words

Most of you can continue on in your web surfing without stopping at today’s post. It is directed to a very small percentage of you who either have or are considering turning in a visit note without actually making a visit. This seems absurd. I know. Who would do that? What could they be thinking?

I have no earthly idea. I do know this. More than one client over the last year has discovered a staff member submitted paperwork for visits never made. These discoveries are not based on the occasional call from a confused patient. They are well documented and leave me with no doubt that some staff members have submitted fraudulent paperwork to Medicare Certified Home Health agencies. And in more than one instance, harm has come to the patient as a direct result of not being assessed as ordered.  And every single time this has occurred, I was astonished.  Knowing the clinicians involved, I simply could not believe they would do such a thing.

In some agencies, I suspect the culture of the agency is such that not turning a note, forgetting a recert or creating a LUPA situation results in being terminated. If that is the case, find another agency. There are worse things than being fired.

What could be worse than being fired you ask? Well, for starters, if it ever occurs to you to simply write a note and not make a visit, understand that you are committing Medicare fraud. This is a federal crime. Being convicted of Medicare Fraud has and will continue to ruin many lives. Prison is never fun from what I hear. Even if you are not convicted, the lawyer fees will bankrupt you.

Secondly, I cannot think of a single state’s nurse practice act that doesn’t consider fraudulent documentation to be an offense worthy of licensure revocation. If you think it is difficult working in the field for a living, try working at Taco Bell. (No offense to the crew of my favorite fast food restaurant.) And because missing a visit can potentially harm a patient and is related to professional standards, termination for a cause such as this must be reported to the state board.

I know that many of you are thinking this is a silly post. Everyone knows better than to commit fraud. Yet I am always surprised at the people who are caught. And how many are not caught? How many times do we have a small, nagging doubt about someone that is never proven?

When it occurs to you that it will be easy to just submit a note so you can get paid, avoid being fired, etc. get over it. Get fired. Hand in a missed visit slip. Screw up. Be a human. Ask for help. There are three F words at our office. The obvious one, fraud and forgery. If you succumb to the temptation to indulge in the latter two, you find plenty of occasions to use the obvious one.


5 Comments Post a comment
  1. Delaine Henry #

    Great article Julianne!

    August 26, 2010
    • Valerie Milantoni #

      Dear Julianne,

      I don’t normally post comments on sites, but I simply could not pass this one up. I am from Michigan, so I am sure that I don’t need to say anymore than that.

      I read your “F word” article and had to clean my morning coffee off of my p.c. monitor screen. I love it… Preach on!

      August 27, 2010

  2. There is fraud in homecare, just as there is in all parts of healthcare. Tighten up the ship and you’ll have less people thinking they can get away with this. Start off your orientation with a big warning and have them sign it. Commit fraud and we’ll turn you in ourselves. Let them know the implication of licensure revocation EARLY in the orientation. They’ll think long and hard before making up fake visits.

    August 26, 2010
  3. Lisa #

    In 20 years of homecare, I have PERONALLY turned in 3 “professionals” for fraudulent visits. Fortunately I caught them before we billed for any of these “visits” so they were off the hook with Medicare. I did report them to their respective state boards (2 nurses and 1 OT). The ONLY person punished for these acts was the OT. I submitted clear evidence (notorized statements, comparison signatures) to prove that these visits were fraudulent and our nursing board dropped it…Makes you want to not even waste your time…I will still waste my time…These people have no business being called anything but THIEVES!!!!

    August 27, 2010
  4. Maurice #

    Another great piece!

    August 27, 2010

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