Palmetto’s Claim Review Tool
Use the same clinical record review tool that the reviewers at Palmetto GBA use.
Dec 1
Use the same clinical record review tool that the reviewers at Palmetto GBA use.
Nov 25
Today is the last day most of us will work this week because of Thanksgiving. I looked back over the last couple of years to see if there was any inspiration in prior Thanksgiving posts and there wasn’t a whole lot. Medicare still seems to be working against us and we are still fighting hard to stay in the game. We are tough and we will survive. It’s a given.
It isn’t that I am ungrateful. I am grateful most days when I wake up and take note of my life. Compared to about 90 percent of the world, I have everything; a home, a family and a son with a dog I love dearly. Who could want more?
Maybe you could want more. Maybe some of your patients could want more.
So this year I choose to not make a big deal about all I have to be grateful for as other people are coping with illness or the loss of a loved one. Being grateful is good. Flaunting my good fortune in the face of others who are not so fortunate does not tell a story about me that I like.
At some point between the Turkey and the doors opening for Black Friday, maybe we should all pause and consider how we can give something to those who do not have a warm family and home to celebrate with on Thanksgiving Day. Maybe we can give someone something to be grateful for if only for a minute.
If you live in an urban area, consider keeping some Karma Bags in your car. Cheap, easy and versatile, if all home health and hospice nurses making home visits carried a half dozen of these, that would make for a lot of meals. This is what I do for less than ten bucks.
Hit the Dollar Store and go through extra stuff at your house and on your desk to come up with useful things. Consider some of the following.

The list is endless and I choose what goes into the bags based upon what is available and priced so I can buy multiples.
Assemble the Karma Bags in whatever handy container you have available. I have used zip lock bags, sports water bottles (a client had some left over from previous owners with the name of an agency that was no longer in business and burlap bags from the Kraft store that were on sale. The best part of this kind of giving is that it isn’t limited to the holidays.

Not everyone feels their heart reach out to the homeless people. That’s okay. Some people are drawn to other causes and there are so many worthy causes. I personally am useless around sick kids but that doesn’t mean that I don’t care and I am very grateful for those who can provide care and attention to them.
If you have another idea that you think could brighten the day of someone whose day really needs brightening, please share. And if you do Karma Bags, please send us photos.
If you are someone who will be missing someone or has otherwise been disappointed by life, try Karma Bag therapy. You might find that your day is brightened as well.
Two years ago, I posted about Beverly Cooper who was convicted of multiple counts of fraud and was facing up to a ten-year sentence in Federal Prison. See Press Release. She admitted to signing visit notes when unlicensed personnel made the visits giving the impression that she made the visits; among other things – lots of other things. Signing off on a visit that was made by someone without a license could have easily proved deadly to a patient. Maybe Ms. Cooper is lucky that she didn’t kill someone.
Today, I received a message from someone, apparently a friend of Ms. Cooper’s pointing out that nowhere in the indictment (or my blog post) was Ms. Cooper’s 15-hour work days or dying relative noted. The writer asked if I knew how wonderful Beverly Cooper was and pointed out that everybody makes mistakes.
Frankly, it would not surprise me if Ms. Cooper was a good hearted, likable woman. Unlike less sophisticated crime, fraud on this scale is usually committed by people who are genuinely likable.
The writer of the message mentioned other people involved in the indictment. She wanted to know why I didn’t mention them as well. Frankly, they were not included in the press release. Furthermore, Ms. Cooper was a Registered Nurse. This blog is all about nursing and nurses and those who occupy our worlds. That’s why Ms. Cooper made the blog post list.
I don’t know the person who wrote me the email and I never have met Ms. Cooper before. I was nowhere near Detroit where all of this took place. I cannot begin to speculate on what might have happened. But, I can make reasonable assumptions based upon the criminal cases I have worked with and some former clients.
Let me reiterate that I do not know anything about these people. They are not the usual fraudsters in Louisiana where we have enough home grown fraud that I don’t have to go looking in places like Detroit. I have met many others who have faced a similar circumstance; enough to make assumptions. I have enjoyed their company and worked hard for them and their lawyers and I took their money for my services. But, when a clear pattern of fraud exists, there is nothing that I can do. Criminal attorneys are brought to their knees trying to find a defense for their clients when there is none. These are not thuggish criminals. They are well dressed, well spoken professionals who say and do all the right things.
Your task if you are reading this is to know what a compliant agency looks like so you can find one to work with or create one to attract the kind of talent that you need to bring your agency to the next level.
The compliant agency:
Mistakes are costly to be sure but not nearly so much as hiding mistakes. If you inadvertently make a mistake that affects billing and are fired after reporting it, smile on your way out of the door. You don’t want to be there. The agency has just sent a message to everyone else that they have a zero tolerance policy for mistakes and future mistakes will be hidden away.
Ms. Cooper may have been caught up in a storm she could not escape. She may have discounted her actions as inconsequential or have been convinced she would never be caught. She has lost her family, her marriage and her job according to the person who emailed me today. She is completely without dignity. On top of all of that, she is facing jail time.
I can’t help but feel compassion for her but more importantly, I am bound and determined to give all of you who take the time out of your day to read my blog the information you need to avoid a similar fate. Unemployment is not half as bad as jail.
Jun 24
A guide for documenting the continuing need for skilled services in home health.
Apr 19
What do HHCAHPS surveys really mean? Are they useful in home health and hospice? Read yet another controversial viewpoint from Haydel Consulting Services.