Nursing home patients are in need of all types of care, which often includes physical, therapy. A report soon to be released by the Department of Health and Human Services states that therapy for nursing home patients is increasing. Not only that, but the classification of therapy required is more often at the highest level, allowing skilled nursing facilities to bill for the most possible under the law. Nursing homes receive payment through Medicare for providing these types of services.
Was Improper Care Given?
It is unclear whether patients received more or longer therapy sessions than they were supposed to receive or if the nursing homes are simply abusing the system. It is curious to note that many of the processing requests by nursing homes were for the exact upper limit allowed for therapy. This could be considered suspicious billing behavior. Indeed, the acting administrator of the Centers for Medicare and Medicaid Services said that he did not dispute the findings of the report and agreed that the current billing procedures are actually an incentive for nursing homes to provide as much therapy as an individual is able to tolerate.
Signs of Possible Problems
Further review of several Medicare claims paints a potentially troubling picture. For example, one patient reportedly received physical therapy five days per week for a period of five weeks while away from hospice care. Medical records revealed that the patient had requested to stop therapy. Yet, in this instance, the therapy allegedly continued and so did the billing. These instances are likely the rule and not the exception because of the way nursing home billing with Medicare is done. This makes it very easy for abuse to occur.
Did Your Loved One Receive Proper Care?
While Medicare fraud is not within your control, it is necessary to ensure that your loved one is receiving proper care. If the doctor has recommended a specific amount of physical therapy per week you should discuss this with caregivers. Be certain that the number of minutes of therapy provided is the correct amount. Currently, Medicare payments to nursing homes are based on days of care as well as number of minutes of therapy provided. If your loved one is not receiving the correct amount of therapy, the result could be harmful to his or her health and wellbeing.
Nursing Home Abuse
Nursing home abuse and neglect are common events. Forcing patients to participate in more therapy than the doctor recommends is a form of abuse. In fact, proper care must be taken when caring for elderly patients in a skilled nursing care facility. If you think that a loved one has been improperly treated or has been injured by receiving the incorrect amount of therapy, it is best to discuss the matter with an attorney. A skilled nursing home abuse lawyer will assist in determining whether abuse has occurred, and if so, will guide you through the process of resolving the situation. Contact the experienced attorneys at Levin & Perconti for a free consultation.
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