VA--Individual

The concerns about the so called concurrent therapy in SNF are legitimate. Why should the taxpayers be reimbursing for private therapy when 2 or more is considered a group! In the real world if one pays for a private fitness, golf or tennis lesson- one would not expect another individual would be present. And if they were the cost would be less. Why should the taxpayers expect less! I would like to hear from your previous commenter about any research studies that show the effectiveness of this dovetailing- because there are none!!!!!!!! My mother was in a SNF rehab where the occupational therapist set 2 or 3 people up with peg boards at a table. There was no motivation in fact most of the patients were insulted!! She would go between the patients but often leave the room and after an hour she would say - "OK- you're done". I did investigate and this was routinely billed as individual therapy. When I questioned the department head she told me they could bill it as indivdual therapy because they were doing it for different reasons. My mother had a broken hip!!! I further investigated the regulations and discovered that Medicare considers 2 or more a group treatment and it should be billed as such. It is only logical it would and should cost less!! This is purely about being able to bill as many minutes in the least amount of time thus saving the SNF money in staffing salaries and maximizing there profits. There was also an occupational therapist sitting at a table doing cross word puzzles with 2 patients who had broken hips- I guess that was skilled therpy and a use of this dovetailing. I spoke to the women who had to endure this inappropriate waste of taxpayer money and she told me she requested her therapy records and this OT disguised this fraud in his notes as A"therapuetic activity to increase endurance". with no mention of the crossword puzzle session. The physical therapists also lined up 2 or 3 patients at a time on these ridiculous and cheap foot bikes( one can purchase at Walmart for $15.00) and had patients just peddle away with no timers set or no ability to change or explain to the patient how the resistance was increasing. They often left the room and walked another pt. down the hall, so the therapists had no idea if the patients actually completed the requred minutes or repetitions. So how did they bill for skilled therapy services? And how did they justify billing for individual therapy!! This RUG minute system is nothing but a joke. It's all about capturing the minutes! CMS would be wise to go to one of these conferences where these so- called medicare experts teach therapists and nurses how to get around the regulations and falsify what they are doing. 2 of the young therapists at this facility told me that the owners of this NH home hired one - who had less than a year of clinical experience as an occupational therapist! They told me she told them to bill for having a patient push themselves to therapy when the patient could already walk, or even when wheelchair mobility was not the patient's goal. They also told me that she told them to bill to talk to a ptient if the patient refused therapy so they could make their RUG minutes. She also told them it was there job to capture minutes to keep patients as long as possible especially the first 20 fully paid days by Medicare!! I took my mother out early and had home health come for a wek and she was indepedent - aster wasting 10 days in a SNF - and they were no happy t- they even threatened me that I was taking her out against medical advice. Thank God, her orthopedic surgeon was supportive and say recognized their scam- he supported our home health decision 100% and sent a letter to the SNF staing he would never recommend them to his patients! At least some one had a conscience! This so called rehab is a waste of Medicare money and should be investigated!!! These therapists should lose their licenses - that would wake them up - and maybe then they would do the right thing!!!!!! .