http://news.springhillcaregroup.net/2013/05/02/patient-outcomes-improve-under-single-home-health-aides/
According to a recent study by SAGE Publications, individuals receiving home health services stand to experience better outcomes if cared for by the same aide day in and day out.
According to the study Continuity in the Provider of Home Health Aide Services and the Likelihood of Patient Improvement in Activities of Daily Living, patients who see the same home health aide across a series of visits have a higher likelihood of improving in various activities of daily living (ADLs) compared to patients whose care is provided by multiple aides.
Visiting Nurse Service of New York (VNSNY) is a large, urban, non-profit Medicare certified home health agency. Base from their studies, they found that individuals who were cared for continuously by the same aide had a 93% chance of improving their ADLs.
Those who experienced low-continuity of care were roughly 14%-15% hardly to recover their ADLs involving home health admission and discharge than persons who were constantly visited by the similar aide. Those who experienced low-continuity of care is implying to care was spread out among a variety of aides over the course of a home health service period.
Furthermore of note in the report, cases where patients had moderate-continuity did not considerably fluctuate from higher permanence cases in their likelihood of ADL development.
Researchers note that the odds of improvement among cases with high continuity are greater than those for low continuity even if a greater part of cases in the study’s populace enhanced in the figure and severity of ADLs between admission and discharge.
“Ideally, patients should receive services from a single aide over the entire period of home care,” writes the study’s lead author David Russell, Ph.D, Center for Home Care Policy & Research at VNSNY. “However, a number of staffing constraints and operational obstacles often present a challenge to achieving this goal.”
Russell added, home health agencies often provide around-the-clock care and have several staff to cover different shifts, but sometimes these staff members carry multiple case loads and have limited time for care planning, monitoring and review.
According to the report, one strategy to combat this could be to use primary provider teams in conjunction with backup provider teams to limit the number of aides who visit a patient.
A succeeding strategy the study suggests is to center on lowering the quantity of cases with low levels of continuity, and work to develop this group to a more modest level.
The results constructed upon wide research that suggests permanence in the relationship between a patient and his or her caregiver amplifies the chances of optimistic patient conclusions even though the study was supported on one non-profit Medicare-certified home health agency.
Showing posts with label news springhill care group. Show all posts
Showing posts with label news springhill care group. Show all posts
Wednesday, May 1, 2013
Wednesday, April 3, 2013
South Jersey Doctor Admits Making Half-a-Million Dollars in Fraud Scheme Involving Home Health Care for Elderly Patients
The owner, founder and physician of Visiting Physicians of South Jersey—a Hammonton, New Jersey provider of home-based physician services for seniors—pleaded guilty today for charging lengthy visits to elderly patients that they did not receive, U.S. Attorney Paul J. Fishman announced.
52 year-old Lori Reaves of Waterford Works, New Jersey, entered her guilty plea to information charging her with one count of health care fraud before U.S. District Judge Freda L. Wolfson in Trenton federal court. Reaves was led to her receiving at least $511,068 in criminal profits because at some stage in her guilty plea she confessed about lying in Medicare billings about the amount of face-to-face time she spent with patients. According to court documents, the physician was the highest-billing home care provider among the more than 24,000 doctors in New Jersey from January 1, 2008 through October 14, 2011.
“Today, Lori Reaves, a South Jersey physician, admitted intentionally overbilling Medicare and pocketing more than half a million dollars she didn’t earn,” U.S. Attorney Fishman said. “The Medicare system depends on doctors and other medical professionals truthfully billing for services they actually provide. Here, Dr. Reaves chose to lie about the major service she was providing to her homebound, elderly patients: her time.”
According to documents filed in this case and statements made in court:
Visiting Physicians of South Jersey (VPA) made home-based physician health care for elderly and homebound patients in New Jersey available, tendering services throughout South Jersey. Reaves was accountable for VPA’s Medicare billings as a Medicare-approved provider as part of her responsibilities at VPA.
A procedure code called a Current Procedural Technology (CPT) code is required together with a physician to state a diagnosis to be submitted by the health care provider to identify services rendered. Medicare regulations necessitate that each provider attest that the services rendered were medically essential and were supplied by that provider. A word of warning at the base of the form particularly says that any fake claims or declarations in accordance to the compliance of a claim for reimbursement are prosecutable under federal or state law.
Reaves presented forms that fallaciously claimed she had endowed with extended service visit to her patients just so she can to persuade Medicare to make payments to her that were extensively higher than the payments she only deserves in many occasions at some stage in the pertinent time phase.
Reaves habitually billed Medicare by means of codes that would have mandate her to spend between 60 and 150 minutes with a patient. This practice is under Medicare regulations and depending on the corresponding service but many of the claims Reaves submitted would have required her to spend a minimum of two-and-a-half hours of face-to-face time with her elderly clients, when she actually spent far less.
Therefore, Medicare reimbursed Reaves more than $511,068 for the fraudulent prolonged service visits Reaves claimed to have made. This is exactly why we cannot really trust anyone, watch out for scams and read and know fraud prevention tips.
Reaves is now facing a maximum possible penalty of 10 years in prison and a fine of the greatest amount of $250,000 or twofold the gross gain or loss caused by her offense. It will also be a compulsory to forfeit the proceeds of her crime. Sentencing is at this time scheduled for July 13, 2013.
The government is represented by Assistant U.S. Attorneys Deborah J. Gannett and R. David Walk Jr. of the U.S. Attorney’s Office Health Care and Government Fraud Unit in Newark while U.S. Attorney Fishman credited special agents of the FBI in Newark, under the direction of Acting Special Agent in Charge David Velazquez, and special agents of the Department of Health and Human Services, Office of Inspector General, under the direction of Special Agent in Charge Tom F. O’Donnell of the New York Regional Office, with the investigation leading to the guilty plea.
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