I worked in the long-term care industry years ago, in a number of nursing homes, for a few different companies. I used to remember feeling as if I was working terribly hard, providing excellent, creative and dedicated patient care and yet none of that mattered. At the end of the day, all that mattered was the number of hours worked against the numbers of billing units I rendered. Truly, that was it. Further, all around me was known "fraud" in the way of billing for treatment that was not rendered, over billing, billing incorrect treatment codes that carried higher weights in terms of reimbursement (treatment which was not actually performed). Rehab. directors were more willing to "turn a blind eye" on that type of behavior, but as I said, God forbid you didn't fulfill the almost undo-able productivity standards. I was "written up" for having low productivity, but was an outstanding therapist. I had a great attitude, mentored younger therapists, was always willing to go the extra mile for patients and families or nursing staff. Didn't matter what kind of therapist you were, how you practiced, what kind of behavior/attitude you showed, only the "units" mattered. Ultimately, I left the industry and the field of OT for 3 years as I was so disgusted with it. I returned to OT, happily, and have been doing home health for quite a few years. My significant other currently works in a nursing home. Nothing has changed. In fact, it's gotten worse in terms of the productivity expectations, billing practices, etc. The system, in my opinion, is set up for one thing: MAKE MONEY! Make as much as you can, as fast as you can, by any means that you can. I mean no disrespect to any of you dedicated, hardworking, and no doubt saintly therapists who are still working in LTC/nursing homes, but it's a flawed system. And, bottom line, because it's flawed so is the care that our precious legacies are receiving. In my humble opinion, the only solution is reimbursement reform. The method of counting minutes, and assigning levels of care to a particular diagnostic group, then "punishing" hard working, talented, dedicated therapists for not collecting those minutes is severely flawed and outdated. We need to visit with our legislators face to face, and with letter-writing campaigns, and somehow hope to affect a change. Wouldn't it be nice of we could have our elected officials, insurance executives, and administrators spend a week or two "locked up" in some of our nursing facilities? Talk about sweeping reform. Done! OK, that's my rant for today. I read the list daily, but rarely am compelled to post often. I'll bet some of you reading this are happy about that. Bill Maloney, OTR
-- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
