Reply With QuoteA nursing home can double the capacity of Medicare patients just out of hospitals, where it pays the most money, and add rehabilitation to the list of services.
The nursing home my mother resides at had done that at the end of 2006. Even renaming one of the nurse's stations to T.C.U. (Tender Care Unit).
In February 2007, there was a norovirus outbreak at the home. Over 125 residents (over 50% of the population) had fought off the infection. Guess where the norovirus epidemic stated? T.C.U.
Another way to increase revenue is when a Medicare/Medicaid resident goes to the hospital for (let's say) a urinary tract infection for four days, and is readmitted to the nursing home, they are placed on Medicare-only for up to 80 days, at a much higher rate of reimbursement.
The only Plan of Care that is recognized is a decreased functional mobility secondary to a recent urinary tract infecton and hospital stay. The goal is for the resident to ambulate, transfer and perform bed mobility. The only intervention is for skilled physical therapy five times a week.
However, there are no other interventions to prevent urinary tract infections. So, near the end of 80 days or when the resident has reached their plateau of physical stamina, the resident is taken off of Medicare-only and place back on Medicare/Medicaid.
If another urinary tract infection occurs, and the resident uses up the allotted time period to meet physical therapy plateu standards, the resident cannot stay on Medicare-only even though the urinary tract indications are not resolved.
Any ancillary services provided due to the hospitalization would also be more renumerative to the company if those services are owned by, or are shell companies belonging to the company (even when they do not pertain to the medical indication).
Whether those ancillary services are independent of the company or not, they are an additional cost burden on residents and/or government programs.
