Providence Home Care LLC: A Case Study

This letter serves as a written notice of Loving Hearts Home Healthcare Inc. appeal to the overpayment amount of $5,034.90, which was identified in the overpayment notification letter. Specifically, those claims billed for Marjorie Savage that have been labeled with a discrepancy code 911. The notification letter provided the following explanation for the discrepancy code, which resulted in an overpayment:

GRC Homecare Provider is a home health agency that is based in San Leandro, California. They are located in Alameda County, San Mateo County, Contra Costa County, and Santa Clara County. Their services include companion care, meal preparation, light housekeeping, laundry, transportation, errand service, grocery shopping, medication reminders, live-in care, recreational activities, grooming, and dressing supervision. GRC Homecare Provider is licensed, bonded, and insured.

Initially we had difficulty obtaining his discharge orders as the hospital care manager replied she had forwarded the documentation, but neither I nor Mrs. Bianco had received a copy. Mrs. Bianco made a visit to Mills Creek and met with Mr. Smith at that time she was made aware of an appointment that Mr. Smith attended. Mr. Smith attended a physician appointment on June 28, 2017 with Dr. Leonard, Orthopedic trauma. Mills Creek assisted with the transportation and a mobile x-ray unit was coordinated to obtain x-rays of the femur at the facility as Mr. Smith didn’t bring his slide board to the appointment and couldn’t get onto the radiology table.

Prestige Care Home/Angelic Visits, LLC is a home health care service institution that is located in Memphis, Tennessee. They service the entire areas of Memphis, Cordova, Collierville, Germantown, Bartlett, Millington, and Atoka. Prestige Care Home/Angelic Visits, LLC provides home health care services, care home services, and intermittent skilled nursing. Their staff of health care professionals are licensed, certified, bonded and highly trained. Prestige Care Home/Angelic Visits, LLC offers a free assessment.

Hello Dr. Ullom, majority of the long term care facilities are under staffed. There is usually one registered nurse in charge to manage a 240 bed facility, with LPN's  and nursing assistance. I feel that these patients would benefit from having one RN to every six -eight patients with a nursing assistance. Not only would this benefit the patient but the nurse as well. Patient are placed in long term care facility with a certain problem, but ends up with additional condition such as UTI, MRSA, pressure ulcers, and etc. These issues are related to poor care they receive because of unstaffing. I'm not placing blame on the LPN or nursing assistance, but with a RN and low nurse to patient ratio, they will receive better care.

Good morning, there have been many speculations about Right Way being bought over by Always Right home care agency. Today I am pleased to announce both companies have reach an agreement and a merger will occur. Although, our assistant living has been proving great care for our seniors in the bay area for 40 years we hope to expand beyond the Tampa Bay area. There has been a growing need to provide more services to our aging population and it is important for our company to grow and expand to meet the needs of our seniors. Right Way vision and mission is to help improve quality of life for all we serve, offer cost effective services, and have unlimited accessibility to variety of services.

The company I chose as my individual outing was Primary Family LLC in Warner Robins, Georgia. I chose this company because this was the only day I had off and had to take my daughter to Georgia to start college. The professional I interviewed was Dr. Ferial Walid, the sole proprietor of the medical practice. Dr. Walid manages three staff members and coordinates all aspects of her practice. Primary Family Practice is a medical family practice with only one physician and no physician assistant nor nurse practitioner. Primary Family Medicine offers a myriad of services. Dr. Walid performs medical examinations to include PAP smears, immigration examinations, wart removal, workman’s comp examinations, Medicare qualifying examinations, hearing examinations,

SC received phone from Pa’s dtr starting that she spoke with provider agency Accucare regarding changing Pa’s schedule from a split shift to one shift starting at 5:00 AM and ending at 9:00 AM. SC informed DCW that she is not authorized to make any change to Pa’s care plan or schedule. DCW was furious demanding to know why she is not authorize to make changes to Pa’s care plan since Pa’s she’s Director of Care. SC explained to DCW that she is not Pa’s director of care because Pa’s is directs own care and moreover she cannot be the direct care worker and the Director of Care because both role conflict with each other. DCW stated that she is only being paid for 4 hours but is constantly assisting Pa’s managing her health and navigating services/resources,

****On April 28, the U.S. Justice Department announced that it had filed charges against 25 Miami-area individuals for allegedly taking part in schemes to defraud Medicare of $26 million through the Medicare Part D program.

Payment was denied due to the lack of documentation to support continued need for home care.

Care Matters LLC does not have an overall feedback loop with which it gathers information regarding efficacy. Most of the clients the agency works with are motor vehicle accident survivors who need extensive medical treatment. They are entitled by Michigan No Fault Insurance to a case manager to assist them with coordinating their medical care (Sinas, 2011). The case managers work with many different doctors, insurance companies, and claims adjusters. As such, most of their feedback takes place within outside arenas.

1. Home Healthcare Case: Given what you have learned about the accessibility and financing of home care services, are such services as readily available to other consumers as they were to Joan and Jerry? In this particular case regarding Joan and Jerry, and the availability of home health care services compared to that of others is a quite simple. Lack of knowledge and understanding is of the utmost detrimental in medical terms due to the fact that there are many programs that are available to help those with disabilities or home bound. In this case, perhaps Joan and Jerry 's daughter should have been more involved with the medical needs of both her parents. Especially due to the age of her father who was in desperate attempt to keep his disabled wife comfortable in their home. Home health care services are readily available to covered members of Medicare/Medicaid or other third-party payers. Although in Joan 's later days of life, her medical needs were being attended to by home health care professionals, perhaps her life could have been extended and foreseen medical conditions that could have prevented another stroke. "Being an informal caregiver plays a huge role in providing care and relief to long-term consumers (Pratt, 2010)." If Jerry would have taken advantage of home health care and it 's available services at an earlier stage, then perhaps he would not have to have had a hip replacement by having more rest to take care of himself. "As with other forms of long-term

In 2013, Dorota Slawa Mankowska et al, worked on real study for a home care company that present the care for the at patients in their homes by staff members. They developed the mathematical model that aim to optimizing economical service cost and take care about individual qualifications of the staff, time preferences of patients, number of the staff required to this patient and certain time of patient’s drugs. This model has been able to achieve low average waiting times for patients, low traveling cost for caregivers, a fair distribution of inevitable tardiness, and service hundred patients in acceptable runtime.

Chris Hedges once said “Violence is a disease, a disease that corrupts all who use it regardless of the cause.” Violence, behavior involving physical force intended to injure, harm, or kill someone or something, as well as aggression, hostile or violent behavior or attitudes toward another, is spreading throughout the globe like a disease, corrupting our modern society. The drastic increase in violent and aggressive behavior in modern society can be attributed directly to the prevalence of drug and alcohol abuse, easy availability of deadly weapons and the limitless exposure to mass media that celebrates these behaviors.

The journey to create a new culture in the Customer Care Center at Advanced Home Care stemmed from two pieces of information that in the end required a needs assessment to be completed. The turnover rate in the department was more than 40% and the number of patient event/concern forms for employees in the department was extraordinarily excessive. The decision to conduct a needs assessment was made because the purpose of a needs assessment is to “determine the difference between current and desired states” (Click4ut unitar learning and training wiki. (n.d.). Needs Assessment). It was the hope that in doing a needs assessment there would be data that helped to