Medicare Fraud and James Square

On Friday, August 7, James Square Health and Rehabilitation Centre put a BiPAP machine by the empty door bed in Room 357, where I am in the window bed. Later the same day a big gray machine was also brought into the room; it is my understanding that it was some kind of oxygen generator. They knew a patient with respiratory problems was coming.

At exactly 5:00 p.m. Rural Metro Ambulance brought in Barbara Somebody, an obese 60-year-old woman who said she was there for respiratory therapy. She was on ambulance oxygen, which they removed and took with them. Barbara had come from Upstate Medical Center where she was in the ICU.

The only staff attention that she received during her first 45 minutes here was an aide getting her the remote control for her television.

Around 8:30 p.m. she called for help and was told that she needed a nebulizer treatment but there was no order in the computer and the floor nurse was waiting for an ambulance for another patient. The staff member delivered the message and left. Barbara started gasping and choking and calling for help again.

I sat up and looked at Barbara. The “oxygen generator” was not plugged in. The BiPAP was not set up for use. I called the main telephone number for James Square and said that my roommate couldn’t breathe and asked for the nursing supervisor. Moments later half a dozen staff raced into our room. Somebody had called a Code. They determined that Barbara was breathing and canceled the Code.

Her oxygen was reported as 80%; “healthy” is 95%. She was put on oxygen and the BiPAP, with threats that if she didn’t stop fighting the mask she would have to go back to the ER and ICU.

The nurse stepped around the curtain and asked me to call them if Barbara needed help again. She was from another floor and had come down to help out because the nurse on 3 South was overwhelmed.

It is 9:10 p.m. and Barbara is gasping again. She says she has taken off her mask because she can’t breathe with it on. I call the aide. After evaluating Barbara, she steps out in the hall and calls for help because she doesn’t know what to do.

Two weeks ago I was “admitted” at 6:00 p.m. on Friday. Among other things, I have chronic fatigue syndrome and unstable severe obstructive sleep apnea. I was desperately in need of sleep and spent 3-1/2 hours begging the staff to set up my auto BiPAP machine. They said the hospital discharge note did not provide the settings for the BiPAP. I tried repeatedly to tell them that an auto BiPAP does not have settings. It has a computer chip that readjusts with each breath taken. The staff would not listen or learn. They also would not bring me distilled water for the humidifier.

After 3-1/2 hours of waiting, I was edgy and irritated. The nursing supervisor said she was not going to talk to me until I was “civil,” and walked out. I had not raised my voice or sworn. It was no longer about proper medical care; it was now about serving the ego needs of the nursing supervisor.

I called the NYS nursing home complaint hotline, which was closed and said call 911. I called 911 and was offered the choice of being ambulanced back to the ER, which I took. None of this was recorded in the physician’s admitting note.

The next day a staff member told me that James Square used to limit admissions to daytime hours, then they discovered that they could “admit” late Friday, bill Medicare for bed occupancy Friday, Saturday and Sunday, and not provide services until the following week. James Square is engaging in Medicare fraud.

For Barbara and I, there was no nursing assessment upon admission. Nor were there appropriate medication orders in the computer. Nor were there appropriate orders for nursing care in the Codex. Nor was there any assessment from Dietary, Social Work or any other department until the following week.

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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1 Response to Medicare Fraud and James Square

  1. Pingback: “It Used to be Better” | Anne C Woodlen: Notes in Passing

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