My 88 year old wife had been diagnosed with terminal (incurable) late stage Alzheimer's Disease on entry to a nursing home facility with a specific Health Care Directive requesting that no life saving treatments were to be administered at this stage of life. The Directive requested only palliative care and pain medication relief. According to Medicare Summary Notices, beginning on the day of entry the doctor began ordering Physical Therapy treatments. In the next six months the patient was given over 500 sessions of five different questionable P.T. treatments. The most obvious questionable treatment was 59 sessions numbered CPT 97535 - "Self Care/Home Management Training!" Since the patient's request was in the form of a legal document, the Health Care Directive, as to their wishes and these sessions had nothing to do with "Medically Necessary" procedures, is there anything that can be gleaned from this other than "Medicare Fraud?"