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?"

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A lot left untold here. Who was the POA? Who was the HCP? Somebody had to sign for the treatments. Are you second guessing what you signed for? Was the PT for ROM and therefore pain relief?
I don't see fraud, but I do see a lot of grief and anger. Don't blame yourself, but don't blame the PT person either. If the PT was to prevent muscle contractions that are very painful, it was comfort care.
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I would have asked the head of the facility why were they giving your wife physical therapy right after the first treatment. Sounds like you didn't say anything until way after the fact, or have you asked anything yet? Could be it was a mix-up in orders.

As for Medicare, I was understand the impression that Medicare only pays for the first 20 days of nursing/rehab care. Has that changed?
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