General Forums >> Ask A Nurse >> Is it legal? Case Management
Is it legal? Case Management
13 posts back to top |
Posted almost 5 years ago I am in Case management in Texas and I am getting conflicting responses to this question: Is it legal for doctor's to order a specific Home Health Agency or LTAC when discharging a patient? Are we, as Case Managers, liable when we go through with that order? |
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-57 posts back to top |
| Posted almost 5 years ago I have no idea if you're liable or not. I do know, a physician who is a close friend and lives and practices in northern California prefers certain LTC facilities because she has priviledges there so she can see her patients and write orders. She also prefers several certain home care agencies because she has been happy with the care her patients receive from their nurses. Those are her reasons and I'm sure many other physicians feel the same. Of course, there are always some, who may have other, less than stellar reasons for certain choices. My advice is to contact your state board and ask questions. If they don't know, they can certainly steer you in the correct direction for the information you're looking for. |
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142 posts back to top |
| Posted almost 5 years ago Doctors can request certain facilities, however, the patient has to agree to it. The patient should be asked and sign a choice form that list the available services. Case management also needs to check with the patient's insurance and make sure that the facility is covered by their insurance. Insurance may specify that the patient has to go to XYZ facility. The other thing that needs to be taken into consideration is: does the MD have a monetary interest in the facility that he is referring to. That has to be declared to the patient. That is where the Stark Law comes into play. |
960 posts back to top |
| Posted almost 5 years ago Patients do have a say in where they go, dependent on if that facility can care for their needs, has beds and is covered by their insurance.The Dr may state a certain ecf, but it is ultimately up to the pt, unless other circumstanced prevent it. |
