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ResCare Whistleblowers - Have Evidence of Res -Care Misconduct? 12/16/18, 11:37 AM • The biggest privately -owned home care company, • The biggest community provider of high -acuity neuro -rehab, and • "The largest career center workforce contractor in the U.S" Before being taken over by a private equity firm five years ago, ResCare annual reports were filed with the SEC and public. In its 2012 annual report, the company claimed that it provided services to 61,000 people per day in 44 states plus Washington DC and Puerto Rico. That report also claimed the company employed 46,000 people. Much of the community and in home services provided by Res Care include professional nursing, personal care, Alzheimer's care, dementia care, homemaking and companionship. Services are offered in patients' homes, nursing facilities, assisted living facilities and even hospitals. Services may just be for 1 or 2 hours per week or for patients with more needs, up to 24 hours per day. Home care is offered in 34 states (as of December 31, 2012). In some states, Res -Care provides telemedicine services and emergency call button response, Investigation into ResCare's Billing Practices (Possible Medicaid Fraud) We are investigating claims that Res -Care does not properly bill for home and community based attendant services. 3tients receiving home care services through Medicaid (Medi -Cal) must have those services approved by a physician. Thereafter, those services must be recertified every year and revaluations done every 6 months. The purpose of the annual certification process is to ensure that patients require the services they are receiving and to see if the patients may require additional or different services. As patients recover or as their conditions worsen, their needs change. Medicaid doesn't want to pay for services that are not medically necessary. When Medicaid overpays, taxpayers pick up the tab. Because there are often wait lists for certain services, providers that falsely certify or fail to properly certify home care visits may be causing truly needy patients to go without needed care. Recertification visits generally must be done in the patient's home or wherever the patient is receiving care. The process is quite involved and requires an experienced nurse supervisor to review patients' records, patient concerns and progress notes. That supervisor must also evaluate a patient's need for continued services and establish a treatment or care plan for the next period if services are stil I needed. Physicians must approve those services. These recertifications insure the patient is getting the right services from the proper professionals. ey also insure that taxpayers and Medicaid are not getting ripped off for services that may no https://www.tully-weiss.com/biog.php?article=rescare-whistleblowers-have-evidence-of-res-care-misconduct_76 Page 3 of 11