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Coding the severity of residents’ needs to justify greater reimbursement

Coding the severity of residents’ needs to justify greater reimbursement

You are the finance manager in a long term care facility that is struggling to remain solvent. The facility’s administrator has hired a consultant to work with you to increase Medicaid reimbursement. The consultant recommends that you be more “liberal” in coding the severity of residents’ needs to justify greater reimbursement. The consultant tells you, “everybody does it” and, “it’s an undetectable way to boost revenue”.

You believe this approach is somewhere between inappropriate and illegal. You know the consultant is being paid on a commission and is an old college buddy of the facility administrator. You also recognize that your facility could soon go out of business and leave you without a job.

In a two page paper, respond to the following:

What are your ethical challenges?

What are your options?

What is your chosen course of action?

What will probably happen as a result of this course of action?

Requirements:

  • 2-3 pages in length (not including cover and reference pages)
  • A minimum of three outside resources (one of these resources can be your textbook)
  • Your paper should be formatted according to APA, include a proper introduction, appropriate headings, and conclusion.

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