Woman Arrested Twice In A Month, Accused Of Stealing From Elderly Couple

By: Kristen Weaver

Click to Watch Video

TULSA, Okla. - A woman is back in jail Friday for the second time in a month, once again accused of embezzlement.

This time, the victims are a couple in their 90's on hospice.

An affidavit said Ashley Brown owns Golden Care Home Health and had a five-month contract to take care of an elderly couple on Hospice in 2018.

It said after the contract was over, the couple's children found out money was missing from their parents' accounts.

Investigators said Brown stole more than $26,000 total from the couple and spent it on things like car payments, cell phone bills for her friends, furniture, and computers.

Brown was charged with two counts of elderly exploitation and identity fraud.

"It's upsetting, it really is," said Tashina Johnson.

Johnson worked for Brown at Golden Care and said many of her elderly clients were dealing with the same thing.

"Meds were not being paid, electricity was being cut off," she said.

Johnson's sister Melissa Purcell also worked at Golden Care.

Both Purcell and Johnson said Brown took advantage of employees, too. They said checks from Brown would bounce and said for two weeks they were forced to work without pay.

"It makes a lot of us so angry, especially for our clients who cannot speak for themselves," Purcell said.

We reported on Brown just a few weeks ago, when the attorney general's office charged her with embezzling more than $15,000 from employees at a different health care company where she was in charge of payroll, before she started Golden Care.

"We hope to see justice, especially for the clients," said Purcell.

Brown is in the Tulsa County jail Friday night for the new charges in Creek County. Her Tulsa County charges are still pending.

We tried calling Brown's business but haven't heard back and we couldn't find an attorney listed for her.

Full Article & Source:
Woman Arrested Twice In A Month, Accused Of Stealing From Elderly Couple

More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients

Many Medicare hospital patients classified as observation status “outpatients” currently forego necessary skilled nursing facility (SNF) care and head home to continue care through Medicare’s home health care benefit. This is because they lack a 3-day inpatient hospital stay, which is required for Medicare coverage of most beneficiaries’ post-acute care in a SNF.[1] Beginning January 1, 2020, access to Medicare-covered home care will also be more difficult to obtain for post-observation stay patients.

Under the new Medicare home health payment system effective January 2020, the Patient-Driven Groupings Model (PDGM), the Centers for Medicare and Medicaid Services (CMS) will impose an “admission source category” in making home health payment determinations.[2] Admissions to home care will either be right from an “institution” or from the “community.”[3] CMS estimates that home health agencies will be paid approximately 19% more for institutional admissions than community admissions,[4] even if a patient admitted from the community requires greater resources. Based on case mix adjusted weights in PDGM, the Center for Medicare Advocacy calculates the disparity in payment for an institutional admission could be as high as 25% more than for a community admission – for the same diagnosis, the same level of functional impairment, and the same number of comorbidities.[5]

CMS has determined that home health stays after hospital observation stays will be included in the community admission, not the institutional admission category, despite CMS’ determination that average resource use for observation stay patients is almost 35% higher than for community admissions (see chart below).

CMS Data For Each 30-day Period Average Home Health Resource Use by Admission Source[6]:
Institutional:	$2,171
Observation Stay:	$1,820
Emergency Department:	$1,661
Community:	$1,351

Given the relatively higher-resource use of post-observation patients, and the decision by CMS to classify them in the lower-paying community admission category, home health agencies will be reluctant to provide care for post-observation stay patients. Recent home health industry marketing articles recommend that agencies develop plans to develop more institutional referrals and change their patient mix to reduce community admissions.[7] In the 2019 proposed rule, CMS noted there were 166,762 thirty-day home health periods for post-observation stay patients in 2017. This number is expected to drop significantly as post-observation-stay beneficiaries find it more difficult to access home care after a hospital observation stay.[8]

CMS’s decision to pay home health agencies more for patients admitted from hospitals but not include hospital observation stays will harm beneficiaries, increase problems facing observation patients, and create new barriers to home care.

_________________

[1] Section 1861(i) of the Social Security Act.
[2] https://www.govinfo.gov/content/pkg/FR-2018-11-13/pdf/2018-24145.pdf, page 56468.
[3] https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/Downloads/Overview-of-the-Patient-Driven-Groupings-Model.pdf, page 1.
[4] https://www.govinfo.gov/content/pkg/FR-2018-07-12/pdf/2018-14443.pdf, page 32397.
[5] See https://www.govinfo.gov/content/pkg/FR-2018-11-13/pdf/2018-24145.pdf, pages 56504-56514.
[6] https://www.govinfo.gov/content/pkg/FR-2018-07-12/pdf/2018-14443.pdf, page 32397.
[7] See, for example, Homecare Direction, Volume 27, Issue. No. 7, July 2019, pages 6-9. “Educate marketers about PDGM, and use data to formulate a strategy.”
[8] https://www.govinfo.gov/content/pkg/FR-2018-07-12/pdf/2018-14443.pdf, page 32397.

Full Article & Source:
More Doors to Medicare Home Health Closing, More Harm for Observation Status Patients