Federal Reports

A physical therapist in South Texas claimed Medicare reimbursement for outpatient physical therapy services that did not meet Medicare reimbursement requirements in calendar years 2012 and 2013. Specifically, of the 100 beneficiary claim days in our random sample, the therapist properly claimed Medicare reimbursement on 81 beneficiary claim days, but improperly claimed Medicare reimbursement on the remaining 19 beneficiary claim days.

The West Carroll Care Center (the Nursing Home) (operating in Oak Grove, Louisiana) did not always provide service to its residents in accordance with their care plans, as required by Federal regulations, before the residents were hospitalized with urinary tract infections. Specifically, the Nursing Home did not monitor and document residents' hydration status, monitor and document the residents' conditions, and document residents' urine appearances as their care plans required.