Letter: Forced exposure to the coronavirus

My wife is an occupational therapist, and works at a skilled nursing facility in New Jersey.

She still has to go to work, and is told she is considered “essential personnel”. When I asked why she is considered essential, to a point where she has to expose herself to a possible virus, this was the explanation. Medicare or medicaid will not cover the patients she is helping, if they are not getting the necessary therapy.

So instead of more therapists staying at home and staying safe, medicare and medicaid are forcing my wife and many many others to go into work or they will drop the patients coverage. Would it not
make sense for the government to say that they will not drop payments during this pandemic, and keep countless people safe at home??

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  1. Yes this does seem odd that she has to go in. Furthermore I do billing for a snf and for Medicaid therapy is not required to get covered. For Medicare this used to be the case when Medicare compensated based on the amount of therapy the patient was getting but as on 10/2019 Medicare changed their payment model and is now much more focused on the diagnosis code rather than the therapy although the amount therapy still does play into the payment model but not as much as prior to 10/2019 reimbursements. also Medicare requirements are being relaxed bc of covid 19 for example they are not requiring the 3 day hospital stay prior to being admitted in order to be covered if billed with DR- disaster relief condition code. Hope everyone stays safe and healthy !!!

  2. Why should the government pay if they are not getting services. Your wife should not go. In, she should not get paid and the facility should not get paid. Why would your wife expose herself to bodily harm for a few dollars.

  3. you are making a wrong assumption that this is only for money. does your wife think she is working only to line the pockets of the owners? or she is a OT to help people. The frail people in a nursing home receive OT, PT and speech to help them. these residents are, very often, confined to their beds, they need their therapy, otherwise they will get wounds, they need the therapy otherwise they wont be able to talk or swallow again. they need the therapy otherwise they wont be able to walk again after their hip surgery. they need their therapy to move after having a stroke.
    The therapy in a nursing home isnt done as babysitting,. it is done as an essential job.

  4. While I agree that your wife shouldn’t be forced to go in to work if she doesn’t feel comfortable, Medicaid and Medicare are paying the nursing home for a service, which if not provided they won’t pay for. Your wife is an employee of the nursing home not the government, therefore if she feels like she needs to take sick leave or time off she should take it up with them and not Medicare. Hatzlacha!

  5. I was recently required to stay in a rehab facility for six weeks.Perhaps the same.
    Many times non Jewish therapists would threaten to tarnish my records with “refusals” on days I did not feel up to therapy.
    When I discussed this with the director, I received the same answer.If there is a “no show” then there is no payment from medicare. Outrageous!! It seems that the bottom line is truly money, and not patient care.
    Regarding patients needing therapy. They will not die if they miss therapy and are unfortunately confined to their rooms for the immediate future.

    I believe your Rebitzen’s situation is an immediate “shila” of pekuach nefesh and you must get a p’sak from a Posek Hador. Your Rebbitzen should NOT report to work until you get a P’sak. Stay well.

    (If you post this comment, please use the call name “Reb Zalman” ty)

  6. If your wife is an OT she is providing necessary Rehab for elderly patients, this has nothing to do with pay from insurance.
    Your wife should be commended for being a care giver.

  7. Please read the TLS article below:

    LRRC COVID -19 Government Job Related Coverage and Community Crisis Resources

    https://thelakewoodscoop.com/2020/03/lrrc-covid- 19-government-job-related-coverage-and-community-crisis-resources.html

    She may be able to elect to not go to work around infected persons and be reimbursed. It might be different if she were a surgeon, etc. but check the article. You can contact them via the phone number and email listed in the article.

  8. Being a Healthcare worker in a facility myself, I sympathize with your wife. I think we have to realize that working in Healthcare means sometimes being in such situations that we must take a risk to care for others. OT is an essential job needed in order that people could learn how to swallow that they do not choke. As far as the above comment making it sound like there is too much therapy, wish there was. In most cases therapy and keeping the body moving is extremely important. In fact if anything there is not enough therapy as any honest healthcare worker would tell you. Obviously, she can ask a shaila but she is definitely from essential personal. May she stay well!

  9. It’s sad to see people are picking their career for the wrong reasons. Obviously your wife picked this career because it pays better special ed or a typical office job. Any healthcare provider that is in this field for the right reasons understands how important it is for patients to be seen especially in this time where the hospitals are flooded the focus is to get residents better to go home and free up beds for new patients from the hospital. The last thing we need in a time of crisis is for residents to decline and/or fall and end up back in a packed hospital that has a full blown crisis on their hands. With therapists like this the future of therapy is at risk if you don’t believe in what your doing why should insurance company’s and Medicare believe in it, your basically comparing a trained therapist that provides skilled care to choosing to hire personal trainer. My suggestion start looking for a career that you believe in and can be confident in.

  10. I’m RN Case Manager for a local hospital and mostly deal with quality control. I have not done direct patient care in years and now I’m pulled into the ER. Am I happy? No, however it’s a pandemic and these times call for flexibility.
    Healthcare professional face risk, that’ part of the job. Perhaps you’re wife should’ve went into accounting

  11. Just saying..doesnt sound like the wife is complaining,just the husband…maybe he doesnt understand what his wife really does,and how important it is

  12. From the Husbands point of view,he doesnt want his wife going in to this type of situation,maybe he doesnt understand how important what she does is

    • @Nursing Home Admin–Home is for sure safer,but let me ask you this….are they providing the therapists and nurses with The N95 mask etc?I have heard that in jackson there is a facility that does not

  13. I usually don’t post comments but I feel compelled to add my 2 cents over here because I too faced the same situation, yet with a different spin. I work as a therapist in a skilled nursing facility in New Jersey and i love my job and love working with my elderly patients. Recently however I’ve been extremely nervous to go to work as the number of cases around me, here in Lakewood have exploded and I am truly nervous that I can potentially be carrying the virus and be the catalyst for an outbreak amongst my patients. With many hours of agonizing, I decided I need to take a leave of absence until things settle down. Now, I did NOT do this for my sake (I need the money and i am not the nervous type) yet I did this for the sake of MY PATIENTS because as someone from Lakewood where the virus is rampant right now, I don’t think it’s fair to walk into a nursing home right now. Like I’ve been saying, “At this point I need to be PROACTIVE and not reactive.” And NO- my patients will not die that I’m not there but YES they could die if I bring the virus in cv….Think about the story in EY where the social worker passed it on in a group home and now there’s been a death and multiple people in critical condition as a result. We have to be so careful! Good luck to everyone making these decisions… Hashem should give you clarity.

  14. During times like this, we all need to stay perfectly focused. There are different types of therapists.
    These comments are in regard to an occupational therapist, perhaps the mother of young children, possibly risking her life through exposure to others..
    If a nursing home patient chas vsholom has a potential choking hazard, it will usually be relegated to a specialized SPEECH therapist who has expertise in all areas of the throat and mouth. As warranted,he / she will issue dietary restrictions for preparing special food textures;. chopping,blending, etc and will require a feeding aid to assist at all meals.
    Let us not confuse the specific jobs of different types of therapists. May we all remain safe and healthy..

    • In regards to your comment I AM a speech therapist. When a speech therapist is not present, nursing can downgrade a patient if they are exhibiting signs of difficulty. While I’m not saying it’s the perfect scenario, it’s definitely safer than a therapist who has had possible exposure from all sides coming in at this crazy time…

  15. I too am a speech therapist and am continuing to provide services in the SNF. I know that right now – more than ever, I am ‘essential personnel’. My patients can have a diagnosis that can range from: new strokes, to pneumonia, to Parkinson’s, to Dementia.

    Yes – I am nervous, but firstly, the building has strict guidelines including:
    1. NO visitors, no family, friends, spouses.
    2. There is only ONE entrance to the building – the rest are CLOSED.
    3. Each staff member must sign in at the front desk, take their temp, write it down, & answer a survey of any signs or symptoms they may have had in the past 24 hours.
    4. We are provided with a sufficient amount of masks, gloves, gowns, hand sanitizer – which we all use frequently.
    5. ANY new admission – despite that fact having been tested negative (in the hospital) for COVID-19 – are STILL treated as if they have COVID-19, and are kept in isolation for 14 days under strict guidelines.
    6. Personally, my schedule right now is home, car, work, car, home.
    I feel like work is a great distraction right now from everything going on, AND I am helping people at the same time. I chose this profession for a reason, & although I get nervous sometimes, I’m glad I can still be a part in continuing to help people & change lives.

    • I am incredibly impressed with your positive and professional attitude. If all would be like that, the tension level would be greatly reduced…

      May you be Matlzliach as a Shliach of Hashem to help treat and heal your patients in safe health!

      Thank you for the Chizuk

    • Yes, honestly it’s easier to work than be quarantined in the house for 2 weeks straight with kids. I am assuming your exposure to positive cases/people with symptoms of virus is less than mine. I hope it continues to remain that way. Good for you that you can still provide services safely 🙂

  16. Well I am an SLP in an SNF as well and I am scared because my facility does not allow us to wear masks and does not isolate or have guidelines in place for 14 days after admissions. If we bring up concerns we are admonished for causing a panic.
    I am still going in because I am “essential” and my right to use PTI has been taken away and I do my best to protect myself as best as possible. Be grateful that your facilities are taking the extra precautions because not everyone’s are. Stay safe out there

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