You Get Physical Therapy, I Get Fiscal Therapy.... and Lots of It!

I cannot tell a lie!  I am getting rich servicing all of my 80 year old women clients!  Of course not, you moron...  I am  a Licensed Physical Therapist  providing Contract Services to Medicare Providers.  My marks are SNF's, ICF's ALF's, ARH's, and indeed any Health Services Organization with a Medicare Billing Number and access to a CMS (Center for Mecicare Services) Intermediary Database. 

Seriously, folks Health Care Pros couldn't care less about Obamacare. It's just a political side show. The "Real Money Show" is in treating the 30 million obesse, sugar sucking, grease gobbling, inflamation constricted, 65+ widowed women, all of whom are insanely afraid of dying and yet are doing everything possible to hasten their own funerals.  And that, my friend, is where I come in. You see, I put the "old broads" in play.  I certify them to be "patients" entitled to Medicare paid "Health Services", for, believe it or not,....not being able to walk as well as when they were young.  As goddamn hard as it might be to understand, CMS, and therefore it follows, HHS and Barack Obama want every American over 65 to get help from me, if they are in the least bit fearful that their ability to walk just "ain't what it used to be". 

For $200 an hour, I will watch you walk around in your kitchen, or through the halls at your apartment, often while texting framily to easy the boredom.  After  about 120 days, when the Home Health Agencies HHRG Codes tank, I'll play the "no progress card" and recommend that you relocate to a $4k a month ALF, where I get "referral benefits" and the option to resume watching you walk at $200 twice as often.  As your institutionalized depression kicks in, and your mobility crashes, along with your savings,  I will raise concerns to ALF Management about "independent evacuation". ALF Management will  have a "regulatory moment", and we will all concur that you need SNF Care.  We won't send you directly to the SNF.  We will send you to the Hospital ER, probably for some never fully identified infection.  After 3 days and $40K Medicare Billing by the  Hospital, they will send you to the SNF where you will now live in a shabby  room with a welfare roommate, a pull curtain and an unkept teenage aide mindlessly pouring water; all for a modest $1000 per day in Medicare Payments. Yes, I will receive "referral benefits" and I will now see you daily when the CNA pushes you down to my "therapy suite", where I will help you practice transfering from your wheel chair to a mock toilet. 

After about 100 days of this "worst of all possible worlds", SNF experience, Medicare will "drop you like a hot potato" and your kids will start getting bills at about $250 per day.  This will be your "no therapy time". The kids won't be able to afford me.  They will be home thinking about moving you into their garage. I'll be in the Bahamas on vacation. You'll be in a Hospital bed with the rails up.  (I know this sounds horrible, and I will wish it wasn't true....although I do like the big bucks.)  There will be some hope.  SNF management will try to get you readmitted to the Hospital so they can get you Medicare "new episode covered".  If  the SNF is successful, Ill rush back and we will all push replay.  If not, and more likely, since ObamaCare severly penalizes Hospital's for readmits, it will probably be time to sign you up for Hospice.  The garage will actually be a welcome change from the SNF, and Medicare will pay the Hospice Agency around $4000 per month to stop in once a week for 30 minutes to take your temp/pulse and say a little prayer.  I will be praying that the Hospice Agency remembers my "referral benefits".  

No, I'm not particularly proud of my career.  I have a BS from Mizzou and a Masters from Vanderbilt.  Twenty years ago, I just wanted to help people.  I still do, but there's no way to buck the system.  When I look in the mirror I see a man preying on "old flesh", but then I remember that I'm rich and I laugh like a jackel!