Blaine Huffman

Resolving Everyday Ethical Dilemmas

Ethical Scenario

ou are an OT working at a skilled nursing facility. You know that one of your co-workers
is lying about the number of minutes she is spending each day with clients in order to
make her productivity look higher than what is really is. At your skilled nursing facility,
you are given a financial bonus for having a higher percentage of productivity.

 What makes this situation an ethical dilemma?

This situation exhibits a form of fraud which makes this an ethical dilemma. By
lying about the number of minutes, productivity is falsified and money is given on
false pretenses

 Using the AOTA code of ethics, state which principles apply and why.  Who are
the parties concerned? 

Veracity: This principle states that OT personnel should provide comprehensive,

accurate and objective information regarding services. This principle is based on
honesty and truthfulness. The parties that are affected by the decision made in
the situation would be the co-worker, all other co-workers, the skilled nursing
facility, the insurance provider reimbursing for services.

 What is the nature of their interest and why are they concerned? 

Co-workers: This type of fraudulent reporting can have consequences on the

facility as a whole and could damage the reputation of the facility, also could be
limited by the amount insurance would be willing to reimburse when fraud is
found

Reimbursing Party: Whoever is reimbursing will be paying for services according

to time spent with clients (unless it is Medicare with the new payment model).
They would be paying for more services that were not provided

Skilled Nursing Facility: The facility would be reprimanded and have

consequences for fraudulent service reporting

 What other information is needed before action is taken? 

If there are examples or some form of evidence to prove that fraud is being
committed, this would help when action is taken
 How long has this been going on?

Who would this need to be reported to?

 What are your choices?  For each choice indicate possible consequences. 

Report this to a supervisor to ensure that action is taken: The trust and
relationship with the co-worker would be damaged. There also may be
consequences for the facility and the amount of insurances that would approve
services at this location. Financial incentives would probably be done away with.

Leave the co-worker alone and do not report the fraud: The co-worker would
continue to commit fraud, financial incentives would be given when not deserved,
if the fraud is found and investigation is done I would have to report when I knew
about the situation

 Name 2 professional organizations or systems can assist in resolving professional

ethical disputes (your answers must reflect systems that have jurisdiction over OT
practice).

Department of Health and Human Services

Department of Federal Regulatory Affairs