You have broken my heart. You have created an environment where therapists that truly care for their patients are unable to provide the care these patients deserve. You have taken my passion and hard work for the past 20 plus years and treated it as if it's yesterday's garbage. You have created an environment in which companies are devaluing and eliminating therapist and wrecking patients and hard working therapists lives. You have created an environment where upon unethical companies learn the loopholes they will be back to wasting your money and therefore the American people's money. You have created an environment where elderly people are being given the idea that their lives don't matter and their quality of life is if no value anymore. You have created an environment in which all the ethical and moral therapist will be gone because those people can no longer feel good about their abilities to make a difference in thousands of elderly peoples lives. Great job Medicare PDGM! I pray that you will see the error of your ways and the injustices that you have created before it hurts millions. PDGM has put a formula into place that determines how many visits of OT and PT a patient can receive in home health based on their diagnosis and level of function. Even if the patients level of function shows that they are in need of both OT and PT the formula normally only allows 4 visits of each discipline. Ex: 85 yo female fell and broke their arm and can't perform their daily living skills and can't cook, clean and is no longer driving and has no caregiver. This same person was previously completely Independent and active. They may receive 4 visits or are expected to wait for 30 days to possibly get OT or PT visits because Medicare formula won't allow the visits they need. Medicare needs to speak to therapists and patients who are affected and also needs to review cases involving fraud under 5 million as this is the reason for the drastic changes. There are a lot of good therapists out there who truly care about their patients and as it stands now, the fraudulent companies and employees are winning. They caused these drastic changes to take place all because Medicare won't review cases under 5 million.