Friday, September 30, 2011

Disturbing Admissions

About twenty percent of demented nursing home patients keep going to the hospital for questionable reasons.  The debate is whether these patients are going for real issues that CAN'T be dealt with in the facility or are they going because the nursing home gets a lot of money to take them back.  Medicare pays about three times the normal daily rate for nursing homes to take patients back after a brief hospitalization.  Truth be told, the study shows no causation so the researchers are postulating here.  They forget the fact that many families want everything done for their relatives and many on-call doctors are covering for patients they don't know.  It is tough to be a cowboy these days and manage issues without the risk of being sued.  Still, with the amount of Medicare and Medicaid fraud in this country, this trend is concerning.


Carol Blackburn said...

I hear ya, Doc.....we get those same patients sent to us too. To fill beds????? I think they pass them around to share the money. Some ill winds blowing my way these days because I am a "cowgirl." Prayers welcomed!

Mark C said...

I think some of it involves families who want to "do everything", poorly trained nursing home staff, and fear of liability on the part of the nursing home... but nobody walks away from the money trail created by an unnecessary admission and workup.

Pat said...

Welcome to my world. In my naval aviation days, they kept an "Alert 5" fighter, manned and ready to be blasted off the deck within 5 minutes in case of an urgent situation. I like to joke that hospitals coordinate with their supporting nursing homes to keep an "Alert 5" gomer, ready to be shot over to the nursing home anytime the beds are not filled. Contractured, utterly demented, full-code, appearing just as they did last week, the last time they were sent over for decreased alertness, or "just not doing well"...really?? How could you tell?