Friday, July 18, 2008


I don't know how they do it, but they are amazing!!! These are the case managers who somehow find placement for patients. We are losing nursing homes like crazy as they can't afford to stay open on what little re-embursement comes their way, not to mention skilled facilities or even rehab centers. You can get the patient through the ruptured spleen and the liver lac but the closed head is going to take a while to clear. The case managers step in and try to do their magic. They work in these little closed rooms trying to find somewhere that will accept the patient who is uninsured has both a trache and a g tube.

We had two facilities here in town but both are being sued and already are in the process of shutting their doors. Both of the suits involve patients having decubes and thus the family who doesn't and didn't care before has sued. It doesn't matter that both patients are in air beds and moved constantly, or that their hypotension from their injuries cause the sores. All that matters is the money.

I don't know who is going to accept these patients in the future.


SeaSpray said...

In our state, our wonderful governor (not)wanted to cut financial aid to nursing homes and hospitals even more. The last cut hit the community hospitals hard. But hey..the people voted for him. I did not.

Admittedly, I (the talking head addict/news junkie)am not following any news as much as I should and so I don't know the latest on that.

As I peruse the med blogs and read these disturbing posts about cuts in reimbursement/and funding and hear these frustrating scenarios..I wonder where it is all ending up.

It must be so hard for already established doctors to have known how good things were to be faced with current reduced reimbursements and increased bureaucracy. It seems the funding it takes to support the latter would be better spent on the physicians, patients, equipment and facilities.

One of the surgeons I knew from the hospital told me in the mid 90s that if he could he would get out now/then. He retired last year but actually practices in another state because it is cheaper for him to do so. That IS sad! We New Jerseyans lose the good surgeon!

It was all so much simpler back in the 80s and they definitely had more time for the patients. Actually..they didn't even do triage when I was first hired but I think that is important. But my computer process was 1 screen then 2 screens and then just got so bogged down with all the detail/repetition. Nursing had 1 simple sheet to fill out. And now for everyone there is so much more required documentation and behind all the added paperwork are salaries paying people to perpetuate and increase said documentation. And of course there are improvements and it is for the protection of staff, facility and patient..but it seems out of control and siphons the money from where it matters most.

Or maybe I am wrong. But something has to be done.

We are going to need MORE nursing homes for the aging baby boomer population. And if they remain open..unless they are the expensive ones...patient care will probably suffer.

I predict I will be totally glued to talk radio and talking heads in the fall with the upcoming election. Although..I am STILL not inspired..but rather concerned. (I used to love that I could listen to talk radio while traveling between clients with one of my jobs. traffic jam on problem.)

I am ashamed to say that I don't know what Obama or McCaine's plans are for health care reform.

Case managers must be under a lot of pressure and are miracle workers for sure.

Interesting post!

I feel for you physicians. You really are targets for lawsuits these days and it just isn't right. I may have said this here before but I think if anyone anywhere-not just medical sues someone over something frivolous they and their lawyers should be responsible for all court costs of the other side if they lose.

And I don't understand something. If it can be proven that it was the hypotension from injuries... why is that not defendable? Although an ER doc told me once that if a dr is sued the patient will win anyway because they will opt to settle. he may have meant as a hospital employee..I don't know.

At the risk of mentioning me or my health care I will just say that my urodoc is the one who has had the most responsibility for my health care and been on the front lines for me. I would not ever sue him..Oh my God..I could never hurt him that way when I know he has given such good care and has been HELPING me. I just do not understand people that do that... and you're right..all that matters is the money.

SeaSpray said...

Bloggers remorse! Delete long comment if you wish.