appts outside of your facility

[ktwlpn, LPN]

Bear with me-I have several questions. I work in a 250 bed facilty.We have a staff of former cna's that run our "clinic" The opth, the pod and the dentist all come to us. The clinic co-ordinates transport to all other appointments.We have a 3 vehicle fleet and still often have to call in our local medical transport company to accomodate what seems to me to be a ridiculous number of follow ups...

Can you tell me the size of your facility and how you manage this? We bear the cost for it all -sometimes insurance does pay for the medical transport but often they won't.Family seldom accompany their loved one.We send a driver and a cna on each trip. Do you have a limit on mileage? Do you charge the resident? What happens if a med or treatment is ordered that insurance won't cover? Do you eat the cost? When is it appropriate for someone to say "No more" I have a 98 yr old s/p MI( in HER 40'S) .Never has had a problem since and is now in the later stages of dementia. She is dependent for all adls and no longer recognizes her loved ones.Why is the card still ordering f/u's q 6 months? Sheesh...

I have never seen anything like this in any other LTC. Never have I seen this much back and forthing.We have residents with 6 to 8 consulting physicians and they are always going somewhere and are always stable.Going to live forever....

[CapeCodMermaid, RN]

We tell the families that we do NOT cover the cost of any follow up appointment. They can drive the resident themselves or hire the chair van. If they want a companion, they hire an off duty CNA to go along. I've never done anything else.

[loriangel14, RN]

I work in a small hospital that has many rehab pts. We regularly have pts that have to offsite for ortho rechecks with surgeon, We use private transfer services and send a nurse usually. The cost is covered by the health care system( I am in Canada) but sometimes the back and forth traffic is hectic.I do see pts getting tx when the doctors should say" no more", I know what you mean. It is even harder for families to stop doing too much for someone when everything is covered so cost isn't a deterent.

[classicdame, MSN, EdD]

what kind of "facility" do you work in and could the transport be part of a contract fee that the patient has paid for in advance? If so, you will just have to live with it.

[ktwlpn, LPN]

I work in a county run non-profit facility.The problem is we are in a real budget crisis.We may not be able to continue to "just live with it" We have very few private pay residents-we're medicare/medicaid.

[Not_A_Hat_Person, RN]

At my ALF, residents get a certain number of free van trips per month. After that, they have to pay for them.

[canoehead, BSN, RN]

Follow up visits are not benign for your residents. The commotion and transporting can be very disturbing in an otherwise predictable day. CALL the docs and ask if they can decrease the FU frequency, or cancel them safely, and then if you can get a series of appointments all on the same day, so it's one transport instead of 3 or 4 the impact is lessened. If a patient is admitted to hospital consult everyone so the docs go to the patient!