Can a LTC facility do this?

Specialties Geriatric


I have been working at a ltc for the past year and half and have seen this for the second time now. We recently lost a patient who was admitted to the facitly 1 mo prior. When she came the Dr told the family she was a good canidate for Hospice. Family didn't want her put on at the time and the patient wanted to live. After a week at the ltc the patient gave up and started to decline really fast. At this time family felt hospice was best. At this time the census is really low at the ltc and the DON and Admin both say she has medicare days left and it's not time for hospice. Needless to say after a week of the family talking with the Dr and fighting with the facility the patient was put on hospice and died on the 2nd day of hospice. Now we have another patient that staff feels should be on hospice but you get the same response from the DON and Admin that they have too many medicare days.

I know I don't fully understand the whole medicare thing and was wondering from other point views. :confused:

It is NOT up to the admin to decide when the pt goes on hospice -it is strictly up to the family and doc. This is very greedy and sad.

That's how I feel. I've only been a nurse for 2 years. So alot is still new to me. I really enjoy reading on this site. Thank you.

Yeah, they're doing it for profit. I'm all about business, but this is just disgusting.

Specializes in LTC.

sounds like they are trying to suck as much money as they can out of the medicare system. they place i use to work at would keep pts long then needed so they could do the same thing and then a few days more so the pt's private insurance had to pay for it....wrong and sad.

and hospice is up to the pt and family to decide not a way didnt they just violate a pts right (or two)? i mean they have the right to make an informed decision, and the right to say no, among a few others.

your facility is required to have a phone number posted to call in complaints. you always have to ability to call in ANYTHING you feel is questionable treatment or care. This can be a totally anonymous call-- take the number and call from home. The fact that your census is low probably has a lot to do with this. They are hurtin'! They probably rationalize it to themselves thinking the patient with get care either way. However the patient will often get more care--in the facility I used to work in they would get an aide from the hospice care agency for 2 hours a day. The doc will often be able to give higher doses of meds for comfort too......and not risk their license if ever reviewed. If the DOH for your state is "made aware" of this maybe the facility will think twice before they think about their pockets before thinking about what is best for the patient. Yup they are all about the money that is for sure! Good luck!

Ya I feel that it is all about the money. They jump the one nurse yesterday about charting cause she was charting end of life and not medicare.. Huh go figure. I really would like to see change at this facility. I am wanting to call but everyone is close or is related to each other so when there is a complaint the stories usually match and the funny thing is the Admin lol will pick who they talk to and time the person while they are being interviewed lol. They facility is a good one to work at other then management. Alot are afraid of losing their jobs so nothing ever gets done. Since I have been there they have had one complaint. So they don't get alot of calls. Any suggestions would be helpful. Thanks for all of the input too.. You all are awesome!!!!!!!!!!!!!! Nurses Rule!!!!!!!!

Specializes in ED, ICU, PSYCH, PP, CEN.

medicare fraud

and remember - fraud is money out of our pockets. Medicare is funded by our taxes - not some mysterious money tree.

medicare fraud

that is what i was thinking......and from what i gather, you really dont want to mess with those "boys".

Specializes in LTC, Psych, M/S.

According to the t.v. commercials they are really starting to 'crack down' on it.

Sounds like Medicare fraud.

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