Do you find this article insulting?

caliotter3 · Nov 5, 2011

I think the writer is trying to make a point. Don't see it as a deliberate intent to insult nurses per se.

stephparm · Nov 5, 2011

Some truth in it though.....

dudette10, MSN, RN · Nov 5, 2011

I think the article isn't intended to insult SNF nurses or the existence of such facilities, but it's more a rant about Medicare regulations and unnecessary care made "necessary" in order to qualify for rehab stays.

IMO, the 3-day stay requirement adds cost to an over-burdened system when a patient needs rehab but NOT the 3-day acute care stay.

In some cases, it feels less like "fraud" and more like working the system to get patients what they need.

elkpark · Nov 5, 2011

I think the article is exactly right, and I certainly don't see it as insulting to nurses.

vanburbian · Nov 5, 2011

Happy often irks the heck out of me, but he is 99.9% correct. He's wrong about the term "skilled" as it doesn't obviously denote the level of skill any nursing staff does or does not exhibit.

As usual, just another doc who doesn't "get" nursing.

Skilled only means they require a licensed person to provide a service that unlicensed personnel can not, be that PT/OT/SLP or nursing services.

Sorry to be blunt, but I've worked both sides of this situation- trying to figure out what to do with a patient from the hospital and get them discharged when they no longer needed to be there, and also working for an insurance company trying to find one iota of evidence that at day 50 they were still benefitting from a crappy 14 minutes of actual therapy a day that can be billed as an hour.

xtxrn, ASN, RN · Nov 5, 2011

Obviously written by someone who is ignorant and/or angry- a hospitalist doesn't go to nursing homes.

Yeah- Medicare pays for the first 15 days.... then it's 100 bucks/day for "Grandma's" check book to cough up. But those 15 days are a way to see if Grandma can get strong enough to go home and not become a MediCAID recipient for the rest of her life in the nursing home, once she's well enough to not need SNF.

If the MDS doesn't puke out a RUG, it's SOL and OTD

:uhoh3:

Peetz, BSN · Nov 5, 2011

What I find insulting is the broadness of the comments regarding SNF's. I happen to work in a combination facility, one hall is "skilled" the other two are long term care residents. Our skilled hall has wounds that need tending daily or Q shift, ALL patients on our skilled hall have PT and OT daily, even on the weekends. We don't have 600 lbs patients who are considered skilled and not having PT or OT to improve their quality of life. As a matter of fact we rehab patients so well that we are down to 28 with only 6 of those being on our skilled hall. Our goal is not to keep them there for the paycheck but to get them home. I find the ignorance of the writer offensive.

ErinS, BSN, RN · Nov 5, 2011

I TOTALLY agree with this article. Working in hospice I see Medicare Fraud everyday with hospitals and SNFs playing this game. In fact, I have had facilities tell families that are going for tours 'well, if you take your grandma/mom/wife off hospice, then Medicare will pay room and board'. Guess what? A hospice pt does not progress in therapy. Guess what else? The SNF does not give a sh*t because even if Medicare comes back and says that the pt does not qualify for rehab, the family has already signed a form saying that they will be responsible for the bill if the rehab is not approved. So of course the facility wants to be able to charge $800/day for rehab versus $150/day for room and board.

I do not think this article is anti-nursing, I think it is pointing out the rampant Medicare fraud.

xtxrn, ASN, RN · Nov 5, 2011

I TOTALLY agree with this article. Working in hospice I see Medicare Fraud everyday with hospitals and SNFs playing this game. In fact, I have had facilities tell families that are going for tours 'well, if you take your grandma/mom/wife off hospice, then Medicare will pay room and board'. Guess what? A hospice pt does not progress in therapy. Guess what else? The SNF does not give a sh*t because even if Medicare comes back and says that the pt does not qualify for rehab, the family has already signed a form saying that they will be responsible for the bill if the rehab is not approved. So of course the facility wants to be able to charge $800/day for rehab versus $150/day for room and board.
I do not think this article is anti-nursing, I think it is pointing out the rampant Medicare fraud.

Are you reporting what you see?

psu_213, BSN, RN · Nov 5, 2011

1. I don't put any thought into the comments of "shock" journlists/jocks (this author, Howard Stern, tabloids, etc.)

2. As a nurse I'm not insulted. I think it was not meant to be a criticism of nurses. It's a criticism of the system/Medicare and the foolishness of the laws involved.

3. While not personally insulted, I found the article cynical, rude, and not worthy of my attention.

Nascar nurse, ASN, RN · Nov 5, 2011

Yeah- Medicare pays for the first 15 days....

Not to be picky, but Medicare pays 100% for the first 20 days.

As a 25+ year veteran of SNF nursing, I'm not really insulted by the article. It seemed to me the author was more upset about the 3 day rule than anything else. I agree the rule stinks some times but I certainly didn't make them. There are plenty of ignorant people all over the world and some of them actually get published. I learned a long time ago to just turn the page.