Dx of Brain Ca for MCR A

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Specializes in LTC-Geriatric-PPS-MDS.

Are you guys finding that the Dx of Brain Ca in the elderly is condeming then to Hospice? No matter if the patient is CgA x 1 with aDLs to total assist but still showing progress in therapy...

Have a patient with grade 2 brain Ca (i cannot remember the type) per autopsy reports. Came to us total assist x2 after craniotomy..

after 52 days of therapy- he has made it to CGA x1 with transfers, toileting, dressing- ind with feeding. Otherwise- doing pretty dang good!

He is still making slow progress- but progress with therapy.

HMO has denied him more time- family is appealing. The appeal process manager straight up told me on the phone " My MD is going to see his DX of Brain Ca and deny this appeal."....Really?!

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Specializes in LTC-Geriatric-PPS-MDS.

I say hospice because the first solution from the appeals processor was "well, if the family cannot afford to stay with you guys and cannot provide the assistance needed- then there is always hospice."...

Yes- We have had the discussion with the family that the patient may succumb to his Dx and nvr regain function... but the patient HAS regained function...

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Specializes in MDS/ UR.

HMOs are becoming more sticker on all the diagnoses it seems on the last 6-8 months.

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