Getting people out of the hospital

[RNsub, ASN]

I am an RN care manager, working for an insurance company. Our care managers are based in a hospital and do utizilation review and discharge planning for the admitted patients who carry our insurance plan.

I do not like this job.

My biggest pet peeve lately is the high amount of social admits. It is gross how many families basically abandon their loved one in the hospital. They can't take care of mom, so they bring her to the hospital for vague symptoms and then say they can no longer have mom in their home. Then they expect the hospital to find a facility or AFH. They continue on with their lives, not looking for a place, not caring at all, even though we explain it is their responsibility and pt may be billed for the hospital stay. Many don't care about being billed and blatantly admit they are not going to pay it anyway.

The worst part of all this is how the hospital does nothing to back us up and expects us to find a "safe discharge plan."

***** When did we decide to take on the role of these people's life coaches and personal problem solvers?

Why do people expect their insurance company to take care of finding their relative a home? Or pay for a nurse to come in and watch their relative 24/7?

Rant over, time for a change.

[d'cm]

When I was a hospital CM I certainly saw a lot of temporary social admits but total abandonment by family was pretty rare. That being said people can 'expect' whatever they want but bottom line the hospital is taking the financial risk of not getting paid. If it is a dual coverage Medicare/ Medicaid member they cannot be balanced billed. If the admission was deemed to be not medical necessity they could not even be legally admitted to subacute under Medicare. ( but we all know it is done anyway). If this happens a lot in your hospital, they need a better gatekeeper.

[Katie82, RN]

Selecting a long term facility is not only an unpleasant task (usually against the patient's wishes), but requires more expertise than family members want to account for. They would rather place that responsibility on a third party than have to accept responsibility for making a bad choice. No one wants to take the blame for "putting mom away", let someone else do it.

[GM2RN]

I am an RN care manager, working for an insurance company. Our care managers are based in a hospital and do utizilation review and discharge planning for the admitted patients who carry our insurance plan.

I do not like this job.

My biggest pet peeve lately is the high amount of social admits. It is gross how many families basically abandon their loved one in the hospital. They can't take care of mom, so they bring her to the hospital for vague symptoms and then say they can no longer have mom in their home. Then they expect the hospital to find a facility or AFH. They continue on with their lives, not looking for a place, not caring at all, even though we explain it is their responsibility and pt may be billed for the hospital stay. Many don't care about being billed and blatantly admit they are not going to pay it anyway.

The worst part of all this is how the hospital does nothing to back us up and expects us to find a "safe discharge plan."

***** When did we decide to take on the role of these people's life coaches and personal problem solvers?

Why do people expect their insurance company to take care of finding their relative a home? Or pay for a nurse to come in and watch their relative 24/7?

Rant over, time for a change.

I feel for you. I work in the ER and see this regularly if not frequently. Even if families aren't expecting long-term placement, sometimes they will dump a family member in the ER with trumped up symptoms so they can get a break from taking care of them.