Corporate hospitals and ER’s are using ridiculous policies set forth by politicians to cheat medicare patients out of needed treatments, hospitalization, and short term nursing home/rehab care.
I first noticed this when my dad got sick in 2015 or so. I learned to play the system to get him the treatment he needed, but if I hadn’t been there, JRMC in Jamestown, ND would have literally killed him. He was having “seizure like” symptoms, and when they stopped he couldn’t walk, talk, or swallow. It was an endless cycle of ER/hospital/nursing home/home, as they kept coming back. I quit my job to be there for him, to keep an eye on what the ER and hospital was trying to get away with, and to advocate for him. I went after ER drs to hospitalize him for at least 3 days, and NOT under “observation” as medicare would not pay for continued treatment at the nursing home under other circumstances. I bullied drs and nurses going as far as yelling at people in the halls to get what I wanted. I just wonder how many medicare patients don’t have anyone, or don’t have someone me willing to basically come unglued to make them take care of an elderly man who did nothing but work hard to take care of his family his entire life…and of course pay his taxes.
The worst was when the social worker came into his hospital room and told me the bus was on its way to take him to the nursing home. I told her Dad wasn’t going anywhere until I talked to the dr. She then said it was the dr who released him, and she couldn’t just tell the nursing home bus to turn around!!! I told her (I’ve had run ins with this woman before about medicare). I told her she wasn’t listening, and that Dad wasn’t going anywhere until I talked with his dr. Dr Bates (great guy) called within 5 minutes and asked what was going on. I told him Dad’s BUN and creatinine numbers…they were sky high. His office is part of the JRMC ER/hospital/clinic system. He told me those were NOT the numbers he showed on his computer, and told me I did the right thing. Within 3 hours Dad was in an ambulance headed to Fargo for instense treatment with a team of drs. If I hadn’t been there, and known about creatinine and BUN, Dad would have died an extremely painful death in the nursing home. How many people has this happened to because of greed?
Fast forward to June 2024. The regulations have gotten worse, and the ER/hospital care as well. Travelling drs and nurses don’t seem to care at all. My mom went to the ER for a UTI. The fluids did perk her up a bit, but then she had a reaction to the antibiotics, which I had to point out to the nurse while they were trying to send her home. Benadryl and antibiotics were given. At that point (and even worse than when we got there) she was unable to do anything for herself. Mom has serious balance issues due to severe scoliosis and neuropathy. She can’t get around without a walker, and even then falls. I do live with her, but due to back issues (I was just put on SSI due to disability). I’m sure you understand to be deemed disabled by the feds is next to impossible. I was actually turned down by social security originally because I hadn’t paid in the previous 3 years…that was while I was taking care of Dad and only working enough to pay my bills. One of those bills was my health insurance that was over $1200/month thanks to obamacare. At any rate, they released Mom to me anyhow…even after I told them I can’t take care of her in this condition. I finally just asked the nurse if she would help me get Mom in the car. She refused. It took me 3 1/2 hours to get Mom through a small 3 bedroom ranch house to her bedroom. Because of the Benadryl and steroids she was not only uncooperative, she couldn’t stand even with the aid of her walker. 2 days later I had to take her back to the ER because she didn’t feel well. She was still dehydrated and had low potassium (she should have been receiving fluids in the hospital as she was dehydrated and had low potassium then). This ER dr said her potassium is low, and immediately put her in the hospital, after which she went to the nursing home for rehab.
July 2024 I took Mom to the ER for a painful and swollen toe. Her bloodwork show no signs of gout or infection. The dr “examined” her. He actually looked at her foot without even touching it, prescribed antibiotics for infection and sent us home. The next day she was in so much pain I took her back to the ER. One nurse actually said “I told you it would take awhile before the swelling went down.” This time we got a dr who gave her toe a light lift with his finger and Mom flinched. He took xrays that showed her big toe was so badly broken that if her bone density weren’t so bad it would have required surgery.
July we had one last visit to the ER. Again, it was low potassium. She was hospitalized on the first visit this time, then sent to the nursing home for rehab. She’s home now and doing as well as can be for an 88 year old woman who’s been put through hell by this so-called health care system. I actually bought her a wheelchair after the first visit to make sure JRMC could never put us through what they did again. She’s still walking, although longer distances like the clinic do require a wheelchair.
Because of medicare’s rules, they did not pay a dime for any of Mom’s rehab stays in the nursing home, her supplemental insurance paid out of pocket paid for it.
I’m happy to take care of my mom rather than putting her in a nursing home, but medicare does nothing to help with home care to keep her out of a nursing home, nor do they help with nursing home care. I suppose that’s why they won’t help with home care. Luckily her Blue Cross supplemental that she pays for out of pocket and her nursing home insurance will help with these things.
I wish I could help with policy on this…all I can do is tell someone about it. Telling permanent DC hasn’t worked. Telling ND politicians does nothing. Thank you for this website where we the people have a voice.