Thursday, April 9, 2015

Nursing homes are taking people

Paramedics refer to nursing homes as 'God's waiting room.' In Florida, they are almost universally filled to the bursting point with patients who are largely catatonic, and are poorly cared for by an overworked and underpaid staff. What this means is that the staff that doesn't quit for a better job are stuck there for one reason or another, and the usually begin viewing their patients as a burden.

During my 20 some odd years as a Paramedic, I would frequently walk into a nursing home and see patients who had been left there for hours, lying in adult diapers that were filled to capacity. I learned to associate the smell of unwashed bodies, human excrement, and disinfectants as the "smell of nursing homes." 

They hide these conditions from prospective clients and their families by putting the most healthy and most frequently visited patients in the front of the building, and hide the most neglected in the back. If you found a patient in the last room on the left as far from the nurses' station as possible, in the back hallway of the building, you could bet money that the patent was the one that the nurses found to be the most bothersome, and the patient was most likely being ignored.

I once responded to a call for a patient because the staff claimed that they could not take his blood pressure. I asked when the last time his BP was taken, and they told me just 2 hours before, and that it was fine then. When I got there, it was obvious from the advanced state of rigor mortis that this particular patient had been dead for at least four hours.

Why does this happen? Because nursing home care for a patient who is on Medicare is a cash cow. The goal here is to keep the patient alive and under the care of the nursing home for as long as possible at the lowest cost possible, so that profits are maximized.

I know a physical therapist who was instructed to stop rehabilitating patients for walking unassisted once the patient could walk a certain distance. It seems that once a patient can walk a certain distance (IIRC it is 30 feet, but I may be wrong) they are no longer eligible for the higher amounts paid for nonambuilatory patients. 

But one day last summer, after he disputed nursing home bills that had suddenly doubled Mrs. Palermo’s copays, and complained about inexperienced employees who dropped his wife on the floor, Mr. Palermo was shocked to find a six-page legal document waiting on her bed.&nbspIt was a guardianship petition filed by the nursing home, Mary Manning Walsh, asking the court to give a stranger full legal power over Mrs. Palermo, now 90, and complete control of her money. Read the article, and it will open your eyes as to how the Medicare system is being played, and how this is causing people to be treated like cargo.  
I once had a supervisor at an ambulance company tell me that it was our job to treat the customer well, but that the patient was not the customer, the nursing home and hospital was. "You see," he explained, "the nursing homes and hospitals called for us, not the catatonic patients. The patients were just cargo, and no one cares about whether or not cargo is happy."

Another supervisor at a different ambulance company and I had a conversation where I was explaining that what we were doing was Medicare fraud. During this conversation, I was told: "We are making money, the nursing home is making money, and the patient doesn't even remember his own name. We all win here, so don't rock the boat. You want to keep your job, don't you?"

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