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Apocalypse
02-21-2011, 10:48 PM
From a Blog I visit.


ObamaCare: My 90 Year-Old Mom Kicked Out of the Hospital

For those of you who still think ObamaCare is a good idea, here’s how it’s affecting my family at the very moment I’m writing this…

My 90 year-old mother has taken ill. High fever (103), throwing up, weakness, spasmodic cough and significant respiratory issues. Her neighbor took her to the ER. The doctor says that "due to the changes in Medicare under ObamaCare" (the doctor's own words) he could not admit her into the hospital, even though he thought she should be admitted.

Kicked out of the hospital, even though she’s also a heart patient. Kicked out of the hospital, even though she runs a risk of developing pneumonia.

Would anyone like to try convincing me at this point that the rumors of death panels within ObamaCare are false? Before the new rules took effect, she'd have been admitted without question. We're getting a nurse to stay with her so that (hopefully) she gets proper care.

Those of you who pray, please pray for my mom.

UPDATE 6:00 PM / Feb 21…

The ER doc correctly interpreted the rules. Mom didn't "meet the Medicare criteria" for a hospital overnighter. 103 degree fever, violent coughing, nausea, AND a heart condition. No clue how sick one has to be to qualify.

My older bro & sister in-law are staying there 2nite. A Visiting Nurse will then stay 3 nights. She will be examined and treated as needed. She's stable and feels slightly better but very weak. Taking meds for symptoms and antibiotics.

Thanks to everyone at Free Republic and FaceBook for many kind words.

http://alanburkhart.blogspot.com/2011/02/obamacare-my-90-year-old-mom-kicked-out.html

Stop by and pray for him and his family.

djones520
02-21-2011, 10:51 PM
I'd be curious to know what those rules were that prevented her from staying.

PoliCon
02-21-2011, 10:55 PM
I'd be curious to know what those rules were that prevented her from staying.

Clearly she did not give to the proper political campaigns.

Novaheart
02-21-2011, 10:56 PM
http://damonday.com/wp-content/uploads/smells-like-bullshit.gif

Apocalypse
02-21-2011, 11:07 PM
I'd be curious to know what those rules were that prevented her from staying.
I popped over to Free Republic to read the thread there about it. He's a long haul trucker, and lives out of the state his mom lives in. His brother is taking care of her now and he is trying to learn more.

I hate the forum for FR.

djones520
02-21-2011, 11:09 PM
I'm not convinced that this story is real, but apparently there has been cases where Obamacare has made the determination that people are not "worth" receiving the aid.

http://www.nytimes.com/2010/11/02/health/policy/02medicare.html


Medicare officials said they were right to end coverage of skilled nursing care for Ms. Papciak because she had reached her “maximum functional capacity.”


“Beneficiaries are frequently told that Medicare will not cover skilled services if their underlying condition will not improve,” the letter said. “For example, as people with multiple sclerosis are often not likely to improve, skilled services such as physical, occupational and speech therapies that are necessary to slow the progression of the disease, or maintain current function, are denied. As a result, these individuals’ conditions deteriorate — frequently leading to more intense, more expensive services, hospital or nursing home care.”

In other words, the Obama administration had made the determination that if you will not see improvement, you don't get money. Simply keeping you from deteriorating further is not enough of a reason to pay for it.

Luckily two federal courts have struck this "death panel" interpretation down. :rolleyes:

Apocalypse
02-21-2011, 11:10 PM
Nova, go back under your rock before I step on you.

Kay
02-21-2011, 11:27 PM
The ER doc correctly interpreted the rules. Mom didn't "meet the Medicare criteria" for a hospital overnighter. 103 degree fever, violent coughing, nausea, AND a heart condition. No clue how sick one has to be to qualify.

If only she had been here illegally from south of the border. :(

Novaheart
02-21-2011, 11:30 PM
I'd be curious to know what those rules were that prevented her from staying.

There are a number of red flags in this story.

• It's on Free Republic. Those people are on the mailing list of every bullshit generator on the planet. Whatever the issue, they all know someone who is suffering due to liberals, atheists, jews, , muslims, etc...

• No one likes to be told he's not sick enough to be admitted when he's feeling like crap.

• Why is it the neighbor taking Mom to the ER?

• Family members would prefer that the old person be admitted, so that they can feel off the hook for care.

• People are no longer admitted to hospitals unless they require a certain level of care. If they are sick enough, they are offered the option of a nursing home, an option few seniors are keen on. Some health plans will pay for more home health than others.

• High quality health insurance doesn't change the rules much for admittance. United Healthcare (and you can believe not BCBS) do not authorize hospital stays for people to lie in bed and take anti-biotics.

• None of this is new or "Obamacare"

Rockntractor
02-21-2011, 11:34 PM
There are a number of red flags in this story.

• It's on Free Republic. Those people are on the mailing list of every bullshit generator on the planet. Whatever the issue, they all know someone who is suffering due to liberals, atheists, jews, , muslims, etc...

• No one likes to be told he's not sick enough to be admitted when he's feeling like crap.

• Why is it the neighbor taking Mom to the ER?

• Family members would prefer that the old person be admitted, so that they can feel off the hook for care.

• People are no longer admitted to hospitals unless they require a certain level of care. If they are sick enough, they are offered the option of a nursing home, an option few seniors are keen on. Some health plans will pay for more home health than others.

• High quality health insurance doesn't change the rules much for admittance. United Healthcare (and you can believe not BCBS) do not authorize hospital stays for people to lie in bed and take anti-biotics.

• None of this is new or "Obamacare"

http://damonday.com/wp-content/uploads/smells-like-bullshit.gif

Novaheart
02-21-2011, 11:41 PM
Five weeks ago, my mother who has COPD and is on Oxygen and some respiratory drugs went downhill over the space of a week. I wasn't in the exam room, but the outcome is that whether or not she was diagnosed as such, she was being treated for pneumonia.

It's been a long five weeks of a pretty exhausting schedule for me, but she's come back about 90%. Even considering the work, it's been better than having her in a facility both for her and for me.

Novaheart
02-21-2011, 11:47 PM
BTW, it doesn't make sense, but one of the side effects of the anti-biotics is tendonitis and possible rupture or permanent damage to ankles, knees, or joints. This is not bullshit that they simply put on the label to cover their ass, it's real.

Mom started getting better instantly when taking these drugs. The gurgling in the lungs started going away, the temperature came down, she wasn't constantly falling asleep from fever. Three or four days in she started to lose what limited ability she had to get up and get herself onto the potty chair. It became painful for her to move her legs. Three days later, the course of anti-biotics stopped, but it has taken weeks for her to regain reliable use of her legs and to get to where she doesn't need the potty chair beside or walker.

Rockntractor
02-21-2011, 11:47 PM
Five weeks ago, my mother who has COPD and is on Oxygen and some respiratory drugs went downhill over the space of a week. I wasn't in the exam room, but the outcome is that whether or not she was diagnosed as such, she was being treated for pneumonia.

It's been a long five weeks of a pretty exhausting schedule for me, but she's come back about 90%. Even considering the work, it's been better than having her in a facility both for her and for me.

I hope she has a complete recovery. It is good of you to take care of her:)

Novaheart
02-21-2011, 11:54 PM
I hope she has a complete recovery. It is good of you to take care of her:)

Thanks. I wasn't fishing for compliments though, I was actually surprised that her doctor didn't send her over to the ER, but he considers the hospital a dangerous place for sick old people, and after her last visit there I am inclined to agree. BTW, she has BCBS.

djones520
02-22-2011, 12:23 AM
• None of this is new or "Obamacare"

Read the story I linked.

Novaheart
02-22-2011, 12:53 AM
Read the story I linked.

Wanda Papciak was discharged July 10, 2008.

http://www.paelderlaw.com/pdf/PapciakvSebelius.pdf

Apocalypse
02-22-2011, 11:22 AM
• No one likes to be told he's not sick enough to be admitted when he's feeling like crap.

• Why is it the neighbor taking Mom to the ER?



I'm only doing these two, second first.

First, the neighbor was closest. Her children live too far away. And when sick, does it matter?

First one now.

Two weeks ago, my dad while helping shovel his nieces drive after that blizzard here slipped on a patch of Ice and fell. I took him to the hosiptal, he was complaining of shortness of breath and sever side pain. Fearing he had broken some ribs.

He is 64, heart patient, and diabetic.

He went through the xrays and initially found 6 broken ribs on his right side 3 of them in two places.

The hospital demanded he be admitted for over night surveillance, 4, heart patient, and diabetic was their reason for it, being they feared that it could cause pneumonia. They transported him to Mercy 30 miles away, where further xrays found he had in fact broke 7 ribs and scratched a lung as well. They kept him for a full week. Not because of the lung, which they said at the time could have been critical had it been punctured, but since it was only a scratch it would heal fully fine without problems. Nor was it because of the 7 broken ribs. They kept him because he is 64, heart patient, and diabetic which could develop into pneumonia. Had those 3 factors not been there, he would have been prescribed pain killers and sent home under orders to take it easy till the ribs heal.

Now tell me.

Why is a 64, heart patient, and diabetic patient that could lead to pneumonia admitted, while a 90 year old, heart patient, high fever, weakness, vomiting that could lead to pneumonia not?

PoliCon
02-22-2011, 04:36 PM
Why is a 64, heart patient, and diabetic patient that could lead to pneumonia admitted, while a 90 year old, heart patient, high fever, weakness, vomiting that could lead to pneumonia not?

different insurance?

MrsSmith
02-23-2011, 08:24 AM
I would suspect the reason behind the refusal to admit is the new Medicare rule that makes hospitals completely responsible for all costs associated with infections that originated in the hospital. Especially in an elderly patient with a weakened immune system, going home with all the "normal" bacteria could well reduce chances of catching something else.

Of course, the fact is that if she had been admitted and her condition worsened, unless the doctor had run very extensive tests to prove that she already had __________ at admission, the hospital ends up treating her for free.

The hospital's other choice would be to admit her for observation. This reduces the hospital's reimbursement by about 2/3s, and also leaves the patient or family owing a large co-pay. It also would mean that a transfer to a nursing facility for the recovery time would not be covered by Medicare, and the family would owe the entire bill.

Medicare rules state that if the patient returns to the hospital within 72 hours and is admitted, the initial ER visit and all tests have to be included in the billing for the admission as all one service, and the reimbursement is for the total service. However, if she goes home and doesn't return for more than 72 hours, the hospital is reimbursed twice. As a large percentage of hospitals operate on margins of 2 - 3% - or actually lose money every year - this can be a huge consideration also.

Overall all, though, my best guess is that the doctor felt the patient would recover quicker at home than in the hospital...especially if she has neighbors that will check on her and call an ambulance if she should take a turn for the worse. I will add that, if this was my parent and I was a long-haul trucker that could not be with her, I'd be frustrated and scared also. :(


Oh, and for the BS claims, the facts are that Medicare has changed very recently due to the provisions in Obamacare, and those changes are going to hurt both hospitals and patients. I see firsthand how Medicare hugely increases hospital costs with all their regulations and requirements, while consistently paying a lower reimbursement than anyone else.