Corrupt discharge planning/hospital case managers experience. Is it the norm?
I have had several negative experiences with discharge planning from case managers in the hospital. What if the source of it: insurance companies, DRGs, risk of senior catching infection or sense of institutionalism if left in the hospital longer, etc. To me, it appears they want the senior out as soon as possible.
Issues I came across:
1) One documented I agreed on the short-term facility. I never agreed on that facility.
2) One told me the health care proxy was responsible for signing all admission paperwork. Believing her I did these tasks only to find out later from my elder attorney, I was not responsible for signing all these papers.
3) One told me there were no short-term rehab facilities open except for one. I called around and found others who had open spots. The discharge planner/case manager became furious I did this and double checked her work.
4) A doctor documented he spoke to me (the HCP) for 30 minutes as well as did education. He never spoke to me. (I filed a complaint with the Patient Advocate).
5) One told me the official discharge date was Friday. Because there appeared to be so much misinformation occurring, I filed a complaint with Kepro who did an investigation. The told me there was never an official discharge date written in the chart; thus, my parent was not due to be discharged that friday afterall.
6) Two let another family who was not a HCP decide the facility,
A really good social worker told me all they want is a signature.....
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As Healtcare Proxy not sure if you pick the facility. If Rehab, yes Medicare will pay 100% for 20 days but after that only 50%. So that means either supplimental insurance picks up the 50% or the patient pays it. At that point the Financial POA has the choice because they need to guarentee that the patient has the money.
The responsibility of a HCP is limited. You carry out Lzos wishes. If a medical decision needs to be made not covered by the proxy, you make it based on "what would LO want". You talk to Doctors and staff. But anything to do with finances, like who is going to be responsible for the bills, is the Financial POA. Because thats the person who knows how much money the principle has.
Hospitals run based on a financial business model. They don't want to keep people in who don't have enough (or any) insurance, especially if they are taking up staff "resources" (time and materials). Hospital ERs are chaotic places, with patients often staying longer than most staff shifts.
My son's ex GF is now a nurse. She is as dumb as a box of rocks. It puts shivers down my spine to think she's working in a hospital. Especially my Mom, an RN with 40 yrs of experience who has nothing good to say about most modern-day nurses and hospitals.