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glatt · 08-27-2016, 07:50 AM

Thanks!

The one noteworthy thing about the end was that he was in a rehab facility. A rehab facility is meant to improve the patient. Medicare will pay 100% for the first 20 days but the patient is expected to make progress. My cousin had given up and stopped eating, so he was no longer a candidate for rehab. So on Tuesday, I met with the entire team, signed up for hospice care for him and asked that he be discharged for hospice. It takes a day or two to put in place. On Thursday morning, the rehab place did bloodwork and saw elevated white blood count and so started him on IV antibiotics. This was against the wishes I expressed on Tuesday when I said no to feeding tubes and IV hydration. But their position was that as long as he was still in their care, they had to treat him because they are a rehab place and not hospice. By starting him on a course of antibiotics, they needed to keep him for the 4 day course and couldn't discharge him until Monday. The cynic in me couldn't help but notice that Monday was going to be day 20 and Medicare would stop paying on Monday. But it backfired on them because he died on them and that has got to be bad for their numbers.

08-27-2016, 07:50 AM	#50
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Thanks! The one noteworthy thing about the end was that he was in a rehab facility. A rehab facility is meant to improve the patient. Medicare will pay 100% for the first 20 days but the patient is expected to make progress. My cousin had given up and stopped eating, so he was no longer a candidate for rehab. So on Tuesday, I met with the entire team, signed up for hospice care for him and asked that he be discharged for hospice. It takes a day or two to put in place. On Thursday morning, the rehab place did bloodwork and saw elevated white blood count and so started him on IV antibiotics. This was against the wishes I expressed on Tuesday when I said no to feeding tubes and IV hydration. But their position was that as long as he was still in their care, they had to treat him because they are a rehab place and not hospice. By starting him on a course of antibiotics, they needed to keep him for the 4 day course and couldn't discharge him until Monday. The cynic in me couldn't help but notice that Monday was going to be day 20 and Medicare would stop paying on Monday. But it backfired on them because he died on them and that has got to be bad for their numbers.