Again, it is not up to the admitting physician what your status is. It is up to very strict medicare guidelines. Put the blame where it is due.
Certainly the blame is with Medicare but in reality, a doctor makes that decision and they are people, too. I suppose I could say it's “who you know”, the personal connection you have to your doctor. Plus, the doctor wants to be paid and he knows the hospital wants to be paid. What he puts on the chart decides where the medical bills go.
Our doctor, who had a personal relationship with my dying husband, kept him in the hospital rather than ship him to hospice where they would have let him die right then. When I asked him not to send him to hospice, he said, “I would never do that to him.” He wrote whatever he had to in order to keep him in that hospital and prolong his life.