Posted on 12/27/2013 3:01:19 AM PST by afraidfortherepublic
Hospice patients are expected to die: The treatment focuses on providing comfort to the terminally ill, not finding a cure. To enroll a patient, two doctors certify a life expectancy of six months or less.
But over the past decade, the number of “hospice survivors” in the United States has risen dramatically, in part because hospice companies earn more by recruiting patients who aren’t actually dying, a Washington Post investigation has found. Healthier patients are more profitable because they require fewer visits and stay enrolled longer.
The proportion of patients who were discharged alive from hospice care rose about 50 percent between 2002 and 2012, according to a Post analysis of more than 1 million hospice patients’ records over 11 years in California, a state that makes public detailed descriptions and that, by virtue of its size, offers a portrait of the industry.
The average length of a stay in hospice care also jumped substantially over that time, in California and nationally, according to the analysis. Profit per patient quintupled, to $1,975, California records show.
This vast growth took place as the hospice “movement,” once led by religious and community organizations, was evolving into a $17 billion industry dominated by for-profit companies. Much of that is paid for by the U.S. government — roughly $15 billion of industry revenue came from Medicare last year.
(Excerpt) Read more at washingtonpost.com ...
I don’t argue with the cost differential of home vs. in-facility hospice. I am for care that allows the person to live out their remaining days at home. I am only concerned with what the in-facility costs are and their efficacy wrt to human values.
I have a friend right now in hospice. Death is any second. His wife is a nurse and my wife is also a medical professional. Hospice care plans are part of their daily activities. Hospice is a godsend in many ways. Abusing it is criminal as it could rob those that desperately need it from having it. It also saves money as it stops ineffective medical treatments for those that truly will not survive. It also provides a dignified end to life. Using hospice to give up possible cures is also criminal as is done routinely by liberals that think the elderly should just die.
Hospice can be in-house, with a nurse coming to visit a couple of times a week with pain meds. The care is left to the family full time after a couple of days of extra assistance.
Hospice is frequently in home. We just went through it earlier this year.
But, but, but — people should not be forced into hospice before they need it. That is what this article is about — putting people in hospice long before they are ready just to collect the extra fees. That is what I suspect our private nurse was doing to my mother. She was always trying to get me to sign DNR orders, etc. and then encouraging a hospice evaluation (which Mom could have and stay right where she is, but there would be extra payments transferred from medicare). She’s been suggesting that for more than a year, which is beyond the hospice definition.
I wonder what the logic is of not paying for it?
This should be no surprise. Hospices routinely come into nursing homes to recruit "patients" who then may or may not ever get so much as a visit from a "worker." If they do, the "worker" is likely to just sit and read or do paperwork next to the "patient."
Hospice all too often is merely a vehicle to mine Medicare for dollars, after ordering the cessation of serious medications that might prolong life.
I agree Hospice should not be used as a means to prevent trying cures. There is a difference between cure and something that might buy up to six more months. My dad tried a medication which at the time had jut been approved for clinical trial that would have possibly given him 4-6 months tops but it made him very sick to take it so he stopped it of his own will.
Medicare cost can be cut even made healthier and more efficient for less money but it will take fighting the Nursing Home Lobbyist. That is where a sizable chunk of Medicare goes. The average long term at home patient who could qualify for a nursing home will only get a dozen home health visits per year. In our 28 years my wife has has about a dozen visits total. Last time we called on Home Health I needed an extra hand literally because I had to have hand surgery and could not do all the care.
has something to do with gnats, camels, and straining I think. LOL.
Obamacare must ban prayers
My mom in law was diagnosed with terminal cancer and put on hospice care several years ago. Through God’s grace she lived longer than the doctors thought she would and had to be removed from hospice before she finally got really sick and near death. At least in this case nobody was scamming the system. Hospice is really pretty minimal care - it saved the family a lot of grief at the time though.
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Here we go again! We dare to point out that there are people who'll abuse the system and we're immediately accused of being hard-hearted and lacking compassion - totally unaware that there really is such a thing as a "handicapped" person!
Wrong! We're not against programs that actually help the needy. But, liberals refuse to write legislation in a way that prevents abuse. They write with such a broad brush that scammers are invited to participate!
I say again, I don’t believe scooters were meant to be used to transport a person to the store, etc. They were meant to get them around, once they got there.
Now the next part who qualifies for what? A Paraplegic meaning usually limited or no function in their two limbs {legs} can qualify for a customized manual wheelchair they propel themselves. Those are the funny looking ones you see with slanted wheels usually. These cost about $3k-4K guesstimate as they also have to be custom built for the specific person. Why? Because if not skin break down issues can occur and the chair must also be built in a way they can manually turn the wheels.
A quadriplegic meaning all four limbs effected might possibly qualify for a motorized wheelchair. This is not a scooter. They cost for the basic set up $18K and have to be custom built as well. A Physical Therapist in the case of both manual and motorized wheelchair must measure the patient and order the chair based on those measurements. It takes about six months and the doctors have to fill out considerable piles of justification forms for approval. Even the cushions must be custom made.
Now back to the scooters you loathe so much. They start out at about $1200, are light weight, can in most cases be broken down to fit in a vehicle trunk and quickly reassembled. They are mainly used for patients who can still walk but only short distances such as across the room. Thus they don't need it as much inside the home. They have not yet reached the point of neding a wheelchair but need the scooter as it allows for some major independence including independent living. Where will you see them used in residential areas mainly? Usually where there is housing for elderly and persons with disabilities. Preferred is where a store is nearby so they can get groceries etc.
Look most people dealing with disabilities are on very low incomes. Even if a cab driver would break down the scooter {at a liability to their employer for doing so} cab fares are astronomical even for a short hop to Krogers.
There is nothing wrong with scooters being used to go from home to a nearby {within short walking distance of say a mile} stores. That is what they are designed to do. That said the user is required to obey all traffic laws applying to Pedestrians. You by law are required to recognize them as pedestrians. The fact you see very few stranded on sidewalks pretty well shows the users know the capacity of the scooter.
A scooter is in fact built specifically for both indoor and outdoor use whereas a motorized wheelchair is build more for indoor in tight quarters usage. Under ideal conditions a motorized wheelchair can function outdoors. They require a higher level of caution and use knowledge using them outdoors.
I have never actually heard the word used the way you’re using it (home-based care). Here it means care at a facility when death is expected soon. These things must vary a lot by region.
Wrong! We're not against programs that actually help the needy. But, liberals refuse to write legislation in a way that prevents abuse. They write with such a broad brush that scammers are invited to participate
Look the real problem in Medicare cost is the system is set up not for individual self care but rather higher cost corporate care commonly called nursing homes. How can Diabetic supply company's abuse it when the patient has to be diabetic? Same with Catheters? These require medical justification and in the case of catheters a medical professional fitting the person. Do you know the difference between a 16fr catheter and a 22fr catheter for example? You'll know it when it gets put inside your body. Who determines the size? A licensed medical professional.
We order Ostomy supplies monthly from a person we have used for 28 years. The owner of the company is a RN specializing in Ostomy care. This year I think it was we had to say how many of each item we have on hand. The cost on this is high but all such things are. That is on a corporate level. Cost as such is out of her control. She has to pay the manufacture who must appease FDA outragious standards. Major cost there.
A scooter? Most are cheaper than a wheelchair that would be required as spelled out in previous post. Rentals or used scooters are now in many if not most persons budgets. I've seen them in charity ran thrift stores for sale.
Believe it or not Medicare doesn't cover more common needed items. I use a pair of custom build by mold corrective insoles. Cost to me $300. Cost to Medicare? $0 non covered. Hearing Aids? I'm at 60% loss in voice range. Non Covered. Glasses? Non covered. I'm lucky that VA covers it.
Instead of pitching a hissy fit about scooters people need to be contacting lawmakers to allow families the far lower cost assistance to help care for loved ones at home. 20 years ago when I worked in a nursing home the going room fee per day was $75. That was for bed and food nothing else. Medications and other care was the bonus cost. Do the Math. Let's low ball it and say now room and food is $100 a day that's $3000 a month and $36K a year. Today I'd say it's closet to $75K a year. Assisted living in a Memory Care Unit not covered by Medicare runs on the average of $5K a month or $60 a year just for the darn room.
I'm guessing the average nursing home patient cost is at least minimal $50K plus a year some many times more. Yet Joe and Mary Public trying to care for Granny at home has to make calls. plead, beg, do cartwheels for Granny's twelve home health nurse visits a year. If you want to gripe then at least learn enough about it to see what is in fact running up cost and in some cases fraud.
I've seen persons in a nursing home took there for the simple reason their kids did not want them. This was way before Assisted Living places were built. The persons mainly could not live alone as in cook for themselves but were no where near the point of needing a nursing home.
We aren't all saints and pain tolerance varies greatly. I try to offer up more ordinary pain but no way could I do that with terminal-type pain.
GOD wants us to offer up in faith our belief & love for His Son and fellow man, not our own self torture for not taking pain needed medications.
Salvation and I as Catholics do believe there is a place for redemptive suffering, just saying I'm not much good at it and certainly not in extremis.
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