You might be interested to know that Medicare is attacking hospices, causing them to evict terminal patients, and firing skilled workers. This also affects hospice patients that remain in their homes, because medical staff have to stop their services. Included are newborn infants with life threatening conditions. Nobody knows how many are under investigation because they provide god care for the dying.
While it is supposed to be about money, again pain management is a large factor. According to Kaiser Health News, 12.8% patients outlived their 6 month limit at San Diego Hospice. Kathleen Pacurar, the manager, says that “It’s a catch- 22: Oftentimes these patients have extended prognosis because we’ve been in there working with them.”
In other words, if a patient doesn’t die from infected bedsores, etc. a hospice will probably be investigated because it is good. Miranda Felding MD, radiation oncologist, had her mother kicked out of a Colorado hospice because her mother revived, and didn’t die in 6 months, as expected. She wrote about this in the “Dr. Kev” that’s linked with the AMA MedNotes.
In the commentary section for these 2 articles, most physicians list pain management as the main factor. The lack of adequate pain management in nursing facilities that beats down those with a heart of a lion. When their pain is relieved in a hospice, they become somewhat healthier and brighter. Then both articles comment how a hospice is so much cheaper than 24 hours in a hospital, ER fees, etc. To escape investigation, hospices aren’t accepting patients at the beginning of 6 months, but are cutting the estimated time to be shorter. Some to protect their hospices and their jobs will only accept a terminal patient in the last month. I’m so lucky that my family wants to care for me.