Re: AGH! (WAS: Re: Emergency Transfers)

[Guest guest]

Hi Lou:

SSG.Rick Borenstein again,why legally do nursing homes prefer a private

service when available vs. 911. I will take any patient no matter who

calls. Why do they wait so long to find a doctor to make the transfer

possible. Is there a fear of lawsutis by family or TDH inquiries everytime

a call occurs. I need to understand their mindset,as I can offer better

service to them. Please fill me in on what you know.

Regards,rabbiems,Rick,doc.

> [Original Message]

>

> To: < >

> Date: 8/24/2005 11:57:48 AM

> Subject: Re: AGH! (WAS: Re: Emergency Transfers)

>

>

>

> In a message dated 8/24/2005 11:38:30 A.M. Central Daylight Time,

> lanelson1@... writes:

>

> Maxine Pate wrote:

> A question for the management-types who are reading this: How many of

you

> have a mental black list that contains the names of people you would

never

> consider hiring because of the

> things they have posted here?

>

>

> Gee that explains my inability to find a job.

>

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> LNMolino@...

> (Office)

> (Cell Phone)

> (Office Fax)

>

> " A Texan with a Jersey Attitude "

>

> The comments contained in this E-mail are the opinions of the author and

the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

unless I

> specifically state that I am doing so. Further this E-mail is intended

only for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain

by the

> original author.

>

>

>

[Guest guest]

This kind of incident is all too common.

Barry E. McClung, EMT-P

_____

From: [mailto: ] On

Behalf Of krin135@...

Sent: Wednesday, 24 August, 2005 14:09

To:

Subject: Re: AGH! (WAS: Re: Emergency Transfers)

I have more trouble with nursing home personnel who apparently can NOT

properly assess a patient...such as one that I saw recently where the

patient

(otherwise walking, talking and potty trained) had a slip and fall at

0400...he

complained of hip pain, could not bear weight on the sore hip and was put to

bed,

but the problem comes that the leg rotation, leg shortening and hip flexion

was not recognized by the nurses as a possible problem for 12 hours...even

the

Basic Student doing a ride along that night recognized that problem...

ck

S. Krin, DO

[Guest guest]

-- krin135@... wrote:

" ...I have more trouble with nursing home personnel who apparently can NOT

properly assess a patient...even the Basic Student doing a ride along that night

recognized that problem...

Speaking as a RN and EMT-P (and NOT wanting to start a Nurse vs. Medic flame

war), you have to compare the focus of training. Basic Nursing curriculums (both

RN and LVN/LPN) have a poor exposure to emergency care. That is why you see so

many 'medics gone bad' (g) who practice their nursing in ED and Critical Care.

Also... (deep breath)... MOST (not ALL) of the nurses I have dealt with in

nursing homes are not exactly the 'sharpest knives in the drawer'. They prefer

the recurrance and rare change in acuity, because they seem not to be able to

keep up. MAYBE if their assesssment skills were better, they would be better,

but I haven't seen any evidence of it.

\ " Service is love made visible. Friendship is love made personal. Kindness is

love made tangible. Giving is love made believable\ " - Anonymous

Larry in Houston

[Guest guest]

Rick,

More times than not...it is financial. The NH contracts with an ambulance

provider to transport patients under DRG (diagnostic related groups) payments

because when a patient under a DRG gets moved due to DRG related issues...the NH

pays that and not Medicare...and what they do not spend they get to keep....

In exchange for that, the contracting ambulance service then gets first call on

the rest of the patients in the NH...so they get a chance to make their money

back that they discounted on the DRG's....

I am not going to get into the issues related to this...but again, as with most

things in life....follow the $$$$$$$$$$$$$$

Dudley

Re: AGH! (WAS: Re: Emergency Transfers)

>

>

>

> In a message dated 8/24/2005 11:38:30 A.M. Central Daylight Time,

> lanelson1@... writes:

>

> Maxine Pate wrote:

> A question for the management-types who are reading this: How many of

you

> have a mental black list that contains the names of people you would

never

> consider hiring because of the

> things they have posted here?

>

>

> Gee that explains my inability to find a job.

>

>

> Louis N. Molino, Sr., CET

> FF/NREMT-B/FSI/EMSI

> LNMolino@...

> (Office)

> (Cell Phone)

> (Office Fax)

>

> " A Texan with a Jersey Attitude "

>

> The comments contained in this E-mail are the opinions of the author and

the

> author alone. I in no way ever intend to speak for any person or

> organization that I am in any way whatsoever involved or associated with

unless I

> specifically state that I am doing so. Further this E-mail is intended

only for its

> stated recipient and may contain private and or confidential materials

> retransmission is strictly prohibited unless placed in the public domain

by the

> original author.

>

>

>

[Guest guest]

Hi Dudley:

Yes I see money as a problem. There is an obsession to have a private

amblance service that overides even money can't ovrecome. When an emergency

transfer does occur,Does the medicare,more medicaid rules apply? Also, I

find they have an obsession to get the patient out to a hospital to a point

where the nursing staff gets rude and pushy. They are reluctant to provide

a history on the patient unless the issue is pushed. I think there is more

than money involved. I thank everybody for providing their insights.When a

patient is sent to the hospital, is there any agency that investigates a

911 call v.private provider? that cares for the particular patient

involved.? Regards.rabbiems,SSG.Borenstein

> [Original Message]

>

> To: < >

> Date: 8/24/2005 9:43:43 PM

> Subject: Re: AGH! (WAS: Re: Emergency Transfers)

>

> Rick,

>

> More times than not...it is financial. The NH contracts with an

ambulance provider to transport patients under DRG (diagnostic related

groups) payments because when a patient under a DRG gets moved due to DRG

related issues...the NH pays that and not Medicare...and what they do not

spend they get to keep....

>

> In exchange for that, the contracting ambulance service then gets first

call on the rest of the patients in the NH...so they get a chance to make

their money back that they discounted on the DRG's....

>

> I am not going to get into the issues related to this...but again, as

with most things in life....follow the $$$$$$$$$$$$$$

>

> Dudley

>

> Re: AGH! (WAS: Re: Emergency Transfers)

> >

> >

> >

> > In a message dated 8/24/2005 11:38:30 A.M. Central Daylight Time,

> > lanelson1@... writes:

> >

> > Maxine Pate wrote:

> > A question for the management-types who are reading this: How many of

> you

> > have a mental black list that contains the names of people you would

> never

> > consider hiring because of the

> > things they have posted here?

> >

> >

> > Gee that explains my inability to find a job.

> >

> >

> > Louis N. Molino, Sr., CET

> > FF/NREMT-B/FSI/EMSI

> > LNMolino@...

> > (Office)

> > (Cell Phone)

> > (Office Fax)

> >

> > " A Texan with a Jersey Attitude "

> >

> > The comments contained in this E-mail are the opinions of the author

and

> the

> > author alone. I in no way ever intend to speak for any person or

> > organization that I am in any way whatsoever involved or associated

with

> unless I

> > specifically state that I am doing so. Further this E-mail is intended

> only for its

> > stated recipient and may contain private and or confidential materials

> > retransmission is strictly prohibited unless placed in the public

domain

> by the

> > original author.

> >

> >

> >