Penny Wise, Pound Foolish

Problem about practicing medicine in nursing home is many medical problems which includes cognitive impairment.
The major challenge about nursing home is Medicare billing. The problematic was that in the nursing home environment, many of patients were demented and couldn’t possibly give a coherent history.

No wonder physicians often respond to a call from the nursing home about a sick patient with an order to send the patient to the hospital for assessment. Send a weak nursing home patient to the emergency room and he has so about a 90% chance of being admitted. So instead of paying a physician an appropriate amount for making a visit to the nursing home.

Image source: Nurse Practitioner | Family Practice | Gallup, NM

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