Nursing Homes / Adult Care Facilities Stand By Policies

[mikerabbit 2]

Just wondering...with all of this talk about nursing homes and the strain they put onto the various EMS systems, especially the vol. corps, are there any polices wether State or otherwise that require nursing home or adult care facilities to have a private ambulance contract for stanby or routine transport. I have noticed that there are soma facilities that will call 911 a few times a day for routine transport to the hospital for "a check up".

Mike

[Guest alsfirefighter]

Whether there is such a policy or not, the final solution rests with the agency who puts up with that. Instead of shaking heads everytime it happens they should be immediately meeting with the facility managers to discuss the problem and let them know they will be sending a bill to that facility for every non-emergent transport they come to. Complaining about problems never solves them.

[mikerabbit 2]

I would imagine that the facility never sees the bill. When revenue recovery forms are filled out they go straight to the patient, right? Can an agency actually bill a nursing home for non emergent requests? How about religious homes are they exempt from certain rules?

Mike

[Guest alsfirefighter]

I'm not talking about 3rd party billing, I'm talking telling them you will bill them, whether you can or not. If they call your bluff so be it. Additionally, if you are a nursing home accepting medicare/medicaid you have to comply with DOH and federal rules and be a licensed nursing care facility. How that would work with a "infirmary" where nuns take care of other retired elderly nuns and such I don't know. But my experience with that is they also qualify for medicaid/care so I'm sure they get their cut or they wouldn't be able to run it correctly.

Again, the root of the problem is non-emergent, not even medical based transport. The agency leadership needs to tackle that problem if its occurring. We have had this problem in the past and we have solved some of the problems. We occassionally get called for cases which the patient could have waited for an ALS private bus to arrive. Usually a sit down with the facility management, there has to be someone on site whom is the overall responsible agent and explain to them the issue, and if all else fails tell them you will report them to DOH and pursue the possibility of your legal rights in refusing txp of non medical patients and placing false and malicious 911 calls. Let me ask you this, how many agencies do you see responding code 3 to "transport calls," how ridiculous is that? That's just as bad as starting a 911 agency for a MD appointment.

[Guest 39-1]

These type of problems have been around for as long as EMS has been in its "modern" operations. Often it is a simple meeting with the facilitator and asking him to come up with guidelines for their staff to follow in order to lighten the load. I've found most facilities were blind to the fact that they stressed the 911 system or understood the response system and how it works. Even more often the facilities are often victims of the nursing system in itself where nurses need orders for every little thing which often leads us to receiving patients well established in acute problems, many times that are critical in nature.

[x635 4,066]

Let's not forget that the patients in nursing homes are human beings and deserve the same quality of care as anybody else.

It's disgusting to see some crews take out the frustration of a nursing home call out on the patient and subsequently treat the patient like a fed ex package. As had been said here, the abuse of EMS by long term care facilities needs to be dealt with on a agency administrative and regional MAC level.......no matter what the call, as minor or BS as it may be, or as repetitive as it may be, your job is to CARE for human beings first and foremost.

[TRUCK6018 50]

are there any polices wether State or otherwise that require nursing home or adult care facilities to have a private ambulance contract for stanby or routine transport.

We have an on going problem not just with a local nursing facility but also private doctor offices.

Our friendly local nursing home does have a contract, however, when there is a delay in response from them, they'll call 911 because the patient is experiencing whatever the problem may be. When the EMT is told the patient is experiencing shortness of breath or chest pains, it's a legitamate call.

The problem is even more complicated with the private doctor offices. Most of the time, the EMS crew is told that the patient MUST go to XYZ Hospital regardless if another is closer or not. Not to find out upon arrival that it ends up being a direct admit. This type of behavior, in my opinion, is an abuse of service.

For as long as the doctors and nurses know how to play the game, EMS is obligated to transport as long as the described symptoms are legit or not.