Gene Uzawa Dorio, M.D., is a housecall geriatric physician on staff at Henry Mayo Newhall Memorial Hospital and has been engaged as an advocate in many community activities. He wrote a Commentary for  Below are excerpts of that article:

“As a geriatric physician, I have visited patients in nursing homes for more than a quarter of a century. (Personally, I have vowed to make sure this stop is not on my bucket list.) Why do so many of my elder senior patients already know about the care rendered at these facilities? Easy. They see their parents, spouses, family members and friends arrive there, never to leave. From a physician’s perspective in our country, hospitals admit the patient, make a diagnosis, start treatment, then triage them out as quickly as possible to save money. Because home care, assisted-living facilities and board-and-care homes are not capable or legally allowed to continue this care, patients have no choice but to go to a nursing home.

Here are the problems:

* Once a patient is admitted to a SNF, continuity of care is lost. Only one doctor sees the patient, and that is once a month. You will not see a neurologist, orthopedist, gastroenterologist, pulmonologist, nor any other specialist once you are admitted, as they do not go to nursing homes. Any ensuing medical problem or complication can easily be missed.

* Nursing homes are underfunded. Not only do they have to jump through the medical and legal hoops of state and federal regulations; they also must budget based upon low Medicare-Medicaid-insurance reimbursement. Sometimes the level and quality of care is minimal.


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