Pleasant Law Blog (Insurance Claims, Medical Misakes, and Nursing Home Claims)

Protect Your Disabled Clients with a Life Care Plan

I have written extensively in the past about inappropriate discharge planning from the hospital. Whether the third party reimbursement is based on cost plus (CP) or diagnostic related groupings (DRG), all hospitals have a financial incentive to discharge their patients as early as possible. With the former type, all of the profit is made during the first three days of any hospitalization, so faster turnover leads to a higher bottom line. Likewise, with the DRGs there is a flat rate for an average length of stay for a particular diagnosis so the earlier discharges allows the hospital to keep more of the money. Therefore, discharge planners have the imperative to immediately push the patient out through the front door once the primary care physician declares that the patient no longer needs acute hospital care. This often leads to the hospital dumping your client into an environment that is ill equipped to deal with the catastrophic disability and will fail to prevent the common complications that cause further deterioration and death. When such negligence occurs there is a clear hospital liability. However, it behooves the attorney to protect the disabled client and prevent such complications by hiring a nurse case manager to evaluate the clients needs immediately after arriving from the hospital and present a life care plan. Aside from the humanitarian considerations, a 43 year old otherwise healthy paraplegic male with some upper body weakness (injury at T-6) will incur approximately six million current value dollars in custodial, skilled nursing and medical costs over a life expectancy of 25 years.

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