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  1. Update on last week’s Medicare fiasco. My member is still in the hospital because:

    1. Under Wisconsin law, someone with a developmental disability cannot be admitted to a nursing home without a need for skilled nursing care, which he has so

    2. He needs a pre-admission screening to prove he needs the nursing home level of care but

    3. Since he won’t need to be at a nursing home for 30 days or longer and he would be discharged to the nursing home from the hospital he’s exempt from this screening, however

    4. Now the nursing homes we were looking at are refusing to admit him under this exemption because, let’s be honest, a lot of group homes have a tendency to give a 30-day notice to residents once they go to a nursing home, and the nursing home, rightly, doesn’t want to be stuck with a new resident, so

    5. His group home manager is calling the intake coordinator at the nursing home to assure them that my member will be returning home once his IV Antibiotics are finished.

    Meanwhile he’s still in the hospital. By the time this is all sorted out, he can probably just go home.

    This could have all been avoided if Medicare would just cover the goddamn outpatient IV Antibiotics.