Pennsylvania nursing home - can you choose your own physician? - AgingCare.com

Pennsylvania nursing home - can you choose your own physician?

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My mom is in a NH in Pennsylvania. The nursing home has assigned a physician to my mom. Is she allowed to choose her own physician (family / primary doctor). I have asked for my mom and I am getting unclear answers from the NH social worker and director of nursing.

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tw1129, Under Medicare, you have the right to choose your own MD. Under Medicaid, you would have to go by the rules for your county in PA. In counties where managed care is mandatory, you basically give up your private physician and receive care through a contracted provider.
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Sounds like the major drawbacks to having your own physician is the lack of quick access to doctor if resident gets sick. However, my mom's facility is physically attached to a hospital, and her former family doctor (a geriatric doctor) is 2 floors below her in the same building. I want my mom to get back to this former doctor because she knows my mom's history and has been treating her for a long time. So, I am trying to find out if it is the law (resident rights) in Pennsylvania if you are allowed to choose your own family doctor. I have a call into the ombudsman in Pennsylvania to find this out since I am getting unclear answers about this at the nursing home from the social worker and director of nursing.
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Unless the MD is willing to make house calls, I would rather have the facility be responsible and accountable for mom's care.
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There are several disadvantages to keeping the primary physician, including response time, writing day to day orders for care, medication management and crisis decision making. Unless the MD
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TW, the nursing home where my Mom is living, she has to use the doctor assigned to the facility, even though Mom's primary doctor is a block away.

I believe the reason for this is that all the patients records are controlled by one doctor, who apparently is on call 24 hours a day. I've seen him in the building on weekends. Plus the nurses can get immediate communication with him, where a primary doctor outside of the facility it might takes hours to him/her to reply back.
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I don't know how it works in Pennsylvania. In Connecticut, my mom is a patient of the medical director of the Nursing Home. I wouldn't say she was " assigned" but by dint of the fact that she's a resident there, that's her doctor. There are specialists who come in (dental, podiatry, audiology, dermatologist, wound care); if she needs other specialist visits or procedures, we need to arrange medical transport and accompany her to the appointment.

I imagine if you wanted to keep appointments with her previous PCP, you could, but s/he would need to be willing to work with the medical director in agreeing on a course of treatment.

Once my mother was admitted to the NH, post stroke, post dementia dx and post broken hip, we were no longer interested in the latest diagnostics or the most current curative treatment. We were interested in my mother's comfort.

The nursing home staff is quick to catch pneumonia and pleural effusions, which are the killers we are trying to keep at bay. There's nothing that an outside doc can prescribe at this point for my mother's underlying chf that's going to make any significant difference in her longevity.
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