So Barbara is being down-graded to a lower level of care. I suspected that the decision was not so much a clinical decision as a monetary one. I got absolute confirmation that it is not a purely clinical decision just this morning. Her doctor thought we had at least six days. This morning he was informed that “No, the deadline is tomorrow”. He is PO’ed. He is refusing to write the transfer order.
As far as he is concerned, he wasn’t given enough time to prepare for this level of care change (including narcotic weaning, among other things) and “They [the LTAC] have made plenty of money off her these many months, they can eat a few days” while he gets her ready in an appropriate manner.
I like this doctor. He doesn’t work for the facility directly, and can therefore buck their decision on this. And luckily, he is in a mood to do so.