Can a doctor in a Medicaid-funded nursing home in California terminate a doctor-patient relationship?

Carol, nobody is saying your brother isn't entitled to medical care. Why not look for another facility for him if this one is so awful??
"Morally" right doesn't mean much these days. When I had neck surgery in 2008 and contacted my insurance co about the $250K bill for 1 night at the hospital, they laughed at me, saying that was standard pricing. Meanwhile, the insurance co ASKED that we report what we felt to be outrageous charges.

There were no records in the Nursing Home's records to substantiate the Medicare billings for the month in question. That's why I asked for a reconciliation.

- Nowhere did I say I accused the doctor of fraudulently billing Medicare for services not rendered. I only shared that suspicion here. I specifically asked the doctor for a reconciliation between the Medicare billings and the nursing home records which patients and family members have a right and a duty to do. I only later discovered how this particular doctor services many other facilities with limited staff. I have shared this info with others who are knowledgeable in such matters, and they agree, it should be looked at more closely especially, in light of receiving a termination letter, all of which looks like retaliation. This doctor group has been taking care of my brother at this facility for over a year without any communication he is unhappy with my brother. And then, suddenly, they can no longer take care of his medical needs?
- You seem to be overlooking the fact the nursing home must, by federal law, provide physician care on site and not force patients to go outside of the facility for basic care.
- I already stated I am pursuing a list of other doctors that service this facility. And, as has happened in the past, I am being stone-walled in getting this documentation.
- Even difficult or bipolar patients need and have a right to medical care - TBI, bipolar, or not. That's one reason I go every day to make sure things are running smoothly, to help out the staff where needed, but also to make sure he is receiving the care he needs.

When such patients don't get proper care - as often happens in our society - they end up on the street homeless. There's too much prejudice and lack of understanding on this subject in our society. It's heart-braking for the families and the patients. I am attempting to make sure my brother does not become a 'statistic'.

Yes, Right on and exactly. Cannot abandon, but can refuse to treat, and arrange other care. I have often seen doctors explain to non compliant patients that he cannot continue to treat them in their non compliance, and that the doctor would help them arrange outreach to another decision. It usually is a threat that works more or less well given the capacity of the patient to understand and comply. But usually also just a threat.

You are correct when you say the NP saw my brother more than the NH doctor. However, the doctor billed for an extended visit once a week and the NP billed for two extensive visits a week - total of three extensive visits a week. It's really stretching it to believe this actually happened. I think this is one reason the NH has been refusing to provide copies of his records.

I have plenty of documentation, both email and letters. However, when I have sent out certified letters to the facility and this doctor, the receiving party convenient does not sign for the letters so the sender never receives proof of delivery. This is an old legal trick that's been around forever.

I do realize the doctor can terminate a relationship with a patient. But it should be a substantially better reason than no reason at all.

Maybe I didn't word it correctly. If this doctor has an exclusive contract with the nursing home to provide medical care onsite and he terminates that relationship, he is violating the contract with the nursing home. If the nursing home cannot provide another doctor to provide medical services on site, then the nursing home is not only breaking federal law, but they are violating their contract with my brother's insurance (the insurance plan pays for onsite physical services). Hope that clarifies it for you.

Because of his TBI, I have POA with the nursing home....so yes, I have every right to ask the nursing home and doctor for his records.

Thank you for your helpful response. I pretty much came to same conclusion. I have spent practically the entire day trying to find an open LT Medicaid bed but no luck so far.

Actually, I think the Ombudsman can no longer be helpful (see my comments above). Unfortunately, this is the 4th or 5th person to fill this position in our area-probably because 80% of them are volunteers. There's very little continuity. Not sure how this can ever be effective.

We used to have a Nurse Representative from his Medicaid insurance provider. But after she quit, no one replaced her. I've requested a replacement several times and got - crickets!