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Fucking depraved. In a just world, every single person involved would get a one-way trip to 
I mean Optum is a pretty unsecret thing in nursing homes. I think we've been through like 12 nurse practitioners over the last year and a half I've been working at a nursing home. We're told that if they're an Optum patient they need to be managed by them, but a solid amount of the time we're just going to the primary provider because they're nowhere to be seen because their entire local network is a shitshow. I also know they seem really averse to starting hospice or even having that conversation. I know they're super big about preventing hospitalization and treating in place, but I feel like if I just outright disagreed with a call made I could just speak to the primary provider or if I'm really concerned, override the NP, especially if they're not present in the building.
The examples they give of stroke like symptoms, if I'm on the unit and they clearly are having a stroke, I've already called 911 before I'm calling the provider to ask for orders. Unless they have a history of TIA I'd assume stroke and deal with the back and forth.
In the end there is that little nag from Optum asking you to call before a hospitalization, but there's also a level of nursing judgement that needs to exist with that thought towards patient health rather than an insurance company's nagging.