Rick, it is my understanding that Michelle's friend is in a hospice inpatient facility, so not able to just have him zipped away somewhere else. I'm not sure about hospice facilities, but I know that nursing homes generally have one doctor, who is the Medical Director. They are not specialists and usually have other nursing homes to visit, as well, so they're not in one place all the time. Generally, unless there is an emergency, they only see patients 1-3 x a week. In her friend's case, and from what has been posted, it seems that the physician is not comfortable with paracentesis and considers it an aggressive treatment if done too often. Hospice, by its very nature, does not act aggressively.
Nevertheless, I think Michelle should speak with the Director of the facility, a patient advocate, or even a nursing supervisor, since the patient in question is so uncomfortable.