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Maybe it gives them a black mark with Medicare cost cutting policies?
healthcare has become healthcare by government regulation/checklist. Previously was healthcare by insurance rules/WNL results numbers on tests ordered. Been a long time since it has been health care of the individual. and don't even get into experience or intuition that a good doctor might have or had seen before and knows it when he/she sees it again. If it aint on the checklist and the results are WNL, it aint happening
Germaine, I have no advice that you have not already heard. I would think at the very least hubby should have a nurse and PT visits to help with recovery at the group home.
I just want to extend my sympathy that you and your husband are going through this stressful and very upsetting situation.
Good for you for standing your ground concerning his discharge. Sadly our personal experiences with hospitals recently seemed to be controlled by money and the bottom line.
The bright spot was very caring nurses for the most part so I give them credit.
He absolutely can not be released to a SNF because, as of today, the doctor and therapists said that he did not qualify for any follow-up therapy or follow-up services at all. I am still trying to get him some follow-up therapy at the group home.
I did a bunch of calls on Monday and he will have some additional services.
Quote:
Originally Posted by germaine2626
Monday, November 27, 2017
I don't know if they were fibbing or not but I was told that the hospital did not need my permission (as Hubby's activated Health Care POA) to discharge him and return him to his current group home.
I really do not know why they were being so insistent about kicking him out yesterday. Some of the people, including the doctor and one nurse, were, IMHO, real jerks about it. Being in the hospital for only three days would have been the absolute shortest amount of time that he would ever spent there with pneumonia. Usually he is in five or six days but it has been as many as twelve days. And, that was without the complication of vomiting blood. His admission data also says "acute renal failure" (yikes) and "severe sepsis."
I don't think that I will need to get anyone else involved now that I made an official "Medicare Appeal of Hospital Discharge" or whatever it is called.
BTW, my main point in delaying the discharge was that Hubby's Community Care/Medicaid Team could review the paperwork and make sure everything was covered at his group home (to avoid another fiasco like last time). I just spoke to his case manager and as of 11:15 AM today the hospital still had not sent them the paperwork. She was going to have to contact them to get it.
Quote:
Originally Posted by germaine2626
I did more checking, apparently once you reach a certain level of dehydration (as measured by blood tests) it is listed as "acute renal failure". So, it may, or may not, be as bad as I imagined.
As of 1:15 PM the hospital still had not sent the discharge paperwork to Community Care.
Update November 28, 2017, What a nightmare!
Short version. All day Monday was spend talking with various case managers, social workers, etc. at the hospital. I finally reached my limit at about 3 PM when I was told by a hospital manager that the discharge paperwork had not been sent to Community Care because I had not requested that the hospital do that. I listed the names of all six staff members that I had informed on Sunday to do that, plus the three staff members that I told on Monday, plus the fact that (at least) three different people from Community Care had called the hospital to request the paperwork (as was their legal right). I was livid and called hospital administration to send down the highest level administrator that was a available. Unfortunately, it took almost two hours for someone to come.
By this time I was getting panicked because I had filed a Medicare Appeal of Discharge and if they deny the appeal you will have to pay out of pocket for all of the hospital expenses (after the hospital officially discharges the patient - in Hubby's case -early Sunday morning). Since Hubby's bill was already $30,000 I was having visions of being charged $5,000 for each day (it turns out that it would have been much less - possibly even zero). So, I agreed to have him discharged from the hospital even though his Community Care team had not been sent any paperwork.
I prefer that he not travel at night (due to Sun downing) but he left the hospital about 7 PM, and I met him at his group home. Man Oh Man, all the challenges getting him inside the group home!!! The van driver took him by wheelchair to the top step and it took him, the aide and me (and a walker) just to get him inside the house (two small steps) and to the couch (as he could barely stand or walk). Later the aide and I managed to get him to the bathroom and then into bed. It was exhausting!
I came home and went to bed about 9 PM and woke up at 11 AM (14 hours). I made a few essential calls regarding Hubby to his doctors, therapists, community care case manager and community care nurse (most were related to errors or confusing information on his discharge paperwork). These were the very things that I wanted to avoid by having a second (or third) pair of eyes review the paperwork.
Plus some calls to my doctors (as I woke up in the middle of the night with heart palpitations & mild chest pains and considered calling 911 but was just too exhausted to care).
And then I went back to bed at 1 PM. I fielded a few calls in my sleep and was woken up by a call at 7 PM (so a 6 hour nap for a total of 20 hours of sleep). Needless to say, this last hospitalization really took a lot out of me.
Neither Hubby nor his group home called today so I have to assume (hope) that everything went well.
Back to bed as I have a busy day tomorrow straightening out some of Hubby's medication errors, conflicting information about his new diet on the forms, etc., etc. I hope to sometime find time to do the other things that I need to do like pay bills and handle some problems related to insurance issues (two major problems at two different companies) or care for my own health.
ARRGGG!!!!!
Last edited by germaine2626; 11-28-2017 at 09:20 PM..
OMG, Germaine! This is horrible... & it does not bode well for any of us because this could happen to anybody & at any time.
You know, what makes me so mad right now reading this? Is that even if everything were to right itself starting first thing in the morning; you will never be recompensated for your own losses. And I’m not necessarily speaking of the financial losses, although those have been severe.
I’m referencing your health. Your stress level. Your mental & emotional reserves. Heck; your sleep! We don’t get any do-overs in life & you have friends & family & it’s the freaking holiday season for craps sake.
If you would have been abducted by aliens, MIA, whatever ... Medicaid/Medicare would likely have spent over $6,000, so far, for the month of November, to replace your “servicesâ€, in addition to the hospital bills.
But you’re a good person who is doing “the right thing†so they pull the “carrot on a stick†routine & make you jump through the hoops. And you know, if it weren’t for you? He’d be dead by now.
Sorry for the rant, it just enrages me to see this scenario play out with so many good people who do the right thing & literally suffer loss of life & limb because of it. ( I swear, one day I’m going to trade out my “uncompensated family caregiver†button for one that reads: “Vendor†& start submitting invoices)
Now I know what my grandfather, who was in the 3rd generation of our family who were doctors, meant, when he told his 6 children over 55 years ago “I’m sorry to say it but I’m very glad that none of you decided to follow in my footsteps & become a doctor. The practice of Medicine is headed in the wrong direction, these days.â€
OMG, Germaine! This is horrible... & it does not bode well for any of us because this could happen to anybody & at any time.
You know, what makes me so mad right now reading this? Is that even if everything were to right itself starting first thing in the morning; you will never be recompensated for your own losses. And I’m not necessarily speaking of the financial losses, although those have been severe.
I’m referencing your health. Your stress level. Your mental & emotional reserves. Heck; your sleep! We don’t get any do-overs in life & you have friends & family & it’s the freaking holiday season for craps sake.
If you would have been abducted by aliens, MIA, whatever ... Medicaid/Medicare would likely have spent over $6,000, so far, for the month of November, to replace your “servicesâ€, in addition to the hospital bills.
But you’re a good person who is doing “the right thing†so they pull the “carrot on a stick†routine & make you jump through the hoops. And you know, if it weren’t for you? He’d be dead by now.
Sorry for the rant, it just enrages me to see this scenario play out with so many good people who do the right thing & literally suffer loss of life & limb because of it. ( I swear, one day I’m going to trade out my “uncompensated family caregiver†button for one that reads: “Vendor†& start submitting invoices)
Now I know what my grandfather, who was in the 3rd generation of our family who were doctors, meant, when he told his 6 children over 55 years ago “I’m sorry to say it but I’m very glad that none of you decided to follow in my footsteps & become a doctor. The practice of Medicine is headed in the wrong direction, these days.â€
Excellent post, CosChristi. I can't rep you again but I want to say that you are always very wise -- and an awesome person to boot.
Germaine -- good grief, I really feel for you. This has got to be mind-numbing. Can you get your son to work on some of the insurance issues on your behalf? Even though he is in California, I'd have him do whatever can be done remotely. Also, I wonder if a social worker can be assigned to you to assist with things..after all you are in cancer recovery and I would think that would qualify you for some aide.
OMG, Germaine! This is horrible... & it does not bode well for any of us because this could happen to anybody & at any time.
You know, what makes me so mad right now reading this? Is that even if everything were to right itself starting first thing in the morning; you will never be recompensated for your own losses. And I’m not necessarily speaking of the financial losses, although those have been severe.
I’m referencing your health. Your stress level. Your mental & emotional reserves. Heck; your sleep! We don’t get any do-overs in life & you have friends & family & it’s the freaking holiday season for craps sake.
If you would have been abducted by aliens, MIA, whatever ... Medicaid/Medicare would likely have spent over $6,000, so far, for the month of November, to replace your “servicesâ€, in addition to the hospital bills.
But you’re a good person who is doing “the right thing†so they pull the “carrot on a stick†routine & make you jump through the hoops. And you know, if it weren’t for you? He’d be dead by now.
Sorry for the rant, it just enrages me to see this scenario play out with so many good people who do the right thing & literally suffer loss of life & limb because of it. ( I swear, one day I’m going to trade out my “uncompensated family caregiver†button for one that reads: “Vendor†& start submitting invoices)
Now I know what my grandfather, who was in the 3rd generation of our family who were doctors, meant, when he told his 6 children over 55 years ago “I’m sorry to say it but I’m very glad that none of you decided to follow in my footsteps & become a doctor. The practice of Medicine is headed in the wrong direction, these days.â€
This. All of this. I am speechless (unusual for me!) about the incompetence of your husband's care and the toll it's taking on you.
Is this possible and would you even want to do this?
Assign your POA for husband's care to your paid case manager. Cede control knowing that he/she is working as your agent. Let them fight the fight in your behalf. or a legal person.
You are doing a tremendous job and all that anyone could expect and more but it (IMO) is just becoming too much for you to tackle AND retain your own health. And if the case manager/paralegal was your agent, it would be in consultation with you each step.
IMO from what you have said, the previous group home was failing to perform required and contracted duties AND the hospital seems to be either bullying you or taking advantage. I am not suggesting suits or whatever, it is just that your health has value and sometimes you have to swallow a big pill.
Knowing you, you are working things your own way and good for you. Please take my suggestion as only concern for your welfare.
Is this possible and would you even want to do this?
Assign your POA for husband's care to your paid case manager. Cede control knowing that he/she is working as your agent. Let them fight the fight in your behalf. or a legal person.
You are doing a tremendous job and all that anyone could expect and more but it (IMO) is just becoming too much for you to tackle AND retain your own health. And if the case manager/paralegal was your agent, it would be in consultation with you each step.
IMO from what you have said, the previous group home was failing to perform required and contracted duties AND the hospital seems to be either bullying you or taking advantage. I am not suggesting suits or whatever, it is just that your health has value and sometimes you have to swallow a big pill.
Knowing you, you are working things your own way and good for you. Please take my suggestion as only concern for your welfare.
Good luck
I think the suggestion that Germaine get whatever help she can is a great one.
But I'm not sure about assigning the husband's POA to a state employee. At the most simple point - Just because they're the case manager today, doesn't mean they'll be tomorrow. Additionally, how many cases are they juggling? Can they give attention? Would they even accept that responsibility? (I don't think many would as it might leave them open to liability charges, etc..)
Most important - POA can only be granted by one person - Germaine's husband. (i.e. you cannot give someone POA for your spouse; you do not have that right). I don't know given all the trials he's endured in this last year if he is capable of giving POA any longer. (which is why you get durable POA before you need it).
Germaine - I've been out of the country on business - but checked in and was so sorry to see all the additional travails you're both dealing with.
Unfortunately everything you're reporting regarding care facilities and the hospitals just reinforces my opinions on them. I'm so sorry it isn't easier to get quality help/care. I wish it were the case for all of us on this board, but you and your husband especially.
I so enjoyed your stories of the two of you together (watching jeopardy and maintaining a command of esoteric subjects, even while he had issues with pillow cases and more simple tasks).
I'm really so very sorry for you both. I hope he's able to get some good care that will allow him some recovery. I'm also hoping that as his situation stabilizes you're able to get some rest to aid in your own recovery.
May the holiday season bring you something to celebrate...
Update November 29, 2017, The nightmare continues!
Quote:
Originally Posted by germaine2626
Update November 28, 2017, What a nightmare!
Short version. All day Monday was spend talking with various case managers, social workers, etc. at the hospital. I finally reached my limit at about 3 PM when I was told by a hospital manager that the discharge paperwork had not been sent to Community Care because I had not requested that the hospital do that. I listed the names of all six staff members that I had informed on Sunday to do that, plus the three staff members that I told on Monday, plus the fact that (at least) three different people from Community Care had called the hospital to request the paperwork (as was their legal right). I was livid and called hospital administration to send down the highest level administrator that was a available. Unfortunately, it took almost two hours for someone to come.
By this time I was getting panicked because I had filed a Medicare Appeal of Discharge and if they deny the appeal you will have to pay out of pocket for all of the hospital expenses (after the hospital officially discharges the patient - in Hubby's case -early Sunday morning). Since Hubby's bill was already $30,000 I was having visions of being charged $5,000 for each day (it turns out that it would have been much less - possibly even zero). So, I agreed to have him discharged from the hospital even though his Community Care team had not been sent any paperwork.
I prefer that he not travel at night (due to Sun downing) but he left the hospital about 7 PM, and I met him at his group home. Man Oh Man, all the challenges getting him inside the group home!!! The van driver took him by wheelchair to the top step and it took him, the aide and me (and a walker) just to get him inside the house (two small steps) and to the couch (as he could barely stand or walk). Later the aide and I managed to get him to the bathroom and then into bed. It was exhausting!
I came home and went to bed about 9 PM and woke up at 11 AM (14 hours). I made a few essential calls regarding Hubby to his doctors, therapists, community care case manager and community care nurse (most were related to errors or confusing information on his discharge paperwork). These were the very things that I wanted to avoid by having a second (or third) pair of eyes review the paperwork.
Plus some calls to my doctors (as I woke up in the middle of the night with heart palpitations & mild chest pains and considered calling 911 but was just too exhausted to care).
And then I went back to bed at 1 PM. I fielded a few calls in my sleep and was woken up by a call at 7 PM (so a 6 hour nap for a total of 20 hours of sleep). Needless to say, this last hospitalization really took a lot out of me.
Neither Hubby nor his group home called today so I have to assume (hope) that everything went well.
Back to bed as I have a busy day tomorrow straightening out some of Hubby's medication errors, conflicting information about his new diet on the forms, etc., etc. I hope to sometime find time to do the other things that I need to do like pay bills and handle some problems related to insurance issues (two major problems at two different companies) or care for my own health.
ARRGGG!!!!!
Update November 29, 2017, The nightmare continues!
It turns out that the hospital did not give me all of his discharge paperwork. The group home showed me the Doctor Discharge Summary (which I did not get). It stated that he should continue the antibiotic (treatment for the pneumonia). Unfortunately, they did not include the prescription for this medication.
This brings the total to four different major errors in his discharge paperwork (which was what I was trying to avoid by having his Community Care team look at the paperwork).
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Update November 28, 2017, What a nightmare!
I listed the names of all six staff members that I had informed on Sunday to do that, plus the three staff members that I told on Monday, plus the fact that (at least) three different people from Community Care had called the hospital to request the paperwork (as was their legal right). I was livid and called hospital administration to send down the highest level administrator that was a available. Unfortunately, it took almost two hours for someone to come. 
