Senin, 28 Juli 2008

I'm Appealing

That's not an egotistical statement given the actual topic but I had to use it to get your attention! The topic is nursing homes. Oy Vey you say? Well, I'm overflowing with a half decade of experience associated with these facilities. Most recently I decided to move my mother from the one she was in after they dismissed her from therapy a second time. Isn't that a nice way of putting it...not ended, not quit, but "dismissed", so P.C.
I appealed the first decision. They never provided medical records to the medical evaluator. She was reinstated. I don't think she got therapy but she was back on the books as far as Medicare goes and, frankly, isn't that a lot of what this game is all about?
I now have appealed the second decision for the final two days she was there. I wondered if it was worth it. Yes, it is. She is now a re-evaluated resident in a smaller home, receiving therapy and doing much better as they also did lab work, sent her to the ER for a diagnosis and took her off the meds that were contributing to her demise. I digress.
Regardless, the fact is caregiving starts with the person who has final responsibility. Sometimes one has to get tough, even if one has seen some good care provided. Can't be Ms. Nice all the time!
The other fact is that the facilities are probably pinched financially. In a state such as ours, with an idiot at the helm (I think I can call him an idiot since I didn't name him by title or actual name and I didn't vote for him), all the money is going to the devil knows where. And, the idiot isn't showing his face anywhere. But, the deal is that any state funding, oh heck, let's say, any bills to the state, are going to be delayed further and further. That's got to put the squeeze on big time.
Medicare is federal, I know. All the same, a lot of what gets done gets done or not done by association with the Dept of Human Services. In fact, they were there at facility #1 when I went to retrieve my mom and move her.
When Medicare stops per incident coverage we go to private pay. That has to be a losing proposition for facilities too. I remember when my dad was in facility #1 and there was a neighbor of his who'd been there for 11 months. Four years ago the rate wasn't as high but this man was on private pay and the family was being hounded DAILY to pay several thousands of dollars. He did have insurance but they didn't want to pay for some reason so the family, in the midst of their sorrow, was dealing with that mess too. Not everyone can pay the soaring rates so what happens to someone who isn't qualified for Medicaid but not well off enough to pay $172 a day to lay in wait?
I don't have answers. All I can say is that each of us has to take on the system from time to time. This is my time!

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