A MiceChat friend of mine suggested that I post a thread regarding the hassle we are receiving over my critically ill mom's hospitalization.
We had been taking care of her at home with the assistance of a local outpatient nursing company, and our family doctor. Our doctor is also a pulmanoligist. She had COPD among several other severe conditions and was dependant on an oxygen aperatus, though not a ventilator. Over the past several years she had been in and out of the regular hospital ICUs after having entered thru emergency. She had been in sub acute care nursing homes for short stays a couple of times.
While at home around five months ago, we had an ambulance take my mom to a hospital emergency room due to her having unsafe trouble with breathing. From there, she was admitted to a room in the hospital's ICU. After several weeks went by, her health improved and she was moved to a less critical area in ICU. She was there for two or three days when she suffered a stroke. subsequently, she was brought back to the main ICU unit (and placed on a ventilator) and then improved enough to be brought back to the lesser "acute care" area again. However, she has remained on a ventilator ever since.
Our doctor visited and monitored her every day. We, our family and friends also visited her regularly. She hadn't been able to speak since being placed on the ventilator. But, she gradually reached the point of moving both feet and legs, and both hands and arms - although stonger on the left side. She was also making eye contact with us and squeezing our hands in direct response to questions.
At this point, our doctor decided to ween her off of the vintilator and have her moved to a local long term rehab center that had ventilators. He signed transfer papers at the hospital without realizing that the rehab hospital had been shut down. The regular hospital decided to move her a hundred miles away to another long term hospital. Our doctor protested for three days, but they wouldn't listen to him. They told us to either sign the transfer papers or else pay thousands each day that she remained there. With heavy hearts, we were coerced to sign and my mom was moved. She is no longer close enough for her doctor to take care of her. Instead, she has seven rotating doctors that don't know her or personally care about her.
For three months, we have been traveling to visit my mom at least once a week - sometimes more than that. We were told 28 days in advance by a hospital administrator that her Midicare would run out. My dad has Blue Cross/ Blue shield coverage and we figured that they would cover her after Medicare lapsed. The 28 day period ended two days prior to Christmas Eve, and we were told by the administrator that they had found a nursing home for my mom. The place was 170 miles from where we live. So, we appealed to Medicare against the move due to the distance. We did so in spite of threats by the administrator to pay over a thousand a day after the bed at the other hospital was no longer available.
We contacted Medicare again. They told us that they understood our problem, and that the sub acute care hospital the admistrator where my mom is refered to is a nursing home with a ventilator unit. We also contacted Blue Cross/Blue Shield. They had her hospital records sent to them, and have decided to pick up the coverage costs from the day that Medicare stopped. Now, the long term acute care hospital is trying to find a closer sub acute care hospital (with a ventilator unit) to move my mom to. My mom's vitals have improved, and she is breathing partially on her own ..though still on the ventilator. The hospital recently tried to ween her off the ventilator completely, but her blood gasses increased and they had to abandon the effort.
So, now they intend to make a decision to transfer her to a sub acute care hospital at some point in the near future. They are also telling us that a sub acute care hospital is not a nursing home. We are also being told that Medicare will cover her for the first fifty days. and that Blue Cross would pick up the costs (in part or in full) after that. The administrator at her hospital is advizing us to apply for MediCal for her so that she would be covered by anything that Blue Cross doesn't.
A problem exists in that Blue Cross had told us that they don't cover custodial care at nursing homes, and that they consider sub acute care hospitals to be nursing homes. The administrator at my mom's hospital said that she believes that Blue cross would pick up the tab in full or in part due to her extenuating circumstance of being dependent on a ventilator.
Another problem is that my dad and mom were told by MediCal a long while back that she didn't qualify (before we had to bring her to emergency when all of this first started). I believe that it was due to my dad's retirement income being too high.
So, first of all we want to bring her back to this area. But, the regular hospital that she was at has stated that they do not want her back. there are no sub acute care facilities with a ventilator unit here. A local Kaiser Hospital has ventilator care. But, they have their own insurance plan and do not accept Blue Cross. At this point, I am getting ready to ask legislative representatives to help us look into qualifying for MediCal.
Any suggestions on what we might do would be greatly appreciated. Her vitals are strong. She is responding by moving her head and making eye contact when we speak to her. She is also moving her hands, arms, feet and legs - and squeezing our hands. WE love her to no end, and all of this hurts. It's all one big mess.
Kenny - Ride Warrior