Sunday, January 06, 2008

Documenting - The Paper Trail

As I was advised, I put together a document for this meeting Monday. Tomorrow we'll fax a copy to Kathy at Senator Saland's office, Joanne at the Northeast Center and the Appeal's Manager at Blue Cross. We'll leave a copy at the President of the hospital's office, with the head of ICU, Michelle's boss and his head nurse.

It will be on all the right desks come Monday morning with the 8AM appeal and then the meeting with the President and those people.

I've sat and re-read it and it's pathetic the way it's been mishandled. I know I can be a bit of a drama mama but it doesn't take much to see this is insanity.

It's being proofread by people more literate than I so yes, this copy has typos and grammatical errors. Between my head being held together by elmer's glue and my inability to adjust to a laptop keyboard I'm amazed I spelled his name right.

It's really long and I don't expect anyone to read it but a few people will want to read it so I put it behind the cut.

Screw party lines, give me a candidate who will tackle health care and they have my vote.

Michael - thank you for your email to Senator Saland. It touched me that you cared enough to do that.

I continue to fight the good fight!


Charles Ives - 11/04/33

11/27/07 - Can't breathe, goes to ER in ambulance.

12/10/07 - Letter re. Michelle (see attached)

(vent 100% for all of this, told to 'prepare for worst.')

Blue Cross file marked by Northern Dutchess Hospital as no significant recovery expected - This was never updated.

12/13/07 - Tracheostomy in, unable to insert PEG - may need more surgery to insert PEG.

12/14/07 - Trach takes, begins day with vent lowered to 92%, by end of day lowered to 85%.

12/14/15/07 - Fever develops, source unknown.

12/15/07 - Vent lowered to 75%.

Vent consistantly lowered day by day at this point.

Things take a quick turn here.

He is able to be given food. Puree and mush at first, applesauce and jell-o. This continues to spaghetti/meatballs, macaroni and cheese and other 'solid' food. PEG deemed not necessary.

Develops sever diarhhea and fever continues - no source identified

Is helped to sit up on bed, dangles feet actively. Has strength in feet. Does this for 10 minutes.

Is helped to stand up out of bed and walk to chair. In the words of the nurse, he did 'most of it' himself.

Vent continues to be lowered, blood oxygen level hits 100 with the vent at 40%.

Blue Cross should have been notified by Michele that significant recovery was in fact underway. Never done.

Staph infection identifed as source of sputum excess - MSRA

Strong evidenc of depression/frustration. When wife shows up he almost resorts to infantilism and this past week kicked and spat at the nurses. Too long in the ICU.

As of this writing, vent is at 35%. Diarrhea continues, has a history of reacting to antibiotics with diarrhea.

Week of 12/23/07 - Family informed that two employees from the Northeast Center for Special Care (A sub-acute/SNF and Empire Blue Cross Participant) have been to see him. Family told this is where he will be going and to go take tour.

12/28/07 - Family tours Northeast Center for Special Care and loves it. Works in ALL ways (see attached comparison of facilities).

12/31/07 - Family casually informed by Michelle that he woud be unable to go to Northeast Center for Special Care and given pamphlets for Wingate. No explanation offered.

01/02/08 - Family begins investigating frantically. Daughter spends six hours on phone between Blue Cross, NDH and Northeast Center for Special Care . ICU nurses agree this place is good for him,

01/02/08 NY State Senator Stephen Saland's office returns call, to be given full authorization by family to step in, see all medical records and speak to all parties involved.

01/03/08 - Michelle assures family she is 'fighting' and working 'all day' to get him to Northeast Center for Special Care .

The next information is what has transpired in coversations with Blue Cross, Michelle and Northeast Center for Special Care . It is our sincere hope you will see that things are not being handled in the best interest of the patient by any means.It had become evident that Michelle is doing nothing to assist the family in their attempt to move Charles to where he will recover. At the end of this document we will provide all the phone numbers needed and Joanne Ligori of the Northeast Center is ready and standing by to provide the information Blue Cross claims they never received and Michelle never sent.

01/02/08 - Daughter calls Blue Cross. Blue Cross CS Rep. points finger at NDH and says their person never submitted paperwork validating need for care, they didn't deny the claim, the didn't have paperwork.

Blue Cross CS Rep. gives her number to call Medical Management to have his "Dr. submit the papers." Note quotes.

Daughter then calls Michelle at NDH who begins a different story. She says the paperwork comes from her, not the Dr. She makes some vague offer about how perhaps with the holidays the paperwork was not where it needed to be.

Daughter is promised that Michelle will work as hard as she can to make it go with NCSC. She makes no promises but claims to be on side of family. Says she is off 01/03 but promises to call daughter 01/04 with update.

Daughter afraid of vendetta over previous letter about Michelle, calls Joanne at Northeast Center for Special Care , the one person who seems to actually care about Charles.

Daughter learns that neither Michelle or the BC CS Rep. had it right. The claim was denied by the Medical Management doctor because NCSC is not an 'acute-care' facility and they said Charles needs 'accute care.' The denial was based on this.

Charles Ives does not need accute care. This is on his record as per his many doctors' diagnoses. He was denied on incorrect paperwork as submitted by Michelle.

Daughter given name of nurse who was insisting Charles need accute care (Sheila) and pre-authorization number of 1276075.

This is the apparent paperwork Michelle was referring to, the paperwork she never completed.

01/03/08 - Wife meets with his doctor in ICU and Robin who assures her the paperwork has been redone and re-submitted.. This should take care of the mixup.

01/04/08 - No call from Michelle to either wife or daughter, as promised.

01/04/08 - Wife arrives at NDH to be told that Michelle has done all she can, he was denied once and for all and there would be a 'family meeting' Monday.

Daughter calles Medical Management, is given name of person handling his case - Karen Ella.

Supervisor tells daughter in no uncertain terms that Charles was denied entry
to NCSC for three reasons:
a) he was denied acute care, needs Skilled Nursing Facility.
b) they had no EBC ID# for Northeast Center for Special Care
c) didn't even know if Northeast Center for Special Care has a bed.
These are the factors that caused his denial.

Daughter told that the only notation on his file for 01/04/08 from Michelle is "family members refuse SNF" and mention of a family meeting on Monday which daughter learns is to prod them towards Wingate.

**Note. Family members did NOT refuse Skilled Nursing Facility, they want the one that will add in reovery. Northeast Center for Special Care is a Skilled Nursing Facility.

Daughter told that his file reads 'no significant recovery expected' and this all comes from Michelle. As stated before, he began to recover Christmas week and for whatever reasons, Michelle never updated to his BC file. This is unacceptable.

Daughter told to call Karen Monday morning after being reminded twice it was 'after 5 on Friday.'

Daughter then calls Joanne at Northeast Center for Special Care.
a) Skilled Nursing Facility is sub-acute care, this woman was feeding daughter
bad info. Northeast Center for Special Care is a Skilled Nursing Facility.
b) Of course they have the ID#, NCSC is 'on par.'
c) They've had a bed, why didn't BC know this.

Private room has been waiting for Charles since 12/28/07, along with the willingness to take him with the MSRA.

Again - Why was BC never notified of this?

Daugher is told that Michelle did in fact call NCSC once time today but it was not geared towards fighting to put Charles in there.

There is serious concern that Michelle is acting on spite from the letter and not doing what is the want and right of the family and patient. From all accounts there are to actual reasons for Charles to be denied access to Northeast Center for Special Care except the proper paperwork has never been submitted and there has never been a coordinated effort to put him into Northeast
Center for Special Care .

Charles has been through a trying time and although he has made tremendous strides that have surprised everyone, there is still much to be done. It is no secret that recovery is a large part mental/emotional. Putting Charles into Wingate will do nothing to help his recovery as outlined in the following page.

Appeal scheduled for 01/07/08 with BC Medical Management.

The medical care at NDH has been way above part, the nursing staff in the ICU are all anyone could have hoped for and he has made much improvement. To throw it all away over missing or incorrect paperwork and the unwillingness of one employee is cruel. The trust of the family is put into the care worker, there is enough to deal with in the every day for the family, when the person who is supposed to handle his release follows their own agenda and does a truly shoddy job, where is the family to go?

Please see the attached comparison chart for Wingate and NCSC. What will be clear is the benefit to Charles at NCSC and what Wingate does not have to offer.

We request that Michelle be permanently removed from anything further to do with Charles and written proof be submitted to the family that the correct paperwork has been submitted to BC so they can send Charles where he needs to go.

If necessary, family will litigate. The medical care is wonderful, the administrative end of his care has been ineffective, dishonest and detrimental to the overall recovery of Charles. Michelle's unwillingness to put any effort into the wishes of the family should not go unnoticed and her blatant lies about her efforts are exactly what is wrong with health care in America today.

Attached please find previously mentioned letter to NDH about Michelle, a comparison of Northeast Center for Special Care and Wingate and a list of contacts and phone numbers.

Comparison of Facilities, Non-Medical Care:

Visiting Hours:
Wingate: Closes at 8PM
Northeast Center for Special Care : 24 hours
Daughter lives in Westchester, would only get to see her father on weekends.
Charles is a night person, 24 hour visiting crucial.
Wife works in Hyde Park, would only get to see him one hour a day. She has
been going to ICU 4-5 hours a day every day.

Pet Therapy:
Wingate: No
Northeast Center for Special Care : Yes. Charles has a dog he loves dearly. Pet therapy has been proven
to aid in recover.

Atmosphere:
Wingate: Depressing. Much like nursing home.
Northeast Center for Special Care : Bright, cheery, mobile.

Online Complaints:
Wingate - Yes
Northeast Center for Special Care - None found

Attitude Towards Healing:
Wingate - Unsure if they have an 'isolation room' for him.
Northeast Center for Special Care - Had had a 'private room' for him
since 12/28. This room would remain his for the duration of his stay.
Use of term 'isolation room' strongly put family off.

Touring:
Wingate - Showed up unscheduled, no one there.
Northeast Center for Special Care - Showed up unscheduled, welcomed warmly

Document with phone numbers omitted.

1. I’m so very proud of you, Heatherlyn. I shed tears. Yes, asshole me shed tears. Especially this part…

   We request that Michelle be permanently removed from anything further to do with Charles and written proof be submitted to the family that the correct paperwork has been submitted to BC so they can send Charles where he needs to go.

   If necessary, family will litigate. The medical care is wonderful, the administrative end of his care has been ineffective, dishonest and detrimental to the overall recovery of Charles. Michelle’s unwillingness to put any effort into the wishes of the family should not go unnoticed and her blatant lies about her efforts are exactly what is wrong with health care in America today.

   Amen, amen, amen!

   I will be the first to tell you that nursing homes and the ambience of a recovery spot is critical. I’ve seen many repugnant nursing homes with good, or even excellent care, but the ambience drove me as a visitor to depression. Places of recovery should inspire hope that things are going to get better. But, if they aren’t, they should know that life isn’t over and plenty of people live using (insert tool here).

   Also imperative, possibly the most important factor of all, is outside support. Do not lose faith, Hlyn. Health care is a mess but badasses like yourself and my parents are what keep people like me and your dad alive. That fiery, indefatigable support, love, and care. With a change, the broken, profit-driven and corrupt health care system in the US, along with liars like Michelle will be eliminated and reformed. Yes to change.

   Again, I commend you wholeheartedly and wish you the best of luck. I have written to numerous politicians in both parties in Ohio and have been met with generic or bored replies. But, keep the spirit up - you can do it!

   Bobby  on  01/06  at  04:32 AM

2. Bravo Kitten, keep up the good fight!!!!

   Nicki  on  01/06  at  11:57 AM

3. I wrote a letter appealing to the Senator that you’d received correspondence with. I urged him to follow through with his commitment to help out. I told him that he wouldn’t want his own father going through this, and neither would he want his family to go through it either.

   I wanted you to know, that although it is a small gesture, it’s all I could do from here besides praying. I’ll keep writing.

   Love
   Mare
   Keep up the good work Chuck, hold in there Mom. (I don’t know her name.)

   Mare  on  01/06  at  05:45 PM
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