My heart goes out to you. God Bless.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Sherrie A. Diggs
Sent: Wednesday, November 19, 2003 5:38 PM
To: '[EMAIL PROTECTED]'
Subject: ALJ hearing on Medicare Denials...
was horrible.
The so called "Medical Expert" an ancient orthopedic surgeon from
california couldn't understand why
we were rehabing 80 and 90 year old people with multiple diagnoses including
alzheimers. Even though I explained that one of these "90 year old"
residents had been in the facility within the previous 1-1 1/2 years to
rehab s/p hip fracture to be able to discharge to assisted living in a
functionally independent level, thank you very much, and family requested to
return to our facility (100 miles from their home town) to rehab again. I
was unable to explain the resident with the alzheimers diagnosis, who by the
way had been in our facility for several years prior, I personally knew on a
day to day basis for 3 years, was functionally independent with only min to
mod memory & decision making problems prior to a fall and hip fracture--
again the so called expert didn't understand why he received skilled rehab--
when I attempted to explain the judge declared it "irrelevant"--
Marie we really could have used you yesterday!!!!!!!
Hopefully the judge didn't take the doctor's expert opinion too seriously if
so I don't think I'll be in long term care much long than the end of the
year---nursing and patient care is more important than as the judge put it
-- "We must follow the letter of the law young lady not your so called
holistic care"
I said nothing about holistic care... I just asked, if we don't try to
rehab those 80 & 90 year old people with chronic diseases in exacerbation &
fractures to get them stronger and function again to go home or to an
assisted living environment and Medicare doesn't pay for it, rather than
drop them in a nursing home and forget them -- what are we to do?????
I love Geriatrics and long term care, of the 8 1/2 years I have been a RN
this is what I have done.....
but as of yesterday my heart is breaking because of our government and our
laws for the people I love most and the profession I love most..........
Sherrie Diggs,RN,ADON
Medicare Coordinator
Parks Methodist Retirement Village
111 Parks Village Dr.
Odessa, Tx 79765
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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
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