3-17-2022 Still in the hospital, still waiting for what's next...

 (Tricia)

Linda is now in her third week in the hospital, not because the doctors say she is not ready for discharge, but because we are in the same state of limbo we were in when St. Luke's wanted to discharge her as she was coming out of her coma. The doctors and hospital say Linda needs to go to a long-term acute care hospital, but the insurance company says they will only pay for a skilled nursing facility. Unlike last time, however, when a single SNF agreed to take her, the hospital can find no facility willing to take Linda as long as she requires intravenous antibiotics (which she will need for at least the next three to six weeks).  

So, here we stay. I have spoken with an elder care consultant and a palliative care consultant, and both suggested that I upgrade Linda's Medicare Advantage Plan as soon as possible.  If I had known more about how Medicare works back during the annual enrollment period in November, I would most certainly have upgraded her then. But at the time, I thought it was better to maintain the status quo.  Big mistake. It would have been far better to upgrade her to Original Medicare when I had the chance. As it is, Linda qualifies for "special enrollment" because she technically has changed address in the eyes of Medicare, so we can at least upgrade her to a more robust Medicare Advantage Plan.

I don't know why this country has to make health insurance and healthcare so impossible to navigate. It's all fine if you stay well, but the moment you become ill--especially seriously ill--that's when you realize how much or how little your insurance company will pay for your care. This incomprehensible system just makes a bad situation so, so much worse.

The good news is that Linda is beginning to eat well again and the doctors tell us that her wound is healing nicely and they've gotten her blood sugar under control. So, the biggest hurdle at this point is, as it has always been, therapy. I seem to be the only one who can convince her to do it, but therapy here, as at NHC, will not give me an indication of when they will see her.  Only it's worse--it's not just that they won't give me a window of time when they'll work with her. They won't even give me a DAY. Their explanation is that they are short-staffed, and simply can't make any commitments of any kind.

I'm now on Day 2 of staying at the hospital all day, just hoping to be here when the therapists get here.  The nurses say they don't know whether PT will be coming today. So, I've called and left a message with Mo-Bap's PT office, hoping that they'll call back and at least let me know if they're coming again today or tomorrow. It has been a week since Linda has actually been helped into a standing position. The nurses can only use the Hoyer lift to move her from bed to chair and back again.

Regardless, we're in a holding pattern until we find out who blinks first regarding Linda's next steps--the insurance company or skilled nursing. If I can get her insurance upgraded, though, perhaps that will make a difference. 

(Note to everyone on Medicare: Be wary of those $0 premium Advantage plans. They work up to a point, but if you need complex care, they will leave you with few to no options.)