The Merry-Go-Round Continues...

Yes, that's right. It's day 5 of my husband's return home after a long illness and things still aren't in place for home health to come in and help with his care. I'm stuck with having to take yet another day off of work on Tuesday, May 5th and perhaps will need May 6th as well.

I called the home health agency this morning at around 9:15 to inquire about the status of our case with them. I spoke with the RN that had come out to do the assessment to see if there had been any new developments regarding his care. She tells me that they still haven't gotten in touch with the nursing facility about some sort of paperwork error than came from the doctor. The case worker with home health called me a little while later and explained what the issue is. Apparently when my husband was discharged from their facility, the physician discharged him to a nursing facility!!! Unbelievable! How can you discharge a patient to the same status as he was prior to discharge? So you think it's ok to discharge a patient to nursing home care when you clearly know that he's going home? Why on earth is this an issue? The case worker explains further and says that the little section on the paper that's for Medicaid patients was marked with the category 1 designation which means he was discharged to a nursing facility and that Medicaid won't pay for home health if a patient is discharged to a nursing facility. This keeps Medicaid from having to pay multiple caretakers at a time. In other words, it keeps these folks honest. It ensures that a nursing facility won't continue to draw payments on a patient that's been discharged to home and vice versa. However, it has become the bane of my puny existance.



I've been trying since Friday afternoon to find out why home health isn't coming in to help. I wasn't told very much on Friday except not to expect anyone to help until Tuesday at the earliest. I was taken by surprise because I gave both entities a 1.5 - 2 week heads up of the discharge date. I felt that was sufficient. And it should have been. But as we all know the best laid plans of mice & men...etc.



I started my quest again this morning at 9:15am with a call to the RN who had come to assess my husband's medical needs. She didn't have an answer but I told her that I needed to know what was going on. She informed the home health case worker that I had called so the home health case worker called me. She was the one to inform me of this teeny, tiny mistake. All she needed, she assured me, was to get someone to change that Medicaid "status" from a 1 to a 4 and they could get someone out here. She informed me that she had been trying and then ever so sneakily dropped these words in the conversation. "Mrs. Freeman, that's why I told you to call us as soon as you had a discharge date for Mr. Freeman." I said, "excuse me but I did call 1.5 weeks prior to his discharge to give you the date and left a message with the person who answered the phone because you were not there at the time and I was assured that you would get the message and get things going." I tried phoning the nursing facility and getting things worked out over the phone. I got bounced around from person to person to person.



I called the home health case worker and informed her of my bad luck. She suggested that I go to the nursing facility and do a "face to face" with the folks out there. So that's what I did. I spoke with 3 people there and thought (silly me)that things were taken care of when I left the facility. If you know Murphy's Law, you know it wasn't taken care of.

I called the nursing home social worker again and she then called the home health case manager and they came to the conclusion that neither one of them should change the code on the form and that my husband would have to undergo another Medicaid screening to determine his level of care therefore enabling the home health agency to take over his care. This could take up to a month! A MONTH? "You're kidding, right?" That's what I heard myself telling the social worker. And then I heard her say, "no Mrs. Freeman". My heart sank as I realized that perhaps this wasn't meant to be and that I had just doomed myself to putting him back into a nursing facility after trying hard to do what I had promised him those years ago. I couldn't bring myself to do that.

I called it quits for another day w/o help from the agency and laid down to sleep thinking, "OMG..what have I done?"