Update 2/6/15, Day 7 After Surgery


Update 2/6/15, Day 7 After Surgery

tire-track-582691_640On Sunday evening all she wanted to do was sleep.

On Monday, she had  dialysis and OT and PT so I did not get to see her until afternoon. She was tired from her therapy and dialysis but over all seemed better. They unwrapped her leg for the first time today and it looks better than expected. Hard dressing is finally ordered as the social worker did not do anything on it Friday! I have filed a complaint on the social worker and so has her MCO and the surgeon is not happy with her either.

On Tuesday, Mom is very alert today and has had OT and PT, They are teaching her to move with a slide board. I will be more involved in therapy and being trained once they move her to rehab. They are looking at moving her to a rehab center tomorrow but again the social worker had done nothing on this to coordinate with her MCO!

On Wednesday morning, dialysis today. They took her down late and then off to PT and OT so did not get to see her this morning. This afternoon she was very tired when I was finally able to see her after her PT and OT as well as dialysis. The social worker still has done nothing on getting a nursing home lined up for rehab. We are getting to the point where insurance will not pay for her to stay in the hospital but they can not discharge her to home as she does not have the strength or the skills to go home. Insurance also requires a rehab stay before going home if they are going to continue coverage for follow-up. I have talked to the MCO and they have said we will not have to pay anything if insurance stops paying because they have not made the rehab center arrangements and the hospital will be required by Medicare to eat the bill because they dropped the ball.

On Thursday, I received call at 12:32 p.m. from hospital social worker when I was at a client and was told that they were discharging her to a nursing home about 45 miles from the hospital and the transport will be there in 30 minutes. Luckily my client was understanding and I had all the daily necessities done and he told me to go a half hour early so I could be with her. I get to the hospital by 12:45 p.m. and they were already loading her!

I made the 45-mile trip to the nursing home and meet with the social worker at the nursing home. She was also upset as they still do not have her hard dressing, they have not submitted the paperwork to get the foot rest on her wheelchair changed, they sent no discharge paperwork with her or any medical orders! All of this was to be taken care of by the social worker at the hospital. Just before 5:00 p.m. the social worker from the nursing home was able to get a faxed copy of the discharge and medical orders. She stayed till after 8:00 p.m. to work though all the paperwork even though she was to be done at 5:00 p.m.. Come to find out that the social worker at the hospital did not even put in for the rides for mom’s dialysis treatments. Seeing that she has dialysis in the morning the nursing home is having their driver come in and bring her and pick her up even though they are not responsible for it as her MCO is but the hospital social worker did not coordinate the rides as she was supposed to do! I got home about 9:30 p.m. and have to get outfits together for Mom, her nightgown and other items she will need as well as her dialysis supplies and then I will have to meet her at the dialysis center with them tomorrow morning at 6:30 a.m.!

On Friday at dialysis they were not expecting her as the hospital social worker did not let them know as she was supposed to! They had to set her box back up as they had cleaned it and had not set it back up as she was not scheduled to be back yet because the hospital social worker did not do her job.

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Thank goodness at least someone is on your side. Hope it works this time.


Oh, my gosh, the social worker is incompetent! Have you been working with the same social worker the whole time? Or, have you had the bad luck to have two social workers who've dropped the ball?\r\n\r\nThank goodness you've got a team in place that will scramble with you to make sure your mom receives the care she needs. But, what a nightmare!\r\n\r\nI hope the rest of today goes okay. Thanks for keeping us posted--I'm thinking of you and your mom.