Congregant released from rehab. Does anyone know NYC Medicare appeal rules?
I got a call from my Rabbi today; a congregant in his late 80s who lives alone recently broke his hip and was in rehab. Texted with this gentleman the other day to make sure he was safe and sound during the COVID crisis.
They released him yesterday without meds nor a care plan, it seems. He says he "protested" but not sure if there was a formal Medicare appeal.
To complicate matters, a friend drove him to his apartment, which is apparently hoarded to the extent that they were unable to get the wheelchair in the door. The Rabbi arranged for him to go to a local hotel where he has a 12 hour aide. I dropped off his meds this afternoon and it appears that he is bedbound. Not safe without 24/7 care.
Does anyone know NYC Medicare appeal rules? We will appeal on his behalf (I need to find out if he has a POA or healthcare proxy) but at least one MD in the congregation tells us that calling 911 and getting him take to an local ER for readmitted might be the best thing.
Let me know if you have any thoughts!
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LOL, Barb! Mostly laughing because I'm relieved - I was all ready to be horrified that rehab et al knew the gentleman's circumstances and just didn't care because they need the beds and the staff hours that badly.
It's a bit like the stray cat you lavish luxury brand cat food on and buy all sorts of little treats for because you're so sorry for him, poor homeless pusskins with no people of his own; and then gradually discover that, yeah, it's you and every other house in your road thinking exactly the same thing about exactly the same cat. No wonder you only see him one morning in eight.
Did you get hold of the POA. He should now be taking over. Maybe its time Bob goes to an assisted living. People only help so long.
So, briefly, Bob (not his name) is a congregant. I went to visit him in his hotel room with aide. I dropped off his meds, pizza, mouthwash etc what he'd asked for.
Got the SW at the rehab on the phone today. He was in rehab for 36 days(!!) Can walk 200 feet unassisted with a walker and supervision (I said yes, but without??).
He left with a passle of info but didn't inform rehab when he didn't go back to his apt (I've seen pictures; it's hoarder central).
Got him and his aide the number of the rehab agency that is trying to set up home services. I have a call in to the local contracted Area Agency on Aging to set up case management services, to get a needs assessment at the least.
Bob has contacted his super to do some sort of cleanup to the apartment so that he can return home.
1. There are some mental health needs. Clearly.
2. Others in the congregation are doing deliveries, friendly visits. Etc. I am better utilized as organizational person
3. Always give ocisl workers the benefit of the doubt. She said wryly to me "Bob told us he had "no one" and gave us the number of his POA attorney (who has not responded). For someone who has nobody, I'm getting an awful lot of phone calls".
4. The rabbi didnt leave a callback number. Hence her inability to be in touch. Really, listen first and have a list of questions to ask.
5. Bob is a retired professional. He has financial resources. He will be fine with our support. Folks, if you are going to get old, join a reliable religious congregation.
Other thoughts: I believe that nursing homes have to provide discharge papers, but I confess that I've forgotten a lot since my father passed and would have to review old medical records.
Does NYC have its own ombudsperson for nursing homes? That's an option as well.
Suggestion: contact the facility administrator; sometimes the power of a dissatisfied and unhappy client, and potential of negative publicity, as well as support through any religious organization, can motivate them to rethink their behavior.
You might also contact Medicare directly. I've found them to be very helpful, much more so than years ago. And if I recall correctly, the last time I called I learned they're open evening hours, which are better times to call b/c most people aren't aware that they work in the evening.
You might ask where the script for home care referral is, since they apparently didn't call a home care company, or make arrangements as would be anticipated for someone who's bedbound.
Sometimes admins can be embarrassed when they're told that the arrangements you thought were made don't seem to have been done, and ask WHEN the social worker made arrangements for his home care. If there's a long, long pause, you might have created a situation in which they're embarrassed by being caught red handed.
I'm trying to think of specific categories of potential abuse by releasing someone who's bedbound without even making arrangement for home care; "negligence" comes to mind, but I know there's another term which I just can't think of.
Does anyone in the congregation have any recommendations for a facility which could meet his needs?
I assume there's Jewish Welfare Federation in NYC? I've found them to be helpful in my Michigan area. And they seem to have broad based experience.
If I can think of something better I'll post again tomorrow. My mind is kind of tired from CV overload.
That is exactly what I would do if I was in your shoes. 911 please help this vulnerable senior.
Make sure that someone has POA to help fight for him. Surely you have a notary in your congregation that would be happy to process the documents.
Best of luck for this precious brother in his time of need.
Just want to offer support. I hope others will have helpful suggestions. I will say a prayer for him.
Wishing all the best in this situation. Thank you for being so kind to him. You’re very thoughtful.