|1||Family members of a 70-year-old woman were appealing her skilled nursing facility’s decision to discharge her because they believed doing so would be premature and unsafe after what they called an unnecessary tracheostomy. The patient’s loved ones complained that they got nothing but runaround when they pressed the facility again and again to remove the tracheotomy tube and close the hole.
A facility representative repeatedly told the family members, all of them excluded from care planning, that a pulmonary doctor’s scheduling conflicts had delayed removal of the tube. Family members pointed out to facility staff that the unnecessary tracheostomy had hindered the patient’s ability to manage activities of daily living and participate in therapy, and resulted in her further decline. Still, the family members’ pleas to staff at the facility resulted in no action in response to their concerns.
Livanta’s Patient Advocate intervened, guiding family members on how to advocate for their loved one and how to document and respond to the care facility’s unresponsiveness to their concerns. The Patient Advocate also urged the patient beneficiary to request a care plan meeting about grave concerns over leaving the tracheostomy tube in place unnecessarily and referred the beneficiary to discharge-planning tools and resources.
Although the discharge appeals were unsuccessful, intercession by Livanta enabled family members to advocate effectively on behalf of the patient. The Patient Advocate’s efforts, along with the engagement of family members, resulted in the care facility’s making arrangements to remove the tracheostomy tube promptly. The critical support and guidance from Livanta made it possible for the patient to participate fully in therapy and achieve great progress toward returning home.
Family members expressed enormous gratitude to Livanta for going to bat for their loved one with crucial guidance, support, assistance, and resources, as well as advice on ensuring the skilled care facility followed up properly.
|2||A 51-year-old man who had been hospitalized for treatment of seizures and excruciating back pain was appealing his discharge from a skilled nursing facility, arguing he needed continued treatment there. The patient pointed out that the pain hindered his ability to perform activities of daily living. He also cited his need for seizure medications and noted he had had a history of psychoactive substance abuse, difficulty walking, muscle weakness, epilepsy, anxiety, and dependence on sedative, hypnotic, and anti-anxiety medications.
Livanta’s Patient Advocate researched assisted living and home health services in the beneficiary’s area, with the goal of returning the patient home when he could handle activities of daily living. The Advocate instructed the patient on how to advocate for himself; referred him to web-based, discharge-planning tools; and urged him to schedule an appointment with a doctor, who prescribed the painkiller Percocet. The patient also was advised to make an appointment with a primary doctor soon and to apply for for Meals on Wheels.
Livanta’s intervention, both during and after the unsuccessful discharge appeal, enabled the patient to be seen quickly by his primary care physician after discharge, thus dramatically increasing the likelihood of outpatient management of his conditions and reducing the chances of readmission to a hospital.
The patient’s representative thanked Livanta for following through with health care providers and for connecting the patient and all his loved ones to an abundance of valuable resources and guidance on how to proceed.
|3||An 86-year-old woman was facing discharge from a skilled nursing facility after hospital treatment for a fractured left hip she suffered in a fall. The woman’s son, her representative, had appealed the facility’s decision to discharge his mother. He cited concerns about her lack of mobility, her inability to function independently or walk without using a walker, and her dementia, which reduced her mental capacity. The son explained that his mother had been improving with physical and occupational therapy at the skilled nursing facility and asserted she would not receive the same level of care if discharged.
Although the appeal was unsuccessful, the son did have the opportunity to participate in devising his mother’s discharge plan. Livanta’s Patient Advocate worked closely with him and with representatives of the skilled nursing facility. The facility added a third-party advocate to its care team, who continually updated the son on his mother’s status. The Livanta Patient Advocate educated and empowered the son and other members of his mother’s family, providing invaluable guidance on advocating effectively, and marshalling available resources, discharge tools, and advice on devising a safe discharge plan. Among other things, the Patient Advocate suggested the son tap into his sister’s registered nursing expertise for medical advice on responding to their mother’s needs.
As a result of the Patient Advocate’s efforts, the son became more accepting of the skilled care facility’s decision to discharge his mother, who further stabilized while he and other family members helped care for her at his home. The son expressed gratitude to the Livanta Patient Advocate for all the resources, guidance, and unwavering support as he navigated the bewildering process of arranging quality care for his mother. Speaking of the Patient Advocate, the son said, “You are Number 1 in my book.”