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Thread: How can I get my dad transported to his home state?

  1. #11
    Definitely Medicare will not pay for air ambulance for this circumstance, as has been clearly stated above.

    I have read a few stories on this board of people fighting to get their private medical insurance to pay for transport to out of state rehabs like Shepherd, and winning after extensive appeals/letter writing and doctors helping them. But Medicare will never help. I do not recommend trying to appeal to Medicare. Save your energy and look elsewhere.

    But do get familiar with the details of Medicare coverage, and the limits for number of days in the hospital per year and per lifetime. You need to get him to rehab as soon as he is medicinally stable so that those precious days are used in rehab.

    We were in the same situation as the OP. Parents stuck out of state, no one cares about getting you back home. And when you are older, they care even less.... And when you are older with a spinal cord injury.....
    Last edited by hlh; 10-02-2014 at 12:16 AM.

  2. #12
    The information I have collected from you all is invaluable. This is where we are with my dad:
    1- Denied rehab; the hospital wants LTAC for him.
    2- We stood our ground about sending him home; the hospital case manager is looking for places, and so are we.
    3- My dad has Medicare with an HMO: Transportation might be possible on a case by case basis.
    4- We applied for Medicaid in Georgia.
    5- Family and friends are willing to add to any fundraising effort; all my siblings and mom have to agree first though (that was a great fundraising site recommended).
    6- We speak with the lawyer tomorrow and give information we have collected about my dad's case. The lawyer sent out detectives yesterday. We still have no police report.
    7- I checked into some air ambulance services (another great link/site provided), hence the thoughts on fundraising.
    8- My mom, siblings, and I are exhausted (we all live in different states). -I'm in Louisiana.

  3. #13
    Some good things here.

    I'm sorry to hear about the rehab denial - was that Shepherd? Did they say why he was denied? Did someone from your family call and speak with them directly? Definitely do not trust the case manager alone on this one. Ask why he was denied. No beds? No beds specifically for his injury type? Why not? etc... Ask to speak with the highest supervisor you can find. If there are any doctors (?neurosurgeon) that have been helping your Dad that seem good/caring/aggressive, ask if one of them could call Shepherd and have a doctor to doctor discussion about accepting your Dad. It's worth a try.

    Maybe others from Shepherd on this board can give advice?

    When the rehab we wanted was full, I just continued to stall and call the rehab every day until a bed opened up. I tried to find a nice person who let me know when they thought a bed might open up.

    Perhaps KLD/nurses can speak to how hard it can be for patients with these high injuries to get into rehab at a place like Shepherd?

    Maybe the Medicare HMO plan is a good thing. There may be a chance for getting coverage for transport after all. It is easier to argue for coverage if he is going to a rehab place like Shepherd because it is highly specialized for spinal cord injury and your father has such high needs.

    I found it very tough to be worrying about the lawyer at this stage. Everyone is in shock and it is the last priority. But it will be important down the road and it is very useful to have a good lawyer.

    If there is any way one of the kids can go to where your parents are.... that would help tremendously. But it sounds like your mom is one tough Cookie. Good for her. I bet your Dad is tough too. Tell her to keep whispering in his ear that you are getting him home. Give it some time for the bleed to start getting reabsorbed and see if things improve. Remember, this is still the very acute injury stage and things will change over time. Don't give up hope, as no one knows yet what his prognosis will be. But it will be tough, and he will need his friends and family around him.... and if possible.... to get to a rehab like Shepherd.
    Last edited by hlh; 10-02-2014 at 12:17 AM. Reason: bad speller

  4. #14
    We could not get specifics about being denied rehab at Shepherd, although we feel the hospital referral might not have been a strong point. We are still prayerful that this decision might be reversed, and continue to communicate with them. We continue to request specifics.
    I have one brother in Connecticut and one in Rhode Island. They have both been physically present through this ordeal and have done, and continue to do, a lot to support and guide my dad's, and mom's, care. My mom was in the accident as well, and so they have had to juggle getting her medical needs met as best as possible.
    My sister lives in Georgia. Her and my parents have lived together for a few years now. I am looking into FMLA so that I can head to Georgia and help out. My kids would come with me. They, and my husband, are on board with this plan.

  5. #15
    His age may also play a role in why he was denied especially if his health was poor before the accident. Good luck to him and your family, keep us updated.
    T6 incomplete from MS and an aortic aneurysm surgery that went bad.

  6. #16
    We believe, unfortunately, that there is some hesitation because of age. His age does not reflect his determination or his mental stamina. Before the accident he had high blood pressure, which of course is no longer an issue. Otherwise he has been in great health and has kept a healthy lifestyle. We were always amazed that my dad never got sick.

  7. #17
    Tell hi. To keep his head up and things will fall in place! He should not give up as you shouldn't either. Keep fighting for what is best for him.
    T6 incomplete from MS and an aortic aneurysm surgery that went bad.

  8. #18
    There is considerable age discrimination by many rehabilitation programs for older people with SCI. It is sad, but common, and no one seems to be advocating for this population. We see it often in Veterans who are referred to us only after being turned down by regular private sector rehabilitation programs. I would also recommend contacting the help line at the Christopher & Dana Reeve Paralysis Foundation: www.paralysis.org as they may be able to help advocate for your dad.

    Unfortunately I don't share SmashMS's optimizum that "everything will fall into place on this". Our LTACs (long term acute care hospitals) which often serve as "vent farms" are full of people like your Dad who could not get access to appropriate rehabilitation services due to age. I do agree that you should not give up though. hlh had given you some excellent advice about refusing to allow him to be moved to an LTAC/SNF facility. Keep pushing!!!

    (KLD)

  9. #19
    I understand your desire to move your Dad to Georgia because it is his home state. Have you also asked the Case Manager to refer him to other SCI Rehabs to see if he would be offered a bed elsewhere? I know this seems counter-intuitive but it would be interesting to see if any other acute rehab will offer a bed. They might not want to bother with this, so I would present them with a list and contact information for some other centers. It does not matter that the hospital wants LTAC, their goal is to transfer ASAP. I see the point of digging your heels in to try to get him placed and moved to Shepherd. When Medicare determines that he is medically stable and can be transferred to the local LTAC, they will issue denial of coverage and back you to the wall. You can appeal the discharge however in this case it will be tough to beat. Still I do not blame your family for your choices. I would review the PT notes in his chart. Are they supportive and favorable for acute rehabilitation? You would need him to be motivated and eager to participate in PT at the hospital and for this to be documented in strong language. It is rough because the healthcare world is quality and outcomes driven, and mostly ignorant when it comes to understanding what a motivated person with paralysis can do. If there is a social worker at the hospital, ask for some support.

    I wish you the best as you go through this process,

    Mary
    1FineSpineRN

  10. #20
    Quote Originally Posted by Elegrier View Post
    We believe, unfortunately, that there is some hesitation because of age. His age does not reflect his determination or his mental stamina. Before the accident he had high blood pressure, which of course is no longer an issue. Otherwise he has been in great health and has kept a healthy lifestyle. We were always amazed that my dad never got sick.
    We also had some difficulty with getting the appropriate treatments and assessments because of my father's age. And in the ICU with a million tubes coming out of him, he looked even older...

    You actually need to keep reminding the case managers, doctors, administrators at Shephard how healthy he was before the accident. He was extremely healthy for his age, with no major medical problems. If he could walk a mile, say that. If he was still volunteering or working part time, say that. It is important for people to start looking at him as a person.... and not just an elderly patient with a SCI.

    I would have someone from your family start calling Shephard directly. Keep pushing and calling every day. Find the people in charge of these decisions, and keep talking to them. Do not wait. No miracles will happen on their own with this one. Ask the physical and occupational and speech therapists working with him now to assist you in indicating his rehab needs and potential. If any of them seem at all helpful or kind or motivated, ask them to help you with the referral process. And make Shephard answer your questions.... Have they ever had high injuries like your father before accepted to rehab before? Yes? So why not him? Have they ever had patients his age accepted before? Yes? So why not him? When will the next bed be available?

    This is the time to fight.

    Great idea to call the Christopher Reeve Foundation and see if anyone can give you advice on how to advocate. I'm sure they have seen cases like your Dad's before.

    Hang in there.

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