The private room

Today my journeys took me from Erie to Arvada to Longmont to Boulder. Just another typical day in the life of the Director of Parks and Recreation.
 
This morning I conducted my final meeting as the chair of the Directors Section for the Colorado Parks and Recreation Association. The meeting was held at a huge recreation complex in Arvada. During the meeting my cell phone went off. It was the Peaks Nursing Facility, the facility where my mom is a resident.
 
They called to inform me that they were going to move my mother out of her private room.
 
Let me provide a little context on this. When my mom was admitted to the nursing facility she shared a room. When we got there, I asked if it were possible to get her a private room, because that is what she wanted. When I met with the marketing manager and the center manager they told me that private rooms were normally offered to medicare patients and more specifically patients that had a short rehabilitation time or a short time to live.
 
My mother was on medicare and her prognosis is 2-6 months. They got her into a private room pretty quickly. I was very concerned after a couple of weeks about how her medication was being handled by the nursing facility. I decided to call in hospice (and I am glad I did – my mom has been pretty lucid and they got her off a lot of medications)  which really opened up a can of worms. You see, once you call in hospice, then hospice is in charge of her medical care and hospice receives the medicare reimbursement for her medical expenses, not the nursing home. The nursing home can charge a facilty charge, but they miss out on the medicare medical reimbursements. So, for all intents and purposes, they are making less money.
 
When I switched to hopsice, the marketing manager told me that it might be difficult to keep my mom in a private room. She again reiterated that private rooms were normally used for rehabilitation purposes and for shorter term care. I again restated my mothers prognosis and she and the center manager said, "You know what Jan, don’t worry about it for now."
 
So when I got the call today, I was furious. It’s not that I had forgotten that they had spoken to me about their policy. But there were a couple of distinct things that really rubbed me the wrong way.
 
First of all, they made it sound on the phone to me that they were going to move mom and do it now. I got pretty upset and I said, first of all why wasn’t I given more advanced warning about this so that if indeed we had to move her, I could be the one to prepare for this so that the move would not be as stressful At this point, my mom had no idea if I knew what was going on, and I am sure because she did not know if I was aware of the situation, that made her stressed and upset.
 
Secondly at the beginning of this month the nursing home presented me with a bill – not just for the month of July but they told me their policy was to bill a month in advance. I paid the bill – and I was billed for a private room for the month of August.
 
Thirdly, I got hot because it just reeked of "we can get more money for this room if we give it to someone that we can bill medicare for" even though we are paying their charges and paying on time.
 
I told the staffer who called me this morning that this move was not acceptable to me – that I wanted to speak to meet with the head administrator, and that if they moved my mother I would work quickly to move her out of that facility.
 
The staffer told me that she would have the administrator call me back. I told her that I did not want a phone call from the administrator but that someone should contact me to set up an appointment to meet with him/her.
 
When I hung up the phone, I ran back into the meeting I was chairing to make sure that things were moving along. Then I left the room again and called the marketing manager (Jean). Jean is the person that I wrote about that I had a great conversation with about nursing facilities, what they should be and what the future of these facilties will be with the baby boomers aging.
 
I told Jean that I was very upset and I reiterated to her that I would move my mother out of there if they took her out of her private room. Jean told me she was sorry I found out the way that I did, and asked if she could call me back in 20 minutes. I said ok.
 
After my meeting ended I drove from Arvada to Longmont to pick up the paperwork that my mom’s primary care physician filled out to submit to her insurance company to begin the process of getting her long term nursing benefits. Since mom’s nursing facility is only a block away from that office, I stopped in briefly to see if they were starting the process of moving my mom. My mom told me that she had not heard anything and did not know if anything was going to happen. I told her that Jean said she was going to call me back in 20 minutes (and that was 2 1/2 hours ago). I had to leave her to go to her old apartment as the estate manager was holding an open house for the residents of her building to see my mom’s stuff and see if they had any interest in purchasing anything. I left the nursing facility, stopped by my mom’s apartment and made sure everything was ready to start and then I started my journey back to Boulder to meet with the City Manager’s office before being interviewed by Channel 2 regarding the prairie dog situation that I wrote about yesterday.
 
As I was driving into Boulder I got a call from Jean. She apologized for making me upset. I felt it was important for Jean to know that I did remember our conversation regarding the potential  issues with a private room, and I also wanted her to know that my fuss did not negate all of the good things that I felt the center had done for my mother (which there are many good things). But, I told her that this felt like a money making ploy to me – a way to get more medicare dollars. I reiterated to her that I paid for a private room for the entire month of August, and I also reminded her of the conversation we had about what the mission and purpose of these types of facilties should be.
 
I told her that I was sorry that my mother hadn’t died as quickly as some might have thought – but I also asked her if she ever thought that maybe the reason my mother was doing as well as she was is because she is living in the type of space that makes her feel comfortable and secure, and
 that in turn has helped her to maintain the positive attitude that she has and consequently that has made her stronger and given her more quality of life, and more life period.
 
Jean told me that I should keep advocating for my mom the way that I am and that I am doing exactly the right thing. She told me that because I said what I said to the staffer and her and because of my reaction to this, that she was able to advocate for some things. She said that what she did was reevaluate the overall room assignments in the center. She made some changes to some living arrangements and after those changes were made – surprise, surprise, there was not a suitable place to move my mother. So, at this point, there is no suitable place to move my mom – so she stays put.
 
Jean suggested that I meet with the administrator and tell him/her exactly what I told her – because she believes that nursing homes are about care and quality of life. She also says that we are paying our bills, on time – my mom is one of only 3 residents there that has nursing home insurance, and so what’s the problem.
 
She also says that everyone just loves my mom and that she is so easy to take care of – and she led me to believe that my advocacy gives her more power to help us. I told Jean that I would continue to fight for my mother. I told her that I am powerless to do anything about her cancer – what will be, will be – but I am not powerless to try to give my mother what she needs in order to give her the best possible quality of life for the life she has remaining. That I can do – it is the only gift I have left to give – and I will do that. I began to cry, and Jean began to cry too.
 
So then I arrived in  Boulder to talk to the City Manager about our strategy to deal with prairie dogs and then I was interviewed by Channel 2 news. That way my day, how was yours?
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