My 77-year-old mother has Parkinson’s and needs her medication every 2.5 hours. She was recently hospitalized and later transferred to a skilled nursing facility, but both places were careless with the timing of her meds. This led to severe symptoms and impacted her therapy sessions, which were essential for her recovery. She’s now being denied coverage for her skilled nursing stay due to ‘lack of progress,’ but this lack of progress was due to missed doses and improper medication timing. Do we have grounds for legal action for negligence?
It sounds like there could be a case for negligence. Documentation of missed doses and the impact on her therapy would be key if you decide to pursue legal action.
Quade said:
It sounds like there could be a case for negligence. Documentation of missed doses and the impact on her therapy would be key if you decide to pursue legal action.
Thank you. I’ve been documenting as much as possible. I’ll gather everything from both facilities.
@Eli
Smart move. That could make a difference if you file a complaint or pursue a lawsuit.
You might want to file a complaint with the North Carolina Health Department. They could investigate the facility’s practices around medication timing.
Perry said:
You might want to file a complaint with the North Carolina Health Department. They could investigate the facility’s practices around medication timing.
Good idea, thanks. I’ll look into that with both the hospital and the skilled nursing facility.
@Eli
It’s worth it. This may lead to changes in how they handle meds for other patients too.
As for the coverage denial, you could try a second appeal with Humana. Outline how the medication issues impacted her ability to make progress.
River said:
As for the coverage denial, you could try a second appeal with Humana. Outline how the medication issues impacted her ability to make progress.
I’ll do that. The medication issues were a major factor, so it’s worth presenting again.
@Eli
Exactly. A thorough appeal could help get her the coverage she deserves.
For Medicare and ChampVA, you could ask if ChampVA can cover some costs since the denial was due to factors outside her control.
Harley said:
For Medicare and ChampVA, you could ask if ChampVA can cover some costs since the denial was due to factors outside her control.
Thanks, I’ll check with them. This would help if Humana doesn’t approve the appeal.
@Eli
Good luck. Having options could make a big difference here.
So sorry to hear about this experience. If you do file a complaint, patient advocacy groups can be helpful. They might assist with the process or help push for better care practices.
Alix said:
So sorry to hear about this experience. If you do file a complaint, patient advocacy groups can be helpful. They might assist with the process or help push for better care practices.
Thank you. I’ll reach out to a few to see what they can offer.
@Eli
Wishing you the best. Hopefully, this leads to positive changes for your mom and others.