I write each day not only to report Corey’s daily progress but to try to process and reconcile the details of this injury and its emotional affects. As you can imagine, the daily composition does not include all the details of what is actually digested and managed in a day.
The education we’ve received on Traumatic Brain Injury has been amazing. The clinical portion can be overwhelming until we start to literally “connect the dots” to try and understand how the brain works. The insurance coverage, billing issues, procedures, practices and management of care from ICU to Acute rehab to preparation for long term recovery are details that families work through with any traumatic injury. This does not include the fact that the world still spins and “life continues on” with our family, friends and careers.
Our teachers have not only been the Doctor’s and Nurses’ but the therapists as well. It is fascinating to see how the teams focus helps the body work with the brain including the limitations that are present as a result of the injury. This experience has also brought “Assistant Professors”; aka, former patients and their families. They teach us what they have learned from their experience. Tips, techniques, personal perspective and coping strategies that are invaluable to fill the void of how we desperately look for the interpersonal connection with Corey. Their lessons learned lay the foundation for us to discover our emotional and spiritual direction in this undetermined length of recovery. The culmination helps us live each day despite the world continuing to spin.
That being understood; classes for ‘Living with a Traumatic Injury, 101’ were not cancelled for today. Open your books to the Insurance Chapter please.
We have been approved until February 15th. However, Bryn Mawr is expecting this to be the last week. Corey maintains her score of 12 for her CRS exam. The score actually fluctuates throughout the week depending on a good day or bad day which is normal. She still remains consistently inconsistent in responding to commands. The denial from insurance is because she is not making functional improvement. The criteria they are basing this decision on is progress of TBI patients based on a national average. For those emerging and making progress from the lowest level it’s comparing an amputee to an athlete.
There is an appeal process that will be initiated once we are denied. Bryn Mawr has two possible appeals and we have one. The overall time frame for the appeals might gain us an extra week if they all are denied. The argument we have to prove is that moving her from an acute rehab to a nursing home will be detrimental to her progress of recovery.
We also have to prove how Corey’s needs would not be met in a sub acute nursing facility (nursing home). At the moment, Insurance is arguing that nursing homes have skilled nurses that can ask commands, PT/OT/Speech therapy (not the same quality or quantity but they do offer it) and most don’t have experience with Traumatic Brain Injury but they do have a Neurologist on staff. Is it what we want for Corey, NO! But they can provide “satisfactory” care. Bryn Mawr has been told to start documenting their discharge plan. They have to find the next facility to move her to.
It’s time to ask for your help. We know that many of you love to research. We have one week to come up with STATISTICAL information or any DOCUMENTATION, journal studies, research papers, etc. that will prove “the success of functional independence for a TBI patient as an “INPATIENT” at an acute rehabilitation setting vs. a skilled nursing facility” (nursing home) Alternatively, is there documentation that proves the opposite? Is there proof of “Regression of independent function from post acute rehab to a sub acute setting”?
Secondly, I believe that there is a story here. The insurance piece is definitely part of this; however, the real story is that there are no sub acute facilities for anyone 18 to 30 years old. Families either take their loved ones home or are forced to look at 65+ nursing home facilities. We have to bring awareness to the public that this demographic, regardless of the traumatic injury, has no where to go that is age appropriate! This is a national issue that needs to be addressed. After the accident, the helicopter transports the victim to the ICU, and then they’re sent to an acute rehab, once discharged they’re on their own and forgotten. The quality of long term care/recovery is the battle left for the family to fight. The local media tells me that although this is a tragic story, there is no story here. There’s “no hook”…help me think of a hook! This story is not about Corey or TBI, it’s about all the young people that have a traumatic injury that we may be able to help get the quality of care they need/deserve as well as supporting their families whose lives have been tragically altered too!
Please send any statistics, documentation and ideas to our personal email; firstname.lastname@example.org
As always, thank you! Your love and support means more than we can tell you.
Love, Corey and the Beattie’s xoxo