|
Representative Managed Care Cases
Managed care many times has caused tragic problems for the elderly. At Maloney and Maloney we handle numerous cases involving managed care, such as Humana Gold Plus, a Medicare replacement product that is supposed to cover skilled nursing home care in the same way that Medicare would cover the care. Unfortunately, many times adequate skilled care has been denied to managed care patients by managed care doctors, to the tragic detriment of the patient. For example, we observe tragedies where an elderly person has a stroke or needs a surgical procedure and afterwards requires skilled care in a skilled nursing wing of a nursing home. When this is limited by managed care doctors who receive financial incentives to limit hospital and skilled nursing days, and the resident is placed instead on a custodial wing, dire consequences can result.
Some of our managed care cases include:
An elderly woman who lived alone taking care of her mentally retarded son suffered a stroke. After her acute hospitalization she was transferred to Manor Care Health Services where she suffered a twenty pound weight loss in three weeks and her Humana doctors repeatedly tried to discharge her out of skilled care rehabilitation services to place her in a non-skilled custodial unit. Over the strong objection of the family, she was transferred out of skilled care and placed in a custodial unit at Southeast Nursing and Rehabilitation Center where her dehydration worsened and reached a panic level that went unaddressed. She was dead within two weeks from her transfer.
An ambulatory patient living at home entered the hospital for bowel obstruction surgery and was sent to Broadway Lodge and Convalescent Center. After only one week of skilled nursing care the Humana doctors transferred him to a custodial wing. In a period of three weeks he suffered a twenty pound weight loss, developed profound dehydration and pneumonia and passed away soon thereafter.
A patient who lived alone fell and developed a subdural hematoma requiring surgical intervention. After the acute hospitalization he was given less than two weeks of skilled care before being transferred to custodial care at Memorial Medical Center. He proceeded to develop ten Stage IV decubitis ulcers, gangrene, osteomyelitis and required amputation. During the two and half months at the custodial care facility his Humana doctor never visited until the day before he was transferred out for amputation, after the resident's brother said the stench was unbearable.
A woman operated for a bowel obstruction was transferred to the skilled unit at Normandy Terrace Northeast. After only eleven days she was transferred from skilled care into custodial care even though her wound had opened up and she had signs of infection. Her Humana doctors said the dressings on her wound no longer needed to be sterile and her wound could be cleansed with tap water instead of saline when she was in custodial care. A staff witness described maggots in her wound. She died of massive sepsis.
Personal Injury Practice List
|
