Thanks Squeakr,

I have talked w/ John several times today and he asked that I bring you up to date on the issues you raise.

I have been in contact w/ her HR Department, her disability insurance and health insurance coordinators, and her case manager at the hospital. All have been extremely cordial and very helpful.

Right now, the health insurance provider is instructing WakeMed to complete a discharge summary plan to transition Jill to a non-acute care facility. This is based on her current medical state, which is really quite good. But because she still has a feeding tube, and because that can't be removed until it's been in place for at least 4 weeks, she would presumably qualify for a skilled nursing care facility for another 2 weeks or so. This skilled care facility would also be covered by her group health provider.

After the feeding tube is removed and she no longer requires skilled nursing care, she would have to transition again into a convalescence care facility. Unfortunately her health insurance would not cover the cost of convalescent care, so John is in the arduous process of pursuing Social Security disability and medicaid benefits to meet the costs of this care. Jill will have some long term disability insurance available to her, but that will most likely be applied against the level of SSI or Medicaid benefits she otherwise qualifies for. And you are quite right - she can be admitted on a 'benefits pending' basis, though my preference would be to plead for continued skilled care until the qualification process for SSI and Medicaid is complete.

The bit of a bright light is that neuro rehabilitation will be available to her through her insurance provider both in the nursing home and in the convalescent center, as long as she continues to show improvement. This would be true even after she is able to take sufficient care of herself to come home. That is to say, a home health agency will still be available to Jill for rehabilitation. And speaking of improvement - she apparently ambulated 300 feet w/ only stand-by assistance this week!

The hospital's case manager for Jill, working together with Jill's insurance provider (Blue Cross' HMO Blue Care), will give John and Mike the available options for a skilled nursing home probably next week. The family will visit the options and make a choice for Jill. At that point she will be transported to her new home. I expect this may occur as early as mid to late next week. This will be a short term home - maybe 2 weeks to a month at most. I've told John that I can be available to Mike to go down and help him tour the options as they make the choice of a convalescent care facility.

I know I represent us all in offering John and Mike all the help we can give in these difficult times...

[This message has been edited by svpii (edited 12-14-2001).]