A Report On Hospitalization

This writer agreed to meet with the patient as she missed group and her scheduled individual session with this writer. The patient apologized to this writer for her absence and then reports about transportation issue. This writer discussed with the patient about her MVA this month on the 18th and the status of obtaining a police report. The patient reports, " I can get the police report by the next appointment. I just have to go to my insurance company that isn't too far from where I live to get a copy of it."

Based upon the information provided, it has been determined that: the requested admission/day(s) is not/or are no longer medically necessary because: After review of the clinical information provided by North Shore University Hospital -Manhasset, the Medical Director has denied your admission to North Shore University Hospital - Manhasset. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 58 year old male, with a pre-authorized outpatient procedure on 09/02/2015 for a cardiac catheterization with an intervention, which was converted to an inpatient level of care. Based on the Interqual criteria (a decision based program to determine medical necessity) this procedure does not require an inpatient level of care, therefore, it does not meet criteria.

There is pain with lumbar flexion and extension. There is no aberrant behavior. The patient feels that he can perform increased activities of daily living with his current medications.

Reporting party (RP) stated he arrived at the facility to meet with resident George Dixon (7/11/52) on 3/29/17. Resident was recently placed at the facility after being released from the hospital. Staff did not allow RP to enter the facility so that he could conduct his metal health assessment for the resident. RP presented his business card from his agency but was still denied entry. The resident has been enrolled in RP's program since 02/01/16 and has been visited previously by Social Worker Kathy Kleinman and by staff Denise Ramirez on 3/10/17. Staff told RP that he has to contact the administrator to make an appointment to visit with resident. RP's agency faxed over the consent for treatment to the facility and the DMH contract. Patient's

:01 PM-3:00 PM SC received a telephone call from Pa states that she was discharged to home on 1/22/2016 from PowerBack Rehab, and she wants her services to start again. SC asked Pa when she was discharged from the hospital. The Pa reported that she was discharged to rehab on 12/22/2015. The Pa stated that she needs someone to help her with her personal care and home management. SC asked Pa where Quintella is (Pa’s DCW/dtr). The Pa reported that she don’t know but she is gone and not coming back. SC informed Pa that the SC spoke with the DCW/dtr Quintilla Bentley on 1/14/2016 and she reported that she (Pa) was scheduled for surgery on the same day 1/14/2016. The Pa exclaimed that whatever she reported was not true. The Pa reported that she had surgery on the 12/14/2015. The SC

Conservative treatment notes included aquatic physical therapy, acupuncture, narcotic pain medications, Transcutaneous electrical nerve stimulation (TENS or TNS), psychologist, and hypnosis. The patient also has tried and failed multiple over-the counter and prescription remedies for her opioid induced constipation including diet modification, stool softeners, and laxatives including Miralax, Senokot, Metamucil. Ducalax. It was noted that Movantik is being provided to help her with this situation. As per interval changes, the patient complains of ongoing neck and left upper extremity pain, and an increase in low back and left lower extremity pain. Patient states that she fell at home 2 weeks ago. She states that she injured her right arm and it has been swollen for 2 weeks. The pain score is 10 without medications and 2 with medications. The medications prescribed are keeping the patient functional, allowing for increased mobility, and tolerance of activities of daily living, and home exercises. Current medications incldue Nucynta, Percocet, Restoril as necessary for insomnia, Cymbalta, Neurontin, Cselebrex, Robaxin, Prilosec, Singulair, Vagifem, and

Michael escorted patient #1974 to Supervisor office as the patient appeared to be upset with regard to her recent HOLD. According to the patient, she complained about her assigned counselor placing her on HOLD for unscheduled sessions and this has occurred on two separate occasion. The patient then reports that on 05/8/2017- an appointment was schedule, but the patient cancelled and was told by Michael that she will receive a phone call to reschedule the appointment but no call was made. In addition, the patient shared that her assigned counselor did not fax her UDS result to DCF/Housing Worker. The patient requested to be reassigned with a new counselor. This information was relayed to Michael pertaining to the patient response. According

I believe that the Hospitalist Project or the Comprehensive Care Program is the ideal program for me. It will be an opportunity for me to involve myself in clinical research as well as obtaining valuable experience that will aid me down my life path.

RT came to the MOP office early to meet with writer and was not aware of his appointment with Dr. Vukasin. However, RT stayed at the TSI office until he met with Dr. Vukasin. RT wasn't too happy about sticking around, but writer encouraged RT to stick around and informed him that it is important that he attends his appointments. Writer inquired about RT's physical and RT informed writer that he still has not got in contact with his PCP. RT provided writer with the telephone number for Hillside Focus Care located at 170-06 Hillside avenue, Jamaica NY 11432. RT claims that Hillside Focus Care was the last place he went to see a medical doctor. Writer contacted the medical office with RT present but writer was unable to schedule the appointment

The patient presents with chronic neck and low back pain status post MVA in 2008. He was ran off the rode while on his motorcycle fracturing his neck and lower back. Mr. Buchanan denies having radiating symptoms down either lower extremity. His pain is constant throughout the day making it very difficult to perform his daily activities. The patient has not had injection therapy or surgeries for his neck and back pain. The patient was told after his last MRI that he has arthritis in both his neck and lower back.

The facility that I work, is near a poor area. As the result, ones in my facility have the chances to take care the homeless with drug addictions. These people have the government insurance to cover all the payment and by law, the facility needs to provide the safest place for them. The placement would become an issue for the facility. When they are medically stable but no safe place to go, the facility still cannot discharge them. People who need acute hospitalization may need to be put on the waiting list. These people have normal competencies without any disability but they use the medical resources as hotel services. While they like, they stay; while they do not like, they leave or assault health-care workers. In addition, they have the

As early as the 1990’s, outpatient care only made up for 10 to 15% of a hospital’s total profits, compared to inpatient care. Since the start of the twenty-first century, this figure has increased to approximately 60%. This shift in healthcare has been occurring in different medical organizations such as university medical centers, local hospitals, for-profit chains, and not-for-profit suppliers. The increase in outpatient services compared to inpatient has been showing no indication of slowing down. The main reason for the development in outpatient care is because of all the medical advancements in techniques and technology that allow for patients to be treated less invasively. Health care organizations are now being compensated in a

This is a 58-year-old female who required inpatient hospitalization due to: came walking to the Emergency Department moaning and noted on distress referred from an urgent care today for further evaluation as she had a room air saturation of 91% and a chest x-ray that showed positive for pneumonia. She went to a MED7 for evaluation prior to coming to the Emergency Department, presented with right-sided chest pain from coughing for the past 3 days, which already brought up yellowish sputum and where she was found to be febrile and hypoxic. She thinks she may have illness from one of her young grandchildren, who have been sick with upper respiratory infections lately. Her medical history was significant for small cell lung carcinoma with metastasis

SC completed monitoring telephone call with the Pa’s dtr/CG Marvit on 2/24 /2016. The SC asked how the Pa is doing. Marvit informed the SC that the PA is doing “okay”. Marvit reported that the Pa don’t use her topical pain medication as much anymore because her ribs are healing now. The CG reported that the Pa is doing really good lately and that may have something to do with her son visiting her from Lebanon for a month. The CG reported that she received the transportation information that the SC mail about CCT and Logisticare. The CG stated that she reviewed and will use them soon. The SC asked if Pa is getting out satisfying her social need and she said yes when the days are nice the Pa go out with her son and other dtr. The Sc asked how is

Per progress report dated 5/02/2016, patient continued to complain of constant pain but is overall doing better. He has pain in the axial neck and low back. The pain radiates only intermittently, rated as 5/10. The pain is relieved with Norco without side effects. The pain medicine relieves pain to a 2/10 which allow performance of grooming and cleaning. On examination, lumbar spine range of motion is limited with 45 degrees flexion due