Lcd And Cma Case Study

SC received a telephone call on 10/16/2015 stared 9:34 and end at 9:41 am from Tricia Crooks at Liberty Resources Home Choices (LRHC) Community Outreach and Enrollment Leader. Stating that she spoke Pa and he wants to resume his service order with LRHC for PAS service. SC informed SC that this information will first need to verify with Pa. SC expressed concerns about LRHC being able to fulfill service since they had the case unstaffed for over two weeks (09/25/15-10/15/2015). Tricia apologized on behalf of LRHC, and stated that they have someone assigned and is ready to go all is needed is the resumed service order ASAP. SC again explained to Tricia that Pa has to confirm this besides Pa was very adamant about switching provider because the

On this date worker made an unannounced visit to the residence of Mr. Lawson Lovett, for the purpose of linking Mr. Bobby Lovett with VA nursing home application and information. When worker arrived, Mr. Bobby Lovett was cutting grass. Before worker could exit vehicle Mr. Bobby Lovett came to worker's car. Worker exited the vehicle and explained the reason for her visit. When worker gave Mr. Bobby Lovett the nursing home application he gave it back to worker and asked worker if she could help him fill out application because he did not have much education. Worker explained to Mr. Bobby Lovett she would assist with the application. However, he would need to gather documentation and sign application for Mr. Lawson Lovett since he was POA. Mr. Lovett gave worker his number and told her to call, they would set up a time to fill out

During interview Ms. Stoker was alert, aware of surroundings, and answered all questions appropriately and independently. During the visit Ms. Stoker dry heaved into a garbage bucket, and visited the restroom once. The worker was at the residence for about 2 hours. Initially Ms. Stoker was shaking uncontrollable to the point of shaking the entire bed. At the end of the visit the shaking had stopped and Ms. Stoker was smiling and interaction with worker while talking about DELETEbeing a wife and mother. During visit Ms. Stoker received a call from Alacare Home Health. She informed them she was out of her pain medicine but did not inform them she was out of all medicine. Alacare called the pharmacy and was informed she did

Background- The scenario in question involves a 77 year old widowed woman, Mrs. Zwick. Mrs. Zwick had a mild stroke, and was admitted and hospitalized as a inpatient for five days to ensure her condition was mitigated. After the five days, Mrs. Zwick was transferred to a skilled nursing facility for rehabilitation. However, Mrs. Zwick was uncomfortable, and tests revealed that she had manifested a hospital-acquired urinary tract infection. This infection was serious enough to require IV antibiotics and extended care for an addition forty days in the nursing facility. Upon discharge, Mrs. Zwick was prescribed several medications and had to get a walker. Due to her age and circumstances, Mrs. Zwick is enrolled in Medicare A, B and D she is not able to handle her bills and paperwork, so her daughter helps out. Mrs. Zwick and her daughter both were unaware that the urinary tract infection was considered a hospital-acquired condition all the nursing staff told them was that it had to be medicated.

He reports the patient’s roommate was subsequently evicted from his home after the landlord inquired about the ambulance visiting. He reports he contacted her father concerning the patient residing within the family home, but the father has said no. In addition, he reports he has attempted to contact her uncle but has been unable to make contact with him. He reports he has attempted to make contact with her said friend who is considering allowing her the opportunity to reside with her but she has not answered her phone and he has been unable to leave a voice message. He reports no one wants her in their home, and the patient has “burned her bridges” with family members. He reports her family would benefit from counseling. In addition, he reports her family has high expectations of CPS. He reports her current case was not going to close within 12 days of 06/30/2017. In addition, the case will not

On 9/15/2016, CM met with the client for Bi-Weekly ILP Review. Client was dressed appropriately for the weather. She was well groomed. As usual client in the meeting was loquacious, and loud. Client continues to be hostile towards this worker. Client continues to repeat to this worker as quote: "I am not mad with you, and this has nothing to do with you. It's all about DHS and your supervisor." Client was hostile due to an Authorization of Release Form client signed for staff to contact her therapist Dr. Iris Yankelevich for a copy of the client psychosocial and psychiatrist evaluations. Client continues to report that she didn’t signed the Authorization of Release Form because the form stated that the form is for HRA 2010e and she doesn’t know how many time she need to repeat herself that she doesn’t meet the ‘CRITERAI FOR SRO”. CM tries to explain to the client that staff is requesting a copy of her psychosocial and psychiatrist evaluation, but then client continue to talk over CM and threat to contact the Coalition and DHS. Client continues to set in her way and refuses to work with staff to meet her unmet needs. CM observed that the client walk with a book bags and a small shopping cart. Client reported she walk with all her documents and letters from Adult Protective Services & Social Security Administration stating that she is capable of living independently.

CCIB Intake received a call from resident Eugene Kunz DOB 2/8/24 in room #6. Mr. Kunz call to state he wanted to remove his daughter Joyce as his Power of Attorney (POA) and pay his $3000 rent each month. According to the caller he has residing in the facility for approximately 3 1/2 years and wanted to return to his home, however due to his slight dementia he was having difficulty with his memory and therefore could not return to his home. Conversely the caller described how his daughter would have him examined by physician who would give him 3 words at the beginning of his examination and at the end would ask him the 3 words. Unfortunately the caller could never recall the 3 words and thus was unable to return to his home. Recently the caller

On 03/11/2016 SC met with Pa in her apartment for a RA visit. Pa 's Agency Model PAS aide was not present while SC was there. The Pa appeared poorly groomed and dressed in dark color clothes. The apartment was dirty and cat litter and feces on the table and floor. All utilities are in working order. The Pa reported numerous hospitalizations between Temple University and Episcopal University. The Pa did know the exact dates of admission and/or discharge. However, the Pa stated that reasons for admission were either asthma exacerbation; COPD and/or fluid around the Lungs. The SC placed call to Temple University Hospital medical records department and inquiries about Pa admission and discharges. The SC was placed on hold for a long time and when the SC did speak with the receptionist she stated that most of the Pa admission was at Episcopal Hospital Temple University and she did not have the time to go over every admission she provided the SC with the medical records department telephone number for Episcopal. The SC thanks her for her time and end call. The dates of ER visits and hospital admissions are as follows: 11/2015, 12/2015, 3/1/2016-3/4/2016, 3/5/2016-3/6/2016; and two ER visits 2/29/2016 and 3/7/2016 at Temple University. SC reviewed Pa’s services and per Pa he is receiving services in the type, scope, amount, frequency and duration as specified in the ISP. But the SC reasons to doubt that the Pa is receiving service according to the ISP. The SC arrived at the Pa’s

The patient is very independent in his home and is able to perform all ADLS within the home without any addtional assistance. MSW asked patient if he was interested in any addtional care giving support in the home, but patient declined addtional support at this time. Patinet stated he gets transportation from his neiabors to the store when needed. MSW offered the patient additional transportation services, but the patient declined needing any addtional transportation services at this time.Patient reported falling back in 2004 off the steps and was air lifted to the hospital. Patient reports having diffculty paying doctors and helicoter bills. Patinet's only income is through SS for $847. Patient reported that was the only time he was fallen in his life. Patinet has only been in the hospital two times during his lifetime. MSW offered life alert services, but the patient was not interested. Patient stated his only concern was being able to afford his doctor and helicotor transportion bills. MSW connected AHCCCS and spoke to represtative regarding getting patient signed up for the medicare savings program. Representative stated the patient has already applied for AHCCCS back in

Client Medicaid is active and she is under Fidelis managing Care. She also submitted NY State of Health Correspondence dated 8/15/2015, stating that the client is eligible to purchase qualified health plan at full cost through NY State Health. The eligible period is effective 9/1/2015. Client reported she already has medical service through Fidelis Medicaid Manage Care

SC asked Soon if Pa could stay late on 1/14/2016 for SC to visit and will she be able to provide her with transportation home. Soon stated that she can try by she can’t promise that. SC thanks Soon and told her SC will discuss above information with SCS and call her at a letter time. SC called with Soon 12 minutes. SC consulted with co-worker about the day care policy and she confirmed that after 4.5 hrs a provider can bill for a full day because it includes transportation. This conversation lasted for several minutes. SC tried to find reading martial about this policy but was not very successful. SC placed call to Active Aid Solution and spoke with Tanya who reported that they had received the service order a while back but it did not include an installation. SC informed Tanya that’s SC had completed service order the installation but SC was not able to put it in before 2/1/2016. SC informed Tanya of this and she stated that the device was installed back in October, 2015. So she was asking SC to back date the service order to match the service delivery

Case manager met with client to develop and issue an independent living plan, which indicated client must apply for public assistance benefits within three business days. Client agreed to apply for full public assistance benefits. Client received and signed and appointment notice, which indicated, the appointment date, time, location, and travel directions. A metrocard was provided to client to attend this appointment. Client was notified that he/she must provide proof of applying by 19/13 Client understood and agreed to apply for PA on 1/2/13 and provide proof on 1/2/13 the client was also notified to comply with all follow up HRA appointments to maintain an active public

The reporting party (RP) stated resident Juanita Knee was placed in the facility by Dignity Healthy on 11/23/16. While present in the facility the resident was hit by a caregiver during the night (name of caregiver was not provided). Subsequently the resident is currently terrified. Additionally the resident has not been given her medications and her oxygen has not been set up. According to the RP the resident has not been able to make her own medical decisions. Consequently the Dignity Health worker (Marguerite, (916) 631-3753) who placed the resident in the facility is contacting law enforcement on the caregiver. CCIB Intake LPA McGaskey contacted APS Pam Ng for additional information will be unavailable until December 5, 2016; contacted

Pa confirmed that there is no duplication of services. Waiver is the payer of last resort for services. Pa reported that his back-up plan that the agency will send a replacement aide if needed has not been utilized, Pa reports that is services are not available, his son, Ralph, will come to assist him, these back up plans remain effective and has never been used per Pa. SC called the Dynamic Home Health Care PAS provider agency and reported that the aide has not shown up for the day and she would the Pa to call out leaving him without proper coverages. The receptionist took SC information and stated that the director of the Waiver service was not in as yet and will have all SC. The called meal site and spoke with Lavern, who resumed Pa’s HMD and set it up for Friday delivery. SC called Theresa the nutritionist at DaVita Dialysis and informed her that the Pa HDM will begin starting 5/13/2016. SC called back Dynamic Home Health Care and spoke with the director of Waiver services. The SC informed her of the Pa’s claims about the aide calling him when she will not be at work instead of the agency so that they can send

During the home health observation day, there were several opportunities to observe a variety of patients with varying levels of functioning ability, different illnesses, and different needs and levels of interaction with the nurse. The first patient seen was a seventy-three year old Caucasian female with an ulcer on her right heel. Several weeks prior, she had scratched her left leg and she also had several small wounds on her left leg. The orders were to clean and redress the ulcer. She has a history of end stage renal disease, pneumonia, weakness, diabetes, dialysis, and right hip fracture. Upon entering the home, the patient was found to be sitting in a wheel chair in the living room watching television with her husband close by her side. She greeted the nurse with a smile and began to update her on her current condition. Her heel was “hurting” and she rated her pain an 8 on a scale of 1 to 10. She also had some “swelling” that she could not “get to go away; because, she could not get up and walk. They need to fix my foot so that I can get up and get around.” She told the nurse that she had been to see the doctor “yesterday” and the doctor had given her a written order that she wanted her to see. The order was written for an evaluation for a soft pressure shoe fitting. The nurse read the order to