My husband was placed in a skilled nursing facility after 8 days in Scottsdale Osborn Hospital, Scottsdale, Arizona. He was in the hospital after falling and suffering a severe brain injury. He required speech, occupational and physical therapies. When he arrived at the center he could not sit up, stand or walk by himself. He was unable to speak clearly or feed himself. He was incontinent and disoriented.
After 21 days in the center, I was told he could no longer stay there because he no longer fit the Medicare guidelines. I believed them at that time and sought a private group home for him. The therapists working at the center told me he was not ready for release because he still needed much therapy. They also told me they had recorded that information in their reports. I found a group home for him at a cost of $5000.00 a month because of the considerable care he would require.
It was some time before I could take time to investigate what had happened. When I did, I realized he had been released from the skilled nursing center well before he should have been according to Medicare's guidelines. I wrote to HealthNet and requested a reimbursement of at least $9000.00 which would have been for the length of time he was still not functioning and fit more than 3 of the required symptoms for continued coverage. The reply was an apology that they could not help me in any way. Suddenly, however, I received a check from the skilled nursing center for the $1800.00 they had charged me! I had never contacted them, so HealthNet obviously knew all along that I was right. I could use the money they fleeced us of, but mostly I would like to see some action to make them be honest.
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