In March 2004, I received a letter from my folks' HMO stating that their Primary Care Physician, Michelle Seo, had requested that my folks be kicked out of the Advocate Health Care provider network. The letter referred to a breakdown in the doctor-patient relationship. They were given a choice of three other network regions, the closest one being an hour or so away.
I called Seo's office, and spoke with one of the nurses. She told me that the decision had nothing to do with Seo, but was in response to my having filed a complaint with the Illinois Department of Professional Regulations against two Advocate doctors, David Kushner and Abkar Khan.
Kushner had been my mother's hospitalist (attending physician) at Advocate Lutheran General Hospital when she was admitted there in April 2003. He was one of the doctors who ignored her medical history, and inspite of my protests, he took her off of a medication.
My mother had not been eating because she was in a great deal of back pain. Kushner told me that he had taken her off the medication because it causes anorexia. I explained to him that it was the pain that was causing her "anorexia", but he ignored me. He also refused to consult with the specialist who had prescribed the medication.
Prior to her hospitalization for the back pain, the biggest problem that we had had with my mother was that she would try to walk around without her walker. After two days in Lutheran General, she was rendered incontinent, and was never able to walk again. She eventually had to be placed in a nursing home.
Khan was the attending physician at Governor's Park in Barrington, IL. That was the nursing home she was sent to ostensibly for sub-acute physical therapy. She had been discharged from the hospital after two days, and had been diagnosed as having a compression fracture in her back. I never was given any proof of this, and had I not been busy having a heart attack, I would have appealed her being discharged so soon.
While at Governor's Park, she was given so much pain medication, that she was somnolent. Consequently, she was not enthusiastic about doing any physical therapy. She did have a history of mild multi-infarct dementia, which was exacerbated by the drugs. I pleaded with Khan to intervene, but without any luck. There were many more problems at Governor's Park, but since I was not as famiiar at that time with the Appeals process, I made some errors in reporting the problems.
Considering that CMS did not enforce the regulations about Appeals, I do not know if I would have had any luck if I did make my complaints about Governor's Park properly.
She was first discharged from Governor's Park in May 2003, at which time she was so doped up that she could not sit up in the car. I brought her from the back of the place to the front, and requested that she be checked back in. They did so as a "favor", but only for several days, until I could find a nursing home to place her in.
It is important to mention that the staff at Governor's Park were insistent that she had Alzheimer's. They ignored me when I told them that the drugs were causing her to be so confused. On top of that, I later found out that she had had a bladder infection while at Governor's Park, and that that could have contributed to her confusion too.
I found a nursing home to place her in, because there was no way that I could have attended to her at home anymore. She survived two years there, and I will touch on that in another post. However, after about a month or so, she was finally backed off on the abundance of meds that she had been prescribed in Governor's Park, and literally within a day or so her cognitive ability bounced back. Unfortunately, she remained incontinent and unable to walk.
CMS had to approve my folks being disenrolled from Advocate, and Weisberg once again gave Advocate her blessing. Her account of why they were disenrolled was in line with Advocate's official (fact free) reason, and the language that she used to describe the reason sounds like collusion. In a August 2004 letter to me, Weisberg wrote that my "behavior" had caused my folks to be kicked out of the network. She just could not resist getting in a dig at me.
More CMS BS from Weisberg
