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Part 3: Mom's Condition when She Moved to MCE

Before being discharged from Legacy Willow Bend, Mom was evaluated by a physician and the therapists there.

Let's take a look at some of the information in the discharge reports so we can establish the condition she was in when she moved to Mustang Creek Estates (her "baseline" condition). Note that all of the following information was provided to Mustang Creek Estates when Mom moved in.

The following are excerpts from over 600 pages of records we have from Legacy Willow Bend; these are the last reports and discharge orders.

 

From the above discharge orders, you can see that Mom needed quite a bit of assistance, and she was supposed to continue to have Occupational Therapy and Physical Therapy and have Home Health Care.

Also note that she was supposed to see her doctor within 7 days of being discharged.

Finally, note that there is absolutely no indication of her needing hospice care.

Let's continue...

This was Mom's medication list. We were told by Samantha that the caregivers at MCE would give Mom her medications on schedule and record everything.

Note here that while Mom was taking several pain medications, nothing she was taking was strong enough or powerful enough, if given in the right dosage, to "knock her out." The strongest thing she took was Tramadol, but she often complained that even that didn't do much good. It never helped her sleep - indeed, nothing did. Very many nights she hardly slept due to the pain she had in her back and legs.

Let's continue...

Note in the above that the physician stated "Resident may attend all activities as tolerated."

Continuing...

The following are excerpts from her care plan at Legacy Willow Bend... Note the Goal Date on these...2/11/2020. Yet as stated above, Medicare basically kicked her out of rehab at the end of December.

Continuing, the following discharge summary (incorrectly dated 12/27/2019 - it was actually 12/26/2019) noted that Mom needed continued therapy and was making slow progress. As the last paragraph notes, what we were planning on, based on what MCE's representative promised us, was that Mom would receive 24 hour care.

 

The last few pages above detail her physical condition - note that she was "in no apparent distress"; she had a "normal respiratory rate...with no distress"; normal cardiovascular conditions; etc.

Continuing, the following discharge summary (incorrectly dated 12/27/2019 - it was actually 12/26/2019) noted that Mom needed continued therapy and was making slow progress. As the last paragraph n

Finally, we come to the discharge summary from her physical therapists. Note that the PTs recommended her go to acute rehabilitation for further therapy, but Medicare did not approve it, apparently because they didn't want to pay for it.

The paragraphs just above are very important. Consider what is written for Patient Response: "Maximum improvement is yet to be attained and Patient is making consistent progress towards reaching ST and LT goals."

And next to Supervision: "Patient is making slow gains towards short term goals and now introducing sliding board instead of hoyer."

Then Rehab Potential: "Potential for Achieving Goals: Good"

Finally, Continued Skill: "Continued PT services are necessary in order to increase functional activity tolerance, minimize falls and increase LE ROM and strength in order to enhance patient's quality of life by improving ability to safely return to ALF (Assisted Living Facility) and prepare for transfers."

So, to sum it all up, the family was optimistic that Mom would improve. It might take her awhile, but Mom was a trooper - and we knew could do it. After all she had been through and overcome the past year, she could do this.

And Mustang Creek Estates - or at least their sales director, Samantha, and Executive Director, Rachel S. - promised us that they would help Mom, that they would provide that care that the doctors said she needed...24 hour care. And she would have Home Health Care come to help...and physical therapy. It sounded like exactly what Mom needed.

If they had not promised us these things, would we have chosen to move her there? Absolutely not.

Some promises are too good to be true.

Continue with Part 4.