My mom Rita was admitted to Windham Hospital with a fall and subsequent brain bleed and was transferred to Hartford Hospital on November 2nd because of a possible drainage that Windham Hospital was not equipped to handle and later fortunately did not happen. She was admitted through the ER and spent 2 days in ICU. I might add that she had excellent care in the ER and ICU. When she was transferred out of ICU to the 5th floor that is when the negligence started. She was a high risk fall case from the beginning with a fractured wrist and consistently and repeatedly they left off the alarm on her bed. I might add she had Alzheimer’s which was documented in her chart. When I observed this negligence I decided to stay in the hospital with her. Constantly there was negligence with leaving the alarm off which resulted in her getting up several times while I fell asleep at night and then awoken by her standing in the dark with potentially would have led to a fall. Aides would come in at night to get her out of bed to go to the bathroom and pull her up by her fractured arm. On two occasions I talked to the head nurse without anything changing. I had to remind them on a daily basis to bathe her and so forth. They made her repeatedly wait long durations for pain medication. I might add this all happened when I was there, I imagine the worse if I wasn’t forced to stay with her 24/7. On Friday, November 8th I demanded to talk to the Nursing Director and conveying my information to her and told her that I was going to transfer her back to Windham Hospital where she originally was and told her if I was billed for the ambulance charge I was not paying for it. The Nursing Director pretty much begged for me to give them one more chance and have her transferred to another floor. I told her why would I trust them on another floor when I reported this twice to the head nurse and nothing was done. It took over 8 hours to transfer her on a cold winters night that did not happen till almost 8:00 p.m. She was transferred to Windham Hospital. I might add that Windham Hospital although small gave her outstanding care, the care that Hartford Hospital should have to any patient. Since then my mom has died and I am faced with paying $1,700 dollars for an ambulance bill that Medicare has denied because of medical necessity and that I did not need to have if they had taken proper care of my mom.
Secondly, follow the guidelines for Medicare appeal in the Medicare summary notice, and make sure you send the appeal/challenge within the time specified and by certified mail.
This will likely take several months (it did when I filed an appeal). The medical necessity should be explained by what you felt was hospital negligence, and therefore necessitated transfer to a more responsible hospital.
Good luck.