CONTACTS
SUBJECTS
Bob Visit Arroyo Grande Community Hospital Recover Knee Replacement
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 12 0000, ref SDS 11 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Talked to Kirk, the nurse, in the Control Center.
040903 - ..
040904 - Kirk said Bob was able to move with the walker this morning only from
040905 - his bed to the door of his room, about 10 feet.
040907 - ..
040908 - Good news!
040910 - ..
040911 - Temperature has come down this morning.
040913 - ..
040914 - Kirk said Bob's temperature was 98.4 with both the skin surface and
040915 - oral thermometers. The staff feels comfortable Bob is now responding
040916 - to treatment after having elevated temperature the past 4 days, since
040917 - surgery on Monday. Kirk indicated Bob is ready for release to get
040918 - rehabilitation. Temp dropping to normal aligns with criteria for
040919 - release from the hospital explained by Doctor Fow last night at the
040920 - hospital, reported on 111103 0709. ref SDS 12 Z23U
040921 -
040922 - [...below Bob reports he has been relocated from Community
040923 - Hospital in Arroyo Grande to Mission View in San Luis
040924 - Obispo, and that his vitals show temperature is now 103.
040925 - ref SDS 0 E692
040927 - ..
040928 - Doctor Ritter, the Infectious Disease specialist consulting with
040929 - Doctor Fow, Bob's surgeon, will examine Bob later this morning to
040930 - release him for discharge from the hospital and transfer to the rehab
040931 - facility. The doctor will decide on implanting a "pic" catheter, so
040932 - that Bob can be treated with antibiotics away from the hospitacl, at
040933 - the Rehab facility and at home by qualified personnel.
040934 -
040935 - [...below on 111104 0952 1710 call from Jeff at Arroyo
040936 - Grande Community hospital, reported pic catheter implanted
040937 - and tested successfully, enabling Bob to be released; he
040938 - was taken to Mission View rehabilitation facility in San
040939 - Luis Obispo. ref SDS 0 05HB
040941 - ..
040942 - Reviewed with Kirk that Doctor Fow indicated last night that Bob
040943 - cannot be treated with antibiotics through an IV at the Rehab
040944 - facility, because they do not have licensed staff for that procedure,
040945 - reported on 111103 0709. ref SDS 12 6T56
040947 - ..
040948 - Kirk said he understands the Rehab Facility where Bob is going can
040949 - give IV antibiotics. He suggested discussing this matter with Doctor
040950 - Ritter, when sees Bob later today.
040952 - ..
040953 - Kirk still has not determined why there was a big disparity last night
040954 - with the modern skin surface thermometer reading 102, and the oral
040955 - thermometer reading only 99.7, reported on 111103 0709. ref SDS 12
040956 - HG6M
040957 -
040959 - ..
0410 -
0411 -
0412 - 1021
0413 -
041301 - Visited Bob. He is configured with the leg bending machine moving
041302 - his leg in a slow bending motion so that adhesions do not form that
041303 - make bending the leg painful.
041305 - ..
041306 - Went through the mail that Bob has received at home this week.
041308 - ..
041309 - While working on the mail, Kirk walked by and said that Doctor Ritter
041310 - will stop by in about an hour.
041312 - ..
041313 - He checked everthing and gave instructions to save some things, and to
041314 - throw others away. Throughout the envelopes as he directed using the
041315 - trash receptical in the room.
041317 - ..
041318 - There were two items that looked like calendars that he decided to
041319 - offer to the hospital staff. He said to put them on the adjacent bed,
041320 - which is empty.
041322 - ..
041323 - Everything else goes back to the house for storage until Bob returns
041324 - home. He said to put the mail on the kitchen counter left of the
041325 - stove. That is where mail and documents have been being placed for
041326 - Bob's review.
041327 -
041328 - [On 111105 0853 at 0922 Robin calls and explains Bob asked
041329 - her to bring his checkbook from house so he can pay bills,
041330 - since he will be hospitalized at Mission View for next few
041331 - weeks. ref SDS 13 NT7M
041333 - ..
041334 - [On 111105 0853 at 1207 explain mail procedures to Allen,
041335 - Bob's brother. ref SDS 13 O743
041337 - ..
041338 - Bob reviewed instructions written out for his brother, Allen, on
041339 - performing household routine, including care for Sandy and listing
041340 - Bob's cell phone number which Allen requested.
041341 -
041342 - [On 111105 0853 submitted instructions to Allen, Bob's
041343 - brotehr, on performing household tasks, and including Bob's
041344 - cell phone number. ref SDS 13 NR73
041346 - ..
041347 - Bob is hopefull he will need only 3 days therapy in the Rehab Facility
041348 - to recover 80% mobility. He feels 80% is enough for him to accomplish
041349 - self-care at home. He then commented that gaining 80% mobility might
041350 - take another full full week.
041351 -
041352 - [...below on 111104 0952 at 1804 Bob now at Mission View
041353 - rehab facility in San Luis Obispo, and reports getting
041354 - notice that he will be getting rehab for 2 weeks; Bob
041355 - reports that he concurs 2 weeks of rehab are likely needed
041356 - before he can go home. ref SDS 0 TR64
041358 - ..
041359 - Agreed with Bob that time to recover from knee surgery is hard to
041360 - estimate. Kirk saying that Bob was able to move using a walker only
041361 - about 10 feet this morning, from his bed to door, per above,
041362 - ref SDS 0 208O, shows a slow rate of recovery over the past 5 days.
041364 - ..
041365 - Yesterday, Doctor Fow indicated in a call that his knee replacement
041366 - patients are not considered safe to go home until they walk 150 steps
041367 - on their new knee joint, reported on 111103 0709. ref SDS 12 QU3I
041368 - Improving 10 feet for week will take 15 weeks to make 150 feet.
041370 - ..
041371 - Bob is now fully committed to getting help at a rehab facility. He
041372 - said that he cannot go home until he is confident about getting in and
041373 - out of bed, sitting in a chair and getting up, and walking across the
041374 - room from one chair to another. This is a significant change in
041375 - perspective from Bob's planning 2 days ago on 111102 0718. ref SDS 11
041376 - OA4L
041378 - ..
041379 - Bob is very disappointed expectations have not been accomplished that
041380 - he would walk out of the hospital 3 - 5 days after knee replacement
041381 - surgery and go home to carry on his life as before, or at least be
041382 - sufficiently mobile to get therapy at home with his dog, Sandy. This
041383 - aligns with his comments last nigth, reported on
041384 -
041385 -
041387 - ..
0414 -
0415 -
0416 - 1055
0417 -
041701 - Said goodby to Bob; will see him later today at his new location in
041702 - the rehab facility.
041704 - ..
041705 - Walked down the hall and asked an attendant if they know the name and
041706 - location of the rehab facility where Bob will be taken later today?
041708 - ..
041709 - Was introduced to a nice, young lady called the discharge
041710 - coordinator.
041712 - ..
041713 - The coordinator said Bob will be taken to...
041714 -
041715 - Arroyo Grande Care Center
041716 - Compass Health, Inc
041717 - 1212 Farroll Avenue
041718 - Arroyo Grande, CA 93420
041719 -
041720 - 805 489 8137
041722 - ..
041723 - Medi-Cal and Medicare licensed.
041725 - ..
041726 - She said that Farroll Avenue is a block South on Halycon Way past the
041727 - stop light on the corner, and turn left. Sounds like less than a
041728 - mile from the hospital.
041730 - ..
041731 - Asked about Community Hospital experience sending patients to Arroyo
041732 - Grande Care Center for medical services that rehabilitate patients to
041733 - full mobility following knee replacement surgery?
041735 - ..
041736 - The coordinator said Community Hospital has a lot of experience with
041737 - Arroyo Grande Care Center. They have excellent rehabilitation
041738 - services, and work closely with Bob's doctor for follow up that is
041739 - needed, since they are only a few blocks away from Community Hospital.
041741 - ..
041742 - The coordinator submitted a brochure explaining Arroyo Grande Care
041743 - Center health services and location. She said Bob will like being at
041744 - the Care Center, because it is close to his home in Nipomo, so it's
041745 - easy for family and friends to visit.
041747 - ..
041748 - Thanked her for Community Hospital being so considerate and thorough
041749 - ensuring quality care for Bob.
041751 - ..
041752 - Drove to Bob's home in Nipomo.
041753 -
041755 - ..
0418 -
0419 -
0420 - 1152
0421 -
042101 - Robin called. She is at lunch, having a hamburger.
042102 -
042103 - Gave an update on Bob's situation, and planning for him being moved to
042104 - Arroyo Grande Care Center later this afternoon, per above. ref SDS 0
042105 - L45H
042107 - ..
042108 - Robin is not familiar with Arroyo Grande Care Center.
042110 - ..
042111 - Explained it is only a few blocks from the hospital on Farroll Avenue,
042112 - per above. ref SDS 0 9E95
042114 - ..
042115 - Robin knows Farroll Avenue. She said that location will be ideal for
042116 - Bob being close so family and friends can visit.
042118 - ..
042119 - Robin asked if Bob's brother is coming up to take care of Sandy, Bob's
042120 - dog, during his rehab?
042122 - ..
042123 - Explained that Allen is coming tomorrow morning.
042125 - ..
042126 - Discussed having a late lunch or dinner tomorrow, so I can drive home
042127 - to the Bay Area in the evening.
042129 - ..
042130 - Robin has tentative plans to visit with friends from out-of-town
042131 - tomorrow. She will corrodinate with them, and let me know tomorrow
042132 - what time she can get together.
042134 - ..
042135 - Robin asked how long Bob will be in rehab.
042137 - ..
042138 - Explained that progress so far indicates he will need rehabilitation
042139 - for a few weeks. Hopefully less, but possibly longer, based on
042140 - discussions with Doctor Fow yesterday that he will not release Bob to
042141 - go home until he walk 150 feet, reported on 111103 0709. ref SDS 12
042142 - EX3F The nurse, Kirk, reported this morning that Bob was able to move
042143 - with a walker from his bed about 15 feet to the door of his room, per
042144 - above. ref SDS 0 L45H
042146 - ..
042147 - Robin has plans for the evening, and so will not visit Bob at Arroyo
042148 - Grande Care Center.
042150 - ..
042151 - I will see Bob at the Care Center this afternoon about 1800, per
042152 - meeting with him this morning, reported above. ref SDS 0 ZV7Y
042153 -
042154 -
042156 - ..
0422 -
0423 -
0424 - 1218
0425 -
042501 - Cindy Johnson called...
042502 -
042503 - 805 929 5654
042505 - ..
042506 - She is the wife of Don Johnson who called yesterday. At that time, I
042507 - did not remember Don, and so told Bob that a Mr Johnson called, and
042508 - assumed he is one of Bob's friends from the gym, like Bill, Rick, and
042509 - others who have called Bob at the hospital.
042511 - ..
042512 - Cindy explained she and her husband Don are Bob's neighbor across
042513 - the backyard fence.
042515 - ..
042516 - Explained that Bob is going into a rehabilitation facility later
042517 - today, and that his brother Allen is coming from LA to care for Sandy.
042519 - ..
042520 - Cindy asked how long Bob will need rehabilitation?
042522 - ..
042523 - Advised Cindy that Bob may need professional therapy to rehab his knee
042524 - for a week, possibly longer, depending on how he responds to therapy.
042526 - ..
042527 - Cindy said she is looking for that kind of work, and wondered if Bob
042528 - would consider her for the job?
042530 - ..
042531 - Cindy said wanted to bring her dog over to visit with Sandy, and
042532 - would that be okay?
042534 - ..
042535 - Asked Cindy if she is a medical professional who can provide specified
042536 - physicial therapy under a doctor's supervision, and/or administer IV
042537 - medications as needed?
042539 - ..
042540 - Cindy said she is not a medical professional. She has cared for her
042541 - mother the past 10 years providing physical therapy and related care,
042542 - so she is looking a job to apply her skills providing in-house care.
042544 - ..
042545 - While we were talking, Bob's phone clicked, indicating another call
042546 - is active.
042548 - ..
042549 - Told Cindy I will pass along her call today, and interest in caring
042550 - for Sandy and Bob.
042552 - ..
042553 - After the call, it seems that Cindy offers an ideal situation who can
042554 - provide the level of care will need after he leaves rehab. Rather
042555 - than Allen coming up from LA, Cindy and Don might be able to take care
042556 - of Sandy while Bob is in rehab, since she already knows the dog, and
042557 - her dog and Sandy play together.
042559 - ..
042560 - Since they are backyard neighbors, the transportation situation is
042561 - ideal.
042563 - ..
042564 - Once Bob is released from rehab, he will need continuing support for
042565 - many months going shopping, cleaning the house, and feeding the dog.
042566 - Cindy seems ideally positioned to do all of this for a reasonable
042567 - rate.
042568 -
042570 - ..
0426 -
0427 -
0428 - 1227
0429 -
042901 - Bob called.
042902 -
042903 - He asked for the phone number of Cindy Johnson, and said to look in
042904 - his black and brown address book in the top drawer left of the stove.
042906 - ..
042907 - Explained that Cindy just called, and that it was her husband Don
042908 - Johnson who called yesterday.
042910 - ..
042911 - Advised Bob that Cindy asked about a job taking care of Sandy and
042912 - helping Bob with his recovery from knee surgery, after Bob is released
042913 - from the rehabilitation fility in a week or two.
042915 - ..
042916 - While we talked, found Cindy's phone number in Bob's address book, per
042917 - above. ref SDS 0 2S9F
042919 - ..
042920 - Bob now seems to be thinking along the lines of employing Cindy.
042922 - ..
042923 - This is the solution we have discussing for 5 weeks, but did not
042924 - Cindy lives so near to Bob and knows the dog. Seems ideal for Bob.
042925 -
042926 -
042927 -
042929 - ..
0430 -
0431 -
0432 - 1233
0433 -
043301 - Called Robin and left message of possible new developments taking care
043302 - of Bob and the dog, per above. ref SDS 0 2S9F
043303 -
043305 - ..
0434 -
0435 -
0436 - 1519
0437 -
043701 - Shari Swartz called
043702 -
043703 - 805 929 8299
043705 - ..
043706 - Shari is a former neighbor who used to live next door to Cindy across
043707 - the backyard fence from Bob.
043709 - ..
043710 - She says Bob has lots of friends who love him and are willing to help
043711 - care for him through his rehabilitation over the next 6 months.
043713 - ..
043714 - Bob has been keeping this a secret from Robin and me.
043716 - ..
043717 - Shari says she knows Robin.
043719 - ..
043720 - Explained earlier call from Cindy, per above, ref SDS 0 2S9F, and Bob
043721 - and called and asked for Cindy's telephone number.
043723 - ..
043724 - Shari said Bob called her about 2 weeks ago, and made arrangements to
043725 - hire Shari's cousin, Terreas, to come clean the kitchen before I
043726 - arrived on Saturday, 111029.
043728 - ..
043729 - This record aligns with understandings from Bob's call with Robin on
043730 - 111030 0916. ref SDS 8 CV9L
043732 - ..
043733 - Advised Shari that Terreas did more than just clean the kitchen. She
043734 - cleaned Bob's bedroom and bathroom, which I had planned to do this
043735 - week.
043737 - ..
043738 - Told Shari to tell Terreas that she did an excellent job under the
043739 - circumstances.
043741 - ..
043742 - Also explained having moved the furniture from the kitchen into the
043743 - garage, and installed the glass shelf in Bob's kitchen garden window.
043745 - ..
043746 - Shari she had offered to take care of these chores, but Bob objected,
043747 - as he did previously on 110917 1420. ref SDS 4 S93N
043749 - ..
043750 - Shari asked how Bob is doing?
043752 - ..
043753 - Explained Bob is being moved from Community Hospital to Arroyo Grande
043754 - Care Center on Farrell Avenue, per above. ref SDS 0 9E95
043756 - ..
043757 - Shari said she is familiar with Arroyo Grande Care Center. She said
043758 - Bob will not like staying there because it is primarily a convalescent
043759 - facility, where senior people go to die.
043761 - ..
043762 - Agreed, that Bob will not like being in that situation.
043764 - ..
043765 - Shari also seemed to indicate that Arroyo Grande Care Center has an
043766 - excellent rehabilitation facility and staff, so that should be helpful
043767 - for Bob, assuming he adjusts to the overall environment.
043769 - ..
043770 - Shari said that Cindy's mom was a very close friend. Shari is
043771 - disappointed with Cindy's care for her mother, and so does not
043772 - recommend Cindy to care for Bob's rehabilitation. According to Shari,
043773 - who lived next door, Cindy took care of her mom until the money began
043774 - to run out, and then "put her in Arroyo Grande Care Center"
043775 - convalescent home and left her die."
043777 - ..
043778 - Shari Bob can be better served by hiring her neice, Terreas.
043780 - ..
043781 - Explained that not being familiear with the circumstances, I will not
043782 - make recommendations that Bob hire one person or another.
043784 - ..
043785 - I will tell Bob that Shari called, and that Terreas is very interested
043786 - and available to help with his care recovering from knee surgery when
043787 - he comes home from the rehab facility.
043789 - ..
043790 - Suggested that Shari call Bob at Arroyo Care Center and say hello,
043791 - and explain options for his care.
043793 - ..
043794 - Gave Shari the phone number per above. ref SDS 0 9E95
043796 - ..
043797 - Thanked Shari for calling, and expressed deep appreciation that Bob
043798 - has many options for getting good in-home care to keep his place up
043799 - and look after Sandy.
043800 -
043801 -
043803 - ..
0439 -
0440 -
0441 - 1552
0442 -
044201 - Called Robin and left message explaining the call from Shari, per
044202 - above. ref SDS 0 9Z3L
044203 -
044205 - ..
0443 -
0444 -
0445 - 1640
0446 -
044601 - Called Arroyo Grande Care Center, per above. ref SDS 0 9E95
044602 -
044603 - Talked to Kathleen.
044605 - ..
044606 - Asked to talk to Bob.
044608 - ..
044609 - Kathleen went off line, and then came online and said that she knows
044610 - about this case.
044612 - ..
044613 - Kathleen explained that Bob was not admitted to Arroyo Grande Care
044614 - Center today, rather he was taken to...
044615 -
044616 - Mission View
044617 - 1425 Woodside Drive
044618 - San Luis Obispo, CA 93401
044619 -
044620 - 805 543 0210
044622 - ..
044623 - Asked why the change? Why send someone who lives in Nipomo 7 miles
044624 - from Arroyo Grande Care Center, to another facility 30 miles from
044625 - home.
044627 - ..
044628 - Kathleen said she is not supposed to discuss it. She said to call
044629 - Community Hospital. They know why this change was made.
044630 -
044631 -
044633 - ..
0447 -
0448 -
0449 - 1649
0450 -
045001 - Called Mission View
045002 -
045003 - Talked to Tony.
045005 - ..
045006 - Tony said that Bob was taken in an ambulance to Arroyo Grande Care
045007 - Center, as reported by the discharge coordinator earlier this morning
045008 - at Arroyo Grande Community hospital, per above. ref SDS 0 9E91
045010 - ..
045011 - Tony then said that Arroyo Grande Care Center refused to take Bob as a
045012 - patient, so he was returned to the Community Hospital. Tony
045013 - understands that Bob is on his way to Mission View, but has not yet
045014 - arrived. Tony does not know what time Bob left Community hospital,
045015 - nor who is providing transportation.
045017 - ..
045018 - Asked why Bob was refused care at Arroyo Grande Care Center to
045019 - rehabilitate following knee replacement surgery at a location less
045020 - than 8 miles from his home, and less than a mile from his attending
045021 - physician, Doctor Fow, and has been taken to a related rehab facility
045022 - 30 miles from his home?
045024 - ..
045025 - Tony said he does not have information on why this was done. He
045026 - suggested asking Bob's doctor, and explained there should be a
045027 - discharge document signed by the doctor with instructions for Bob's
045028 - care at Mission View.
045029 -
045030 - [On 111105 0853 Francis, nurse in Station #2 Mission View
045031 - cannot find Discharge form prepared by Community Hospital
045032 - with instructions for his care at Mission View; making
045033 - inquiries. ref SDS 13 NU4J
045035 - ..
045036 - Thanked Tony for explaining the situation as much as Mission View
045037 - knows.
045038 -
045040 - ..
0451 -
0452 -
0453 - 1657
0454 -
045401 - Called Mission View back, but this time talked to a woman, Laura, or
045402 - something like that.
045404 - ..
045405 - Asked for directions to Mission View from Nipomo.
045407 - ..
045408 - She said...
045409 -
045410 - 1. Drive North on US 101 to San Luis Obispo; about 2 miles
045411 - past the Higera turn-off, get off the freeway at...
045413 - ..
045414 - 2. Los Osos go East (turn right) and drive a block to...
045416 - ..
045417 - 3. Higera go North (turn left) 1 block and turn right
045418 - onto...
045420 - ..
045421 - 4. Tank Farm Road go East about 2 miles and turn left...
045423 - ..
045424 - 5. Broad Streed go North about 2 miles past 1 stop light
045425 - and at next stop light turn right onto...
045427 - ..
045428 - 6. Orcutt road go East past railroad tracks to 1st stop
045429 - light turn left onto...
045431 - ..
045432 - 7. Laurel Lane go North 1 block and turn left onto...
045434 - ..
045435 - 8. South Wood Drive go West 1 block and turn right onto...
045437 - ..
045438 - 9. Woodside Drive go North about a block see...
045439 -
045440 - Mission View
045441 - 1425 Woodside Drive
045442 - San Luis Obispo, CA 93401
045443 - 805 543 0210
045445 - ..
045446 - This seems very complex.
045447 -
045448 -
045449 -
045451 - ..
0455 -
0456 -
0457 - 1710
0458 -
045801 - Received call from Jeff at Arroyo Grande Community Hospital.
045802 -
045803 - Asked Jeff's last name.
045805 - ..
045806 - He said hospital regulations prevent giving his last name, but
045807 - everybody at the hospital knows him.
045809 - ..
045810 - Jeff said that he was told earlier today that Community Hospital
045811 - determined Bob is medically ready for release and so he was driven
045812 - laying on a gurney in an ambulance to Arroyo Grande Care Center, as
045813 - planned earlier this morning, per above. ref SDS 0 9E95 Arroyo Grande
045814 - Care Center called the hospital and said they would not take Bob as a
045815 - patient. Bob was then returned to Community Hospital. Jeff said that
045816 - the hospital has made alternate arrangements, and so Bob was later
045817 - sent Bob to Mission View in San Luis Obispo.
045819 - ..
045820 - [On 111111 0802 Mission View reported they did not receive
045821 - a copy of Bob's discharge documentation from Arroyo Grande
045822 - Community hospital disclosing Bob has infection after
045823 - surgery on 111031, that he required a blood transfusion due
045824 - to low HGB blood counts, nor that Bob had temperature of
045825 - 100.3; as a result, Mission View called and requested a
045826 - copy of discharge documentation prepared by Arroyo Grande
045827 - Community Hospital. ref SDS 15 TC6J
045829 - ..
045830 - [On 111114 0715 Kimbeny in Medical Records Department
045831 - reported that there is Discharge form on file at Arroyo
045832 - Grande Community Hospital for Bob's release from care on
045833 - 111104, and transfer first to Arroyo Grande Care Center,
045834 - and ultimately to Mission View. ref SDS 16 MI6N
045836 - ..
045837 - Jeff's explanation seems to align with...
045838 -
045839 - 1. Kirk's report that Bob's temperature dropped this morning
045840 - to 98.4 from 102 taken last night, per above, ref SDS 0
045841 - L45H,
045842 -
045843 - 2. Doctor Fow advised that Bob cannot be released from the
045844 - hospital until his temperature drops to normal, reported on
045845 - 111103 0709. ref SDS 12 6T56
045847 - ..
045848 - 3. Mission View saying Bob was sent to Arroyo Grande Care
045849 - Center by mistake, per above. ref SDS 0 XR5V
045851 - ..
045852 - Asked the reason entered in Community Hospital records that Arroyo
045853 - Grande Care Center refused to accept Bob as a patient for knee surgery
045854 - rehabilitation? The discharge coordinator this morning seemed very
045855 - enthusiastic about Bob's prospects of getting excellent rehabilitation
045856 - at Arroyo Grande Care Center, per above. ref SDS 0 9E91
045858 - ..
045859 - Jeff said he does not have access to Community Hospital records
045860 - showing the reason Arroyo Grande Care Center gave for refusing to
045861 - provide rehabilitation services for Bob, and sending him back to the
045862 - hospital.
045864 - ..
045865 - Jeff said that within the hour, Doctor Ritter reported in the record
045866 - that Bob completed all of the steps for release to a rehabilitation
045867 - facility, including that patient temperature is "normal." Doctor
045868 - Ritter ordered implanting and testing a "pic" catheter, as planned
045869 - above. ref SDS 0 L28I Yesterday, Doctor Fow, who performed knee
045870 - replacement surgery on 111031, advised that Bob cannot be released
045871 - from the hospital until his infection is resolved shown by his
045872 - temperature dropping to "normal," and further that the decision to
045873 - release Bob from care at the hospital is Doctor Ritter's call,
045874 - reported on 111103 0709. ref SDS 12 6T56
045876 - ..
045877 - This seems conflicting with Community Hospital shipping Bob to Arroyo
045878 - Grande Care Center, then coming back. Logistics getting Bob prepared
045879 - to drive in an ambulance to one facility, him being refused care, and
045880 - returned, and then finding another facility seems likely to have taken
045881 - much longer. Need Discharge record to assess implications of this
045882 - issue.
045884 - ..
045885 - [On 111105 0853 at 1620 Francis, Bob's nurse for physical
045886 - therapy at Mission View Care Center reported there is no
045887 - change in medication that accounts for Bob's noticable loss
045888 - of energy, weak voice, groggy demeanor 1 day after leaving
045889 - care at Arroyo Grande Community Hospital, and that Doctor
045890 - D'Ambruoso is directing Bob's care to recover from
045891 - infection shown by temperature 100.3 on arrival from the
045892 - hospital. ref SDS 13 LM9J
045894 - ..
045895 - [On 111114 0715 Kimbeny in Medical Records Department
045896 - reported that there is Discharge form on file at Arroyo
045897 - Grande Community Hospital for Bob's release from care on
045898 - 111104, and transfer first to Arroyo Grande Care Center,
045899 - and ultimately to Mission View. ref SDS 16 MI6N
045901 - ..
045902 - Jeff said that Bob left in an ambulance for Mission View about 10
045903 - minutes ago.
045904 -
045905 - [On 111114 0715 Debbie called with Apria Medical Supplies,
045906 - and advised that Arroyo Grande Community Hospital purchased
045907 - a walker for Bob and put it in the ambulance with him for
045908 - the ride to Mission View. ref SDS 16 MA5I
045910 - ..
045911 - Asked why Bob was sent 30 miles from his home, rather than get care
045912 - closer to his surgeon at Community Hospital in Arroyo Grande?
045914 - ..
045915 - Jeff said he does not have that information. His job is to call and
045916 - tell the family where Bob has been taken.
045917 -
045918 - [On 111105 0853 Francis, nurse in Station #2 Mission View
045919 - cannot find Discharge form prepared by Community Hospital
045920 - with instructions for his care at Mission View; making
045921 - inquiries. ref SDS 13 NU4J
045923 - ..
045924 - Thanked Jeff for timely guidance.
045925 -
045926 -
045928 - ..
0460 -
0461 -
0462 - 1717
0463 -
046301 - Called Robin and left message that Bob was taken to Mission View in
046302 - San Luis Obispo.
046303 -
046305 - ..
0464 -
0465 -
0466 - 1728
0467 -
046701 - Robin called returning calls, per above. ref SDS 0 ZE6M
046702 -
046703 - Explained recent complications on Bob's discharge from Community
046704 - Hospital to a rehabilitation facility, per above. ref SDS 0 529I
046706 - ..
046707 - Robin is not familiar with Mission View, but thinks she can find her
046708 - way.
046710 - ..
046711 - Decided to visit Bob tomorrow afternoon at Mission View. Afterwards
046712 - will have late lunch or dinner in San Luis Obispo, and I can continue
046713 - home to the Bay Area. Robin feels she can shuffle her schedule to
046714 - accomplish this new work plan for tomorrow.
046715 -
046716 -
046718 - ..
0468 -
0469 -
0470 - 1734
0471 -
047101 - Bob called his landline number at home, while I was talking to Robin
047102 - on the cell phone.
047104 - ..
047105 - He has arrived at Mission View. He does not yet telephone service,
047106 - so he is using cell phone.
047108 - ..
047109 - Bob does not know why his rehab facility was changed from Arroyo
047110 - Grande Care Center a block from the hospital and 8 miles from home to
047111 - a location in San Luis Obispo 30 miles away, per above discussions...
047112 -
047113 - 1. Community Hospital discharge said Bob
047114 - would be discharged for rehabilitation of
047115 - his knee replacement surgery to
047116 - Arroyo Grande Care Center................... 1055, ref SDS 0 9E8M
047118 - ..
047119 - 2. Arroyo Grande Care Center said Bob
047120 - was taken to Mission View in
047121 - San Luis Obispo............................. 1640, ref SDS 0 529I
047123 - ..
047124 - 3. Mission View said Bob was taken to Arroyo
047125 - Grande Care Center in Arroyo Grande by
047126 - mistake and so was returned to
047127 - Community Hospital.......................... 1649, ref SDS 0 XR5V
047129 - ..
047130 - 4. Community Hospital said this afternoon Bob was
047131 - determined medically ready for release to receive
047132 - rehabilitation services; he was sent in an ambulance
047133 - to Arroyo Grande Care Center, but the Care Center
047134 - refused to accept the patient for rehabilitation
047135 - services to recover from knee surgery; as a
047136 - result, Community Hospital sent
047137 - Bob in an ambulance to
047138 - Mission View................................ 1710, ref SDS 0 LB6F
047139 -
047141 - ..
047142 - He indicated having heard something that alluded to the reason, but
047143 - did not say what he heard.
047145 - ..
047146 - Bob said his brother is coming tomorrow. He wants Robin to show
047147 - Allen the way to Mission View tomorrow, so he is familiar with the
047148 - route.
047150 - ..
047151 - This seems conflicting with plan for Cindy to look after Sandy, per
047152 - Cindy's call above, ref SDS 0 OZ32, and Bob's request for Cindy's
047153 - phone number, per above. ref SDS 0 613M
047155 - ..
047156 - Advised that Robin indicates she is not familiar with Mission View.
047158 - ..
047159 - Bob said that Robin was here several times to visit mother, when she
047160 - was a patient at Mission View. Bob said he thinks he has the same
047161 - room today, that mother had in 2007.
047163 - ..
047164 - Told Bob will call him back.
047165 -
047166 -
047168 - ..
0472 -
0473 -
0474 - 1743
0475 -
047501 - Completed cell phone call with Robin.
047502 -
047503 - She heard the discussion that Mission View is where mother was a
047504 - patient.
047506 - ..
047507 - Robin feels now more confident about finding her way there tomorrow.
047509 - ..
047510 - Will stick with the plan Bob proposes for us to help his brother find
047511 - his way to Mission View tomorrow afternoon.
047512 -
047513 -
047515 - ..
0476 -
0477 -
0478 - 1743
0479 -
047901 - Called Bob back on his cell phone....
047902 -
047903 - 805 878 4522
047905 - ..
047906 - Bob said he was informed on arriving at Mission View that the staff is
047907 - planning for him to be onsite for 2 weeks. Bob concurs that his
047908 - progerss this past week, indicates he likely needs another 2 weeks to
047909 - reach his goal of 80% mobility, discussed at the hospital earlier this
047910 - morning when he was hopeful to reach 80% mobility with 3 days of
047911 - rehab, per above. ref SDS 0 WR4H
047912 -
047913 - [On 111109 1032 Bob reports Mission View staff advise that
047914 - infection is delaying rehabilitation so he will need
047915 - continuing care at Mission View past Thanksgiving; he is
047916 - worried that Medicare only pays for 2 weeks, and he will
047917 - incure a huge expense. ref SDS 14 U48O
047919 - ..
047920 - Bob is still planning for his brother to visit at his home for a few
047921 - days, while he works out arrangements to take care of Sandy for the
047922 - next few weeks during rehabilitation at Mission View.
047924 - ..
047925 - This seems conflicting with Bob's call earlier today asking for
047926 - Cindy's phone number, ref SDS 0 613M, who seems like a good candidate
047927 - to care for Sandy while Bob is in rehab at Mission View the next 2
047928 - weeks.
047930 - ..
047931 - Bob said he is worried that Sandy might run off if he is cared for at
047932 - Cindy's across the backyard fence.
047934 - ..
047935 - While this is always a possibility, Cindy might be able to exercise
047936 - some precautions for the 1st few days while Sandy gets used to eating
047937 - at her place. He is already familiar with the place, and the dog.
047938 - Should be an ideal fit.
047940 - ..
047941 - Bob is uncertain. He plans now to put Sandy in a kennel on Thompson
047942 - road when his brother goes home next week on Monday or Tuesday.
047944 - ..
047945 - This planning seems odd.
047947 - ..
047948 - Mentioned to Bob that Shari called and offered services of her neice
047949 - Terreas, per above. ref SDS 0 QX6I
047951 - ..
047952 - Bob said he understands that Terreas is not a licensed nurse and so
047953 - he cannot recover cost of her services from Medicare.
047955 - ..
047956 - Bob said the medical team just walked into his room for a meeting.
047958 - ..
047959 - He will call back.
047960 -
047961 -
047963 - ..
0480 -
0481 -
0482 - 1912
0483 -
048301 - Called Shari, per above. ref SDS 0 9Z3L
048302 -
048303 - Related Bob's concerns that Terreas is not a licensed nurse and so her
048304 - costs cannot be recovered through Medicare, per above. ref SDS 0 JW4V
048306 - ..
048307 - Shari says she is not certain on this point. She said that her
048308 - cousin, Terreas has cared for movie stars, like Elizabeth Montgomery.
048309 - Shari is not certain that Terreas has kept her license current. She
048310 - will ask Terreas to call here in the morning.
048312 - ..
048313 - Shari said that she and Terreas are going to Mission View on Sunday
048314 - to visit Bob and wish him well.
048316 - ..
048317 - They can discuss possibilities for getting the care Bob needs.
048318 -
048320 - ..
0484 -
0485 -
0486 - 1919
0487 -
048701 - Called Bob at Mission View.
048702 -
048703 - 805 878 4522
048705 - ..
048706 - He still has the medical team in the room developing a work plan for
048707 - his care, per above. ref SDS 0 FI5I
048709 - ..
048710 - Bob will call back when the team leaves.
048711 -
048712 -
048714 - ..
0488 -
0489 -
0490 - 1927
0491 -
049101 - Called Robin.
049102 -
049103 - Left a message about discussing scenarios.
049105 - ..
049106 - Advised do not want Bob to have his brother come up from LA and get
049107 - involved in caring for Sandy for only a few days. I can stay a few
049108 - more days and get things in order; if necessary, can put Sandy in a
049109 - kennel, as Bob discussed earlier, per above. ref SDS 0 LP9O
049110 -
049112 - ..
0492 -
0493 -
0494 - 1946
0495 -
049501 - Bob called back.
049502 -
049503 - The medical team just left Bob's room.
049505 - ..
049506 - He said his temperature at Mission View is 103.
049508 - ..
049509 - Temperature 103 is a huge increase from Kirk's report this morning
049510 - that Bob's temperature 98 was had declined abruptly to normal, after
049511 - measuring 102 last night, reported above. ref SDS 0 Q37L
049513 - ..
049514 - Hoping Bob misunderstood, because if temperature 103 is correct, then
049515 - the hospital made a mistake releasing him from care, as explained by
049516 - Doctor Fow last night. 111103 0709, ref SDS 12 6T56
049517 -
049518 - [On 111105 0853 at 1044 Bob advised the medical team at
049519 - Mission View reported that Bob's temperature dropped to
049520 - normal overnight. ref SDS 13 1V3J
049521 -
049522 - ....[correction... temperature 100.3]...
049524 - ..
049525 - [On 111105 0853 at 1620 Francis, Bob's nurse for physical
049526 - therapy at Mission View Care Center reported there is no
049527 - change in medication that accounts for Bob's noticable loss
049528 - of energy, weak voice, groggy demeanor 1 day after leaving
049529 - care at Arroyo Grande Community Hospital, and that Doctor
049530 - D'Ambruoso is directing Bob's care to recover from
049531 - infection shown by temperature 100.3 on arrival from the
049532 - hospital. ref SDS 13 LM9J
049534 - ..
049535 - That is probably why Arroyo Grande Care Center refused to take Bob
049536 - because he is not ready to be released from the hospital.
049538 - ..
049539 - Explained follow up call with Shari that her cousin Terreas is a
049540 - licensed nurse, see above, ref SDS 0 YB5K, which Bob questioned
049541 - earlier, per above. ref SDS 0 FI5I
049543 - ..
049544 - Bob recalled worrying about his brother having to drive up from LA for
049545 - 3 days, while is son is sick in the hospital in LA, which was a big
049546 - concern yesterday on 111103 0709. ref SDS 12 FM6H
049548 - ..
049549 - Suggested I can adjust scheduling to stay in Nipomo another few days
049550 - while arrangements are made to care for Sandy.
049552 - ..
049553 - Asked Bob if he feels Terreas was effective when he hired her to
049554 - clean up the house 2 weeks ago?
049556 - ..
049557 - Bob said he likes Terreas. She did a good job and gets along well
049558 - with Sandy.
049560 - ..
049561 - Explained that Shari and Terreas are planning to visit him at Mission
049562 - View on Sunday. They can discuss arrangemetns to take care of Sandy,
049563 - and I can stay to help make a transition.
049565 - ..
049566 - Bob will think about overnight about calling and telling his brother
049567 - not to come up and stay for 3 days, so that he can be near his son
049568 - being treated in the hospital in LA for spinal meningitis.
049569 -
049570 - [On 111105 0853 discuss plans for helping Bob while
049571 - recovering from knee surgery at Mission View. ref SDS 13
049572 - L45H
049573 -
049574 -
049575 -
049576 -
049577 -
049578 -
049579 -
049580 -
049581 -
049582 -
0496 -