CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 12 0000. ref SDS 11 0000.
040502 -
040503 -
040504 -
040506 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Bob Cut Loose by Mission View Refusal Treat Surgery Complications
040902 - Mission View Refuse Treat Surgery Complications Release Bob Saturday
040903 - Bob Release Saturday Mission View Refuse Treat Surgery Complications
040904 -
040905 - Follow up ref SDS 12 PY4M.
040906 -
040907 - Background, briefed Robin in letter last night, reported on 111117
040908 - 0017. ref SDS 13 SO7Q
040910 - ..
040911 - Bob called.
040913 - ..
040914 - He does not sound strong nor enthusiastic this morning.
040916 - ..
040917 - Bob advised that his neighbor in the adjacent bed is being moved to
040918 - another room, so he will company with a patient, after Bob is
040919 - discharged tomorrow. Bob further explained that his roommate is
040920 - getting treatment for several broken bones caused by falling at home.
040922 - ..
040923 - Discussed briefly knee replacement surgery increases risks of falling
040924 - and suffering additional injuries, when patients have not had
040925 - sufficient rehabilitation, cited previously by Mission View staff,
040926 - e.g., Laurie on 111111 0802 at 0852, ref SDS 9 574F; Laura in Physical
040927 - Therapy later on 111111 0802 at 1822. ref SDS 9 FH64
040929 - ..
040930 - Bob feels he will be okay at home, because the Doctor told him
040931 - yesterday that he has done much better than expected.
040933 - ..
040934 - Asked how far he has walked without his walker, indicating ability to
040935 - function independently at home?
040937 - ..
040938 - Bob said he cannot walk at all without his walker. This clarifies his
040939 - report a few days ago seeming to indicate he has walked without his
040940 - walker, reported on 111116 0959. ref SDS 12 PY5X and ref SDS 12 T85G
040942 - ..
040943 - Bob said today he is working in rehabilitation to use the walker with
040944 - his "natural gait," rather than being hunched over and dragging his
040945 - leg that had knee replacement surgery.
040947 - ..
040948 - Bob said his big challenge is standing still vertically to perform
040949 - routine tasks, like get a glass of water at the sink, turn on a light
040950 - switch, fix meals etc. He feels this will improve with the aid of a
040951 - physical therapyst coming in 3 times a week for a few hours of
040952 - professional care.
040954 - ..
040955 - Asked Bob if the pic catheter has been removed from his arm, which was
040956 - implanted at Arroyo Grande Community Hospital so that Bob can get
040957 - essential advanced hospital treatment with IV antibiotics and blood
040958 - draws to treat his infection, blood clots, and low blood counts,
040959 - reported on 111104 0952 at 1710? ref SDS 6 ZF40
040961 - ..
040962 - He said no, that he is still getting IV treatments, including today.
040964 - ..
040965 - Asked about his report on Wednesday that the IV pole was removed from
040966 - his room?
040968 - ..
040969 - Bob said he does not recall saying the IV pole was removed from his
040970 - room, previously reported on 111114 0715. ref SDS 10 U28O
040972 - ..
040973 - Bob clarified today that he has continued getting IV antibiotics to
040974 - recover from infection since his arrival on 111104. He is worried
040975 - that continued infection will slow his recovery.
040977 - ..
040978 - Bob said that Mission View told him they have scheduled a meeting for
040979 - Bob to see Doctor Ritter next week on recovering from infection.
040980 -
040981 - [...below on 111118 1005 at 1723 Bob reports meeting with
040982 - Doctor Ritter deferred until after he meets with primary
040983 - care, now scheduled for next Tuesday. ref SDS 0 IJ7I
040985 - ..
040986 - Asked if Allen is taking Bob home tomorrow?
040988 - ..
040989 - Bob said Allen is scheduled to pick him up at 1100 tomorrow.
040991 - ..
040992 - Asked if he has practiced to get in and out of the car with his
040993 - walker, so everything goes smoothly tomorrow? Typically, the health
040994 - care provider will transport Bob in a wheel chair, so he does not fall
040995 - on the grounds creating additional liability.
040997 - ..
040998 - Bob feels there should be no problem getting in and out of the car.
040999 -
041000 -
041002 - ..
0411 -
0412 -
0413 - 1240
0414 -
041401 - Called for Ken at...
041402 -
041403 - Mission View - Room 211
041404 - 1425 Woodside Drive
041405 - San Luis Obispo, CA 93401
041406 - 805 543 0210 ext 311
041407 -
041408 -
041410 - ..
0415 -
0416 -
0417 - 1249
0418 -
041801 - Rachael came on line. She said Ken is helping a patient into a room
041802 - down the hall. She said to hold on.
041803 -
041805 - ..
0419 -
0420 -
0421 - 1252
0422 -
042201 - Ken came online.
042203 - ..
042204 - Ken recalled meeting at Mission View this past Monday on 111114 0715
042205 - at 1413. ref SDS 10 SH5O
042207 - ..
042208 - Ken said that since Monday, Bob has made remarkable progress, and so
042209 - he concurs with discharge tomorrow.
042211 - ..
042212 - Asked about Ken's report last Monday, that Bob's rehabilitation was
042213 - behind schedule due infection suffered following knee surgery, shown
042214 - in the record for 111114 0715 at 1413? ref SDS 10 SA31
042216 - ..
042217 - Ken recalled saying on Monday, that Bob will likely need another 2 - 4
042218 - weeks of rehabilitation services at Mission View. He is adaement
042219 - today that Bob has done much better than expected at that time.
042220 -
042221 - [On 111119 0933 Bob home after discharge from Mission View
042222 - shows good ability to handle walker, and to sit and get up
042223 - from chairs. ref SDS 14 NM77
042225 - ..
042226 - Ken confirmed that Bob cannot walk at all yet without the walker, per
042227 - Bob's report above. ref SDS 0 EL80 Ken said knee replacement patients
042228 - can take months to recover ability to walk without the walker. He
042229 - feels that walking without a walker is not required to release
042230 - patients for tertiary care at home.
042232 - ..
042233 - Ken said Bob will be examined by the surgeon at the end of the month.
042234 - The doctor can assess progress and additional care needed at that
042235 - time.
042237 - ..
042238 - Relayed Bob's concern about standing to do routine tasks, per above.
042239 - ref SDS 0 7N9I The family is worried about Bob suffering a fall like
042240 - his roommate, as Bob related this morning, per above. ref SDS 0 3U8F
042242 - ..
042243 - Asked how Bob can prepare a meal and get it to the table using a
042244 - walker? Doesn't standard of care correlate to patient circumstances,
042245 - as Ken seemed to relate in the meeting on 111114 0715? ref SDS 10 JM4H
042247 - ..
042248 - Ken said he is surprised to hear this. He sees Bob using the walker
042249 - expertley to walk around the ward without assistance of a therapyst.
042250 - He explained that Bob will continue to improve muscle strength doing
042251 - exercises designed and supervised by an at-home therapyst.
042253 - ..
042254 - Ken said he would object to Bob being discharged tomorrow, if he
042255 - determined Bob cannot function adequatley at home. Ken explained
042256 - that being at home can accelerate rehabilitation, because of familiar
042257 - surroundings and not being couped up in a small hospital room.
042259 - ..
042260 - Concurred that Bob is anxious to get better so he can go home.
042262 - ..
042263 - Ken explained that Mission View will assign a professional therapyst
042264 - to treat Bob 3 times a week at home. The at-home therapyst will make
042265 - recommendations for home improvements that enable Bob to live safely
042266 - at home getting around for months with the aid of a walker.
042268 - ..
042269 - Ken said the Physical Therapy Department prepares daily reports
042270 - showing patient progress, work plans, and recommendations. These can
042271 - be obtained through the medical records department.
042273 - ..
042274 - Thanked Ken for providing care, and conveyed family appreciation that
042275 - Bob has made remarkable recovery to be released tomorrow.
042276 -
042277 -
042278 -
042279 -
042281 - ..
0423 -
0424 -
0425 - 1310
0426 -
042601 - Called and left message for Bob about discussion with Ken, per above.
042602 - ref SDS 0 014W
042603 -
042605 - ..
0427 -
0428 -
0429 - 1344
0430 -
043001 - Called Shari about visiting tomorrow.
043002 -
043003 - 805 929 8299
043005 - ..
043006 - Shari originally called on 111104 0952. ref SDS 6 9Z3L
043007 -
043008 -
043009 -
043010 -
043012 - ..
0431 -
0432 -
0433 - 1448
0434 -
043401 - Called Apria Medical Supplies, returning call from Debbi on 111114
043402 - 0715. ref SDS 10 MA5I
043403 -
043404 - 805 783 7413
043406 - ..
043407 - Talked to Debbi
043409 - ..
043410 - Explained Bob is being discharged from Mission View tomorrow and
043411 - needs a walker that can help him carry food and things around the
043412 - house.
043414 - ..
043415 - Debbi said that Bob needs a "Rollator" walker. Her explanation was
043416 - like the walker I got after heart surgery on
043417 -
043418 - [...below on 111118 10005 at 1143 Bob feels he doesn't need
043419 - enhanced walker assistance. ref SDS 0 VA4R
043420 -
043421 - [On 111123 1847 Bob encounters problems using standard
043422 - walker, tried his cain, and got fatigued. ref SDS 15 YY5H
043424 - ..
043425 - Debbi said that Apria needs a prescription from Doctor Fow's office
043426 - explaining Bob needs more than the standard walker.
043428 - ..
043429 - Asked Debbi to coordinate with Doctor Fow's office to get a
043430 - prescription for the rollator walker.
043432 - ..
043433 - Debbi said Apria policy prevents the sales department from assisting
043434 - patients get prescriptions for Apria products.
043436 - ..
043437 - We reviewed advantages of Debbi calling Karen in the doctor's office
043438 - asking her to faciliate the prescription.
043440 - ..
043441 - Debbi will call the office manager for permission to contact Karen on
043442 - this.
043443 -
043444 -
043445 -
043447 - ..
0435 -
0436 -
0437 - 1547
0438 -
043801 - Called Debbi back.
043802 -
043803 - She said Medicare will not pay for walker with a seat. As a result,
043804 - secondary health insurance carrier will not pay for the walker.
043806 - ..
043807 - Debbi said they have Rollator walkers in stock.
043809 - ..
043810 - Baseline price is $180. Debbi is trying to get a better price for
043811 - Bob.
043813 - ..
043814 - They can deliver to Mission View today for Bob to take home tomorrow.
043815 -
043816 -
043818 - ..
0439 -
0440 -
0441 - 1554
0442 -
044201 - Called Bob.
044202 -
044203 - Explained Debbi's proposal at Apria Medical Supplies to get him an
044204 - enhanced Rollator walker with brakes, a seat, and basket for carrying
044205 - food, a drink, books, groceries, etc., as discussed with Debbi at
044206 - Apria Medical Supplies, above. ref SDS 0 EZ8M
044208 - ..
044209 - The cost is $180, because Medicare will not pay for it. Offered to
044210 - pay for it so he can have a good start continuing tertiary rehab at
044211 - home next week.
044213 - ..
044214 - Related background of getting a Rollator walker at VA. Fortunately, I
044215 - didn't need it, but Millie said bring it home for her. She really
044216 - loved it.
044218 - ..
044219 - Bob said he doesn't need it, because he will eat at the breakfast
044220 - counter. He feels he only needs to get from room to room, and so has
044221 - no need for additional assistance.
044223 - ..
044224 - We discussed his long-time practice eating while watching television
044225 - in the living room. He likes to go out and the the paper in the
044226 - morning. Many routine daily tasks entail carrying things.
044228 - ..
044229 - Bob said don't worry, everything will be okay. He will be very
044230 - careful, and so there should be no problems.
044231 -
044232 - [On 111123 1847 Bob encounters problems using standard
044233 - walker, tried his cain, and got fatigued. ref SDS 15 YY5H
044235 - ..
044236 - Bob said that Robin is coming over on Saturday to fix dinner for him
044237 - and Allen. Bob said that Allen now plans to stay until after
044238 - Thanksgiving. He objected that Allen should be with his family during
044239 - the holidays. He seemed very pleased that this family support will
044240 - get him off to a good start figuring out how to manuever around the
044241 - house with his walker.
044243 - ..
044244 - Cited advantages of having brakes and a seat to stop and rest using
044245 - the walker. This might be beneficial to avoid falling from fatigue
044246 - while standing, which Bob cited is a concern, in his call this
044247 - morning, per above. ref SDS 0 7N9I
044249 - ..
044250 - Bob was adament that he has no risk of falling because rehabilitation
044251 - has advanced his mobility much faster than expected, so he does not
044252 - want an enhanced walker.
044254 - ..
044255 - Bob did not seem open to considering the Rollator walker, so this
044256 - subject was ended.
044258 - ..
044259 - Related talking to Ken this afternoon, and he concurs that Bob's
044260 - rehabilitation has progressed remarkably faster than expected, since
044261 - this past Monday, per above. ref SDS 0 L16I
044263 - ..
044264 - Bob said he has not worked with Ken. He has been working with other
044265 - physical therapysts.
044267 - ..
044268 - Bob said he now has a meeting scheduled with his primary care doctor
044269 - on Tuesday.
044271 - ..
044272 - He explained the meeting scheduled with Doctor Ritter for next week,
044273 - cited earlier today, per above, ref SDS 0 V24K, is now deferred
044274 - pending coordination with primary care on Tuesday. Bob went on to say
044275 - that he contacted Doctor Ritter's office and was told that since
044276 - Doctor Ritter has previously treated Bob at Arroyo Grande Community
044277 - Hospital, that the doctor can see Bob without a referral from primary
044278 - care. At this time, Doctor Ritter's office is working on scheduling a
044279 - meeting next week for Bob with Doctor Ritter.
044281 - ..
044282 - Bob said he does not have a CBC lab scheduled for Monday, to implement
044283 - treatment plan to evaluate infection and low blood counts that require
044284 - another blood transfusion, planned last Friday, on
044285 -
044286 -
044288 - ..
0443 -
0444 -
0445 - 1628
0446 -
044601 - Called Debbi back at Apria.
044602 -
044603 - She has good news.
044605 - ..
044606 - She talked to Karen at Doctor Fow's office after all. The doctor is
044607 - sending over a prescription for Bob to get the Rollator walker, per
044608 - planning in the call above. ref SDS 0 EZ90
044610 - ..
044611 - Additionally, her office manager said to send the walker to Bob.
044612 - Apria will bill Medicare. They expect Medicare will pay for
044613 - everything except the seat. As a result, Bob will only to pay for
044614 - the seat, which costs $56.
044616 - ..
044617 - Said this sounds like a great seat??
044619 - ..
044620 - Debbi laughed, and said it's just an accounting thing.
044622 - ..
044623 - Explained that Bob says he does not need an enhanced walker, because
044624 - rehabilitation has advanced more rapidly than expected. He feels a
044625 - lot better today, per above. ref SDS 0 VA4R
044627 - ..
044628 - Debbi said her dad said the same thing when he was discharged from
044629 - rehab. A week later after being home and struggling with the
044630 - conventional walker, he ordered the Rollator walker and loved it.
044632 - ..
044633 - Decided to proceed getting the prescription from Doctor Fow. Make
044634 - all arrangements to place the order. After Bob gets home, he can
044635 - better assess requirements based on experience.
044636 -
044637 -
044639 - ..
0447 -
0448 -
0449 - 1733
0450 -
045001 - Called Shari back...
045002 -
045003 - 805 929 8299
045005 - ..
045006 - Continuing call from this afternoon, per above. ref SDS 0 QL6J
045008 - ..
045009 - Explained Bob being discharged tomorrow, and that tomorrow is his
045010 - birthday.
045012 - ..
045013 - Shari will stop by around 1700, can't stay long, due to other
045014 - commitments.
045015 -
045016 - [On 111119 0933 Shari and friend, Patrick, arrive for Bob's
045017 - welcome home/birthday party. ref SDS 14 EH6J
045019 - ..
045020 - She said that Terreas is in San Diego, so she can't come.
045022 - ..
045023 - Shari seemed aware that Bob will hire Terreas for home care.
045025 - ..
045026 - Explained that Robin is fixing dinner, spagetti around 1700.
045028 - ..
045029 - Reviewed Bob's patient profile, reported in the record on 111116 0959.
045030 - ref SDS 12 NG5L
045032 - ..
045033 - Shari asked shouldn't Bob be in a hospital?
045035 - ..
045036 - Explained that Bob wants to come home. The medical team wants to
045037 - discharge him on grounds he has made miraculous progress since Monday,
045038 - per telecon with Ken earlier today. ref SDS 0 014W Appears
045039 - conflicting with standard of care for Bob's patient profile, discussed
045040 - with Missoin View staff, shown in case study on 111116 0959.
045041 - ref SDS 12 JT58
045043 - ..
045044 - Shari said she will get a birthday card, and stop by tomorrow
045045 - welcoming Bob home. She said Bob is very determined and strong, so
045046 - he may come through okay.
045047 -
045048 -
045049 -
045050 -
045051 -
045052 -
045053 -
045054 -
045055 -
045056 -
045057 -
045058 -
045059 -
0451 -