Frank* is a 48-year-old man who has a traumatic brain injury and was in a skilled nursing facility. After four years of treatment he was finally well enough to return to the community with his family. He applied for home and community-based waiver services and was approved in July. Frank was excited to be going home, but everything changed when his nursing home transition (NHT) stalled and a COVID-19 outbreak erupted in the nursing facility.
Frank’s family had been working with his managed care NHT team in an effort to bring him home to live with his sister. They requested home adaptations, such as a ramp, but his managed care organization (MCO) reported timeline delays due to COVID-19. The family requested a needs assessment, but they were told the assessment could not be completed in a timely manner. All the while, Frank who had been excited to return safely to the community, began to grow anxious about staying in the facility any longer due to a COVID-19 outbreak. That’s when Frank’s sister called PHLP.
PHLP worked with the MCO’s legal team to expedite Frank’s discharge and assure his needs assessment was completed and he would have the services needed in the community. We worked with his family to come up with an alternative plan to return Frank safely to the community, without the concern of waiting for home modifications and an uncertain delay. Lastly, we worked with the nursing home transition team to ensure they had all the correct information.
Frank returned to the community safely. He is now living in an apartment with personal assistance services, and the support of his family. Fortunately, Frank did not contract COVID-19 while waiting to transition. He is happy and healthy, enjoying time with his sister’s dogs, and grateful for PHLP’s representation.
*Name has been changed