My mother experienced a medical emergency while attending a family event in Orlando, but she is not an Orlando resident and has never lived there. Our consistent and intended plan has always been for her to return to Miami, where she resides and where all of her established providers are based.
My mother has lived in Miami her entire life and was residing with me prior to her hospitalization. All of her established medical providers are within the Baptist Health of South Florida network in Miami, and her care has consistently been centered there.
During SNF Review, we clearly communicated that her safe and appropriate discharge destination was her home in Miami, where her long-term support system and full medical team are located. However, we encountered significant barriers that we believe were driven more by insurance and administrative factors than by her clinical condition. I was not given a meaningful opportunity to fully explain or advocate for these circumstances during the decision-making process.
Additionally, I was provided with inaccurate information by Stacie, who stated that my mother had been living with my sister. This is not true. My mother has never lived with my sister. My sister is a Cape Coral resident and not an Orlando resident, and she was not part of my mother's living arrangements prior to this hospitalization. This misinformation contributed to confusion during an already complex review process.
We transitioned her insurance from Oscar to United in an effort to address limited provider acceptance and ensure continuity of care. Although she was technically in-network with both insurances, the facility still refused her and then claimed concerned with the switch. Why would I keep her under Oscar if no one was taking her under Oscar? It made more sense to change insurance to one that was more widely accepted. Mind you, this has been her ONLY insurance change.
From our perspective, SNF Review did not adequately take into account her long-standing Miami residency, her established care within the Baptist Health of South Florida system, or her documented medical history. It felt that non-clinical factors had an outsized influence on the process, which was extremely distressing during an already difficult time.
This has been a deeply disappointing experience for our family. We hope that future patients receive more consistent, patient-centered SNF Review planning that prioritizes medical history, established care networks, and the patient's home residence. read more
