Wendy Marcus – The Doctor She Always Dreamed Of (страница 1)
I’m thrilled to be back with two brand-new Medical Romances about Kira and Krissy Peniglatt—two very special sisters who work hard to care for and give to others without expecting anything in return.
In
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I hope you enjoy reading Kira’s and Krissy’s stories as much as I enjoyed writing them! To find out about my other books visit WendySMarcus.com.
Wishing you all good things,
The Doctor She Always Dreamed Of
Wendy S. Marcus
This book is dedicated to my cousin, Justine De Leon, in honour of her becoming a US citizen.
We love you and we’re so happy you’re here!
With special thanks to Barbara Kram for helping me run through some HMO insurance fraud scenarios.
Any errors are my own.
Thank you to my wonderful editor, Flo Nicoll, for always pushing me to do my best.
And thank you to my family, for supporting me in all that I do.
WENDY S. MARCUS is an award-winning author of contemporary romance who lives in the beautiful Hudson Valley region of New York, where she spends way too much time indoors on her computer. Writing. Really! Okay … more like where she spends way too much time on Twitter and Facebook! To learn more about Wendy, and the books she’s managed to write in spite of her social media addiction, visit WendySMarcus.com.
Contents
“I WANT TO speak to the man in charge.”
Kira Peniglatt closed her eyes and pinched the bridge of her nose. “You’ve reached the woman in charge,” she told the angry older gentleman on the telephone who’d been yelling at her and making unreasonable demands for the past ten minutes. “I’m the Director of Case Management here at We Care Health Care.”
No sooner were the words out of her mouth than she regretted them. When talking with disgruntled customers, must remember to use WCHC instead.
“We Care Health Care,” he mimicked. “What a crock!”
If she had a dollar for every time she’d heard that or something similar over the past five years, she’d be a wealthy woman, retired at the age of thirty, living by a lake or a beach, somewhere far away from the crowds and smells of New York City. This job she now hated, her tightwad boss, and harassing phone calls from angry people would be nothing more than a distant, unpleasant memory.
“You don’t care about me,” the husband of client Daisy Limone went on. “And you sure as hell don’t care about my wife or you’d be sending someone to help me take care of her. I can’t do it all by myself. Three days in and my back is aching from all the lifting, my knees are swelled up from all the bending, and my hips are on fire from running up and down the stairs all day.”
Kira wanted to scream, “You brought this on yourself you ornery old man, now deal with it!” But she’d always prided herself on her professionalism, regardless of the challenging circumstances. Lately circumstances had become quite challenging.
By pulling his wife—she glanced at her computer screen: Primary diagnosis: cerebrovascular accident with residual right-sided hemiparesis and expressive aphasia. Secondary diagnoses: hypertension, osteoporosis, and hypothyroidism—out of an inpatient rehabilitation facility, against medical advice, nine days into an authorized twenty-eight-day stay, he’d assumed full responsibility for her care. Before the patient’s stroke she’d filled out a Health Care Proxy designating her husband as her health care agent, giving him complete control over decision-making should her doctor determine she was unable to act on her own behalf—which she wasn’t. As a result, there’d been nothing the hospital staff could do.
“Mr. Limone, your wife wasn’t ready to come home.” He’d underestimated the amount of care she would require, despite being warned—according to hospital documentation—by the case manager, the social worker, a head nurse, and the patient’s physical and occupational therapists. “Research shows, after a stroke, patients who attend independent rehabilitation facilities for intensive rehabilitation, before returning home, show much more improvement than those who don’t.”
“She wasn’t happy there, Miss Peniglatt. She put up a fuss every time they tried to take her to therapy. She wouldn’t eat or drink.” Now, rather than an ornery old man, he sounded like a concerned old man in love with his wife, desperate to help her. “They were threatening to put a tube in her stomach. Neither of us wanted that. She kept saying, ‘home’. She’d squeeze my hand and look into my eyes and say, ‘home.’ Over and over. So I took her home.”
Kira’s heart went out to him, really, it did. But there was nothing more she could do. “Your insurance plan won’t pay for round the clock care in the home setting.”
“Who’s asking for round the clock? Millie James up the street, her mama’s got an aide six hours a day, seven days a week, and she don’t need nowhere near as much help as my Daisy.”
“Do you have any family—”
“My boys don’t live around here. And they’re busy. They got their own lives.”
Family takes care of family. Kira’s mother had been telling her that, and Kira had been doing it, for as long as she could remember.
“Is there any other insurance coverage we could help you explore?” she asked.
“We don’t have no other insurance. All we have is We Care Health Care. And we need for you to do what your ad says and be there for us when we need you. We need you!”
When marketing had proposed a change to We Care Health Care, We’ll Be There When You Need Us, Kira had voiced her concern that the slogan might feed into unrealistic patient expectations. Case in point. “Then can you afford to pay privately for a personal care aide? I could—”
“Why should I have to pay for an aide when I’ve been paying you every month for years?”
He made it sound like he paid her directly. “Mr. Limone, you pay for medical insurance coverage that does not include custodial care such as bathing and dressing provided by personal care aides,” Kira said, trying to keep calm. “What about a friend or a neighbor? Have you asked around? Maybe—”
“You sit there in your fancy office,” he snapped, “trying to think up ways to get out of paying for the stuff you should be paying for. Then you count up the huge profits you make by withholding care from people who need it and divide the money up into big end-of-year bonus checks. You’re a thief! How the hell do you sleep at night?”
Kira inhaled then exhaled. Don’t let him get to you. You do your best. You sleep fine at night. No she didn’t.
“Mr. Limone, as I explained earlier, your insurance coverage is Medicare HMO. Medicare pays for short term, intermittent, skilled care. It does not pay for personal care for bathing and dressing. We contracted with a Medicare Certified Home Health Care Agency in your area.”