Dear Amy Imbesi's Friends, Colleagues, and Family,
Why we’re reaching out to you:
On April 4, 2021, Amy fell at his home and suffered a C5 neck fracture. He was rushed to Harborview Medical Center and had emergency surgery. He was in ICU for a couple of weeks with no movement from the neck down. From ICU, he was transferred to the rehab unit and slowly making steady improvement. With the help of speech therapy, he is currently able to now eat a soft to normal diet and with physical and occupational therapy along with his determination to improve, he is now experiencing some movement of his left leg and left arm/hand, but not quite able to bear weight on that side. The right side of his body is not yet responding. For those who aren’t intimately familiar with Amy’s history, he was already paralyzed on his right side as a result his 2006 stroke(details below).
Given the severity of the trauma from his fall and subsequent spinal cord swelling, the Drs tell us there is no guarantee he will gain full use of his left arms/hands/leg/feet. While Amy has been in the hospital, we have been working with the social worker to make plans for his discharge, which is scheduled for May 6th.
It's really unbelievable and infuriating that Amy's insurer (Kaiser Medicare) is only covering 3 weeks of inpatient rehab for a quadriplegic.
Once his maximum out of pocket deductible of $5,600 is met, his insurance will pay for approximately 80% of some items like a power wheelchair, hoyer lift, and hospital bed, but 0% for bathroom equipment like a tilt in space shower, commode chair (for going to the bathroom and showering), incontinence supplies, and additional necessary ongoing supplies.
Amy has Kaiser managed Medicare and it has been a constant battle as they do not cover skilled nursing facilities (SNF), adult family homes, and assisted living. If Amy had regular Medicare, another private plan, or most versions of Medicaid, then he would be covered for a SNF stay for after completion of inpatient rehab.
On May 6th, Amy will be discharged from HMC to an adult family home on Mercer Island so to be close to the kids. He will require 24-hour care and an adult family home is the only place he will be able to receive this kind of care. The plan is for him to continue his rehab therapy and have home health care through Kaiser while at the adult family home.