Lightning damage opens the door for case management

When a lightning strike damaged Debbie Smith’s* home, it also fried the electronic controls of her hospital bed, creating a new challenge for the stroke survivor.

 

She urgently needed a replacement bed, but Debbie had limited resources and was homebound. Her limited mobility and dependence on oxygen made it difficult for her to leave her home to look for a new bed. She previously had been approved for a new bed, but it had not been delivered, despite records indicating she had recently received one.

That’s when Arkansas Blue Cross and Blue Shield social worker Ashleigh Franck and nurse case manager Michelle Simons stepped in. As Ashleigh worked to untangle a complicated web of providers, equipment vendors and home health agencies, she partnered with Michelle to help ensure Debbie received the care and support she needed.”

Before Ashleigh and Michelle became involved, Debbie had struggled for months to get answers and assistance. Multiple providers were involved, creating confusion about where orders needed to be sent and who was responsible for coordinating her care.

For Ashleigh, helping Debbie became much more than completing a task.

“Helping this member was more to me than just a job,” Ashleigh said. “It was about showing compassion to another human being.”

Together, Ashleigh partnered with Debbie to work through a maze of providers, equipment vendors and home health agencies to make sure she received the care and support she needed.

While Ashleigh worked to resolve equipment and vendor issues, Michelle coordinated medical support, helping reconnect Debbie with home health services and additional wellness resources.

“Ashleigh went above and beyond to help,” Michelle said.

Once the referral reached Ashleigh, she made numerous calls and confirmed that the hospital bed listed in the durable medical equipment records had never been billed or delivered.

Meanwhile, Michelle completed both a social work consult and a medical director consult.

When Debbie’s home health services were canceled for several weeks, Michelle maintained close contact with her and was able to get the home health agency to resume wound care. She also arranged for Debbie to consult with a dietitian, receive nutritional education and learn about dietary changes that could support her healing and overall wellness. Once Debbie made those changes, she experienced improvements in her symptoms and well-being.

“Cases like this are why I still love nursing after all these years,” Michelle said. “And working with people like Ashleigh, who care just as deeply and are willing to go the extra mile, is one of the greatest blessings of this work.”

Ashleigh began calling providers and medical equipment companies to determine exactly where orders needed to be submitted and which providers were responsible for moving the process forward. She continued following up to ensure the requests were completed and that Debbie’s needs did not fall through the cracks.

At the same time. Michelle coordinated with home health agencies and other community resources to help ensure Debbie received the assistance she needed to remain safe at home.

As they worked together, they discovered Debbie’s wheelchair was also broken and needed replacement. The pair expanded their efforts to address that need as well.

“Being able to help her remain in her home longer and more comfortably while she faced some of the most difficult challenges of her life made me feel that I truly succeeded,” Ashleigh said.

Their persistence paid off. Debbie received a new hospital bed, a new bariatric wheelchair and ongoing in-home care support.

The impact was immediate.

Shortly after the equipment arrived and home health nurses began visiting regularly, Debbie emailed Michelle and Ashleigh to express her gratitude.

“I don’t have adequate words to express my deep gratitude to each of you for being an advocate for me, listening and simply showing compassion,” she wrote.

“Thank you does not seem to effectively communicate just how much I appreciate each of you … stepping in without missing a beat.”

Debbie went on to praise the professionalism and compassion both employees demonstrated throughout the process.

“During my career, I often told people that it’s not what you do, but the way you do it, and you all have exemplified professionalism, expertise, and provided the highest level of customer service, all while maintaining true human integrity,” Debbie concluded.

For Ashleigh and Michelle, helping Debbie was about more than replacing a hospital bed or securing a new wheelchair. It was about restoring comfort, dignity and peace of mind during one of the most difficult periods of her life.

“My hope is that I made her life a little easier, even if only for a moment,” Ashleigh said.

Based on Debbie’s heartfelt message, that hope became a reality.

*Note: The member’s name has been changed to protect her identity.