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Mom's battle with illness ended — but did Carolinas Healthcare System care? 

And I thought her Alzheimer's was disheartening

A year ago, after a horrific battle with Alzheimer's, two mini-strokes, a ruined 50-year marriage, two serious falls and a broken hip, my mother died at age 88 in a Charlotte hospice care facility after having first spent a couple of days at CMC-Pineville hospital. By the time of her death, Mom's physical and mental health, as well as that of her second husband, whom I'll call Pop, had consumed 20 months of my life, energy and, at times, my sanity.

You might say this is all a private matter, but I've heard from enough fellow baby boomers who have navigated the netherworld of failing parental health to feel that someone could be helped by reading my story, a now common generational tale.

Mom and Pop lived near Kannapolis. I was an only child. In August 2012, I began driving to and from Cabarrus County daily, tending to M&P's declining health. Pop fell in the tub at home, causing bleeding around his brain. A month later, he left the hospital in Concord and headed to a rehabilitative nursing facility, where he soon caught C.diff, a potentially fatal intestinal infection most commonly contracted in, of course, nursing facilities. He stayed alternately in the facility and the hospital for the next four months.

During this time, Mom was generally alone at home, where her outlook and mental condition darkened considerably. Her muddled mental state made it imperative to get her out of her housebound solitude, and so began a process of checking out various assisted living centers. By late November 2012, my family and I moved her into a nice, well-run assisted living center in Charlotte that was as helpful as it was expensive.

Within a week, she was diagnosed with Alzheimer's, and I started driving her to regular neurologist visits.

Mom's move to Charlotte, however, involved making some dreadful choices. I found out within a couple of weeks of Pop's hospital admission that he had blown all their money in the past three or four years and taken on an additional, breathtaking amount of credit card debt (with nothing to show for it). Now their choices would be more limited than I had ever imagined.

In September, the doctor at the Concord hospital told me that Pop had less than six months to live. Assuming, then, that Pop's demise was imminent, I placed Mom in a pricey place, thinking that her husband wouldn't be joining her later. The doctor was wrong. Pop survived, and when he left his second stint at the rehabilitation facility, Mom had only been at the assisted living center three months. I scrambled to find an affordable place for both of them. With limited funds available, the best they could afford was an "independent living" facility where they could purchase most of their meals — and where, as Mom put it in a moment of lucidity, "They sure don't do much for you here."

I hoped against hope for the best, but things went south pretty quickly. Pop started yelling at Mom regularly, accused me regularly of "stealing all our money" (to which I always replied, "What money?"), and denied that he had run up massive debts, despite the bills placed in front of him. When I asked him if online gambling was the financial culprit, his face registered shock, then he told me to leave, slamming the door to their apartment in my face. In July 2013, he told me that he would no longer help Mom with her medications, nor prepare food for her, and I reached my limit. That evening, my son and I helped Mom move out of the facility and into our home. Not long afterward, Pop broke off all contact with me, I dissolved my power of attorney for him, and I haven't seen him since. Yes, I hate it, but, no, I don't miss him.

My wife and I took a crash course in caring for someone with Alzheimer's, but we had no idea how very hard, intensely stressful, saddening, soul-jarring and detrimental to our own domestic peace the experience would be. Mom — whose habit of walking around silently while ignoring us led to a new nickname, "The Ghost" — was with us for eight months. It seemed like five years. I'll leave writing about details of those disturbing, through-the-looking-glass days until I have time to produce a War and Peace-sized tome. Suffice it to say that it was both the worst experience of any of my family members' lives, but also the right thing to do.

By the time she died last year, Mom had outlived all her close nearby friends and at times was lonely or angry about the lost friendships. But she needn't have worried; now that her long string of bad luck and bad health was over and her ashes scattered, Mom found another friend — one who would write her regularly, despite her death. It was Carolinas Healthcare System (CHS), and she would hear from them repeatedly in the next year.

A couple of months after Mom's death, my primary care physician told me that the symptoms I had come to her for — anxiety, difficulty focusing, strange dreams of my mother talking loudly to dead relatives (something she did while living with us), distractedness, avoiding important decisions — sounded like Post-Traumatic Stress Disorder. I'm still dealing with that.

CHS didn't help things. I had mailed the healthcare giant a letter within a couple of weeks of my mother's passing, informing them of her decease and including a copy of her death certificate. Nonetheless, CHS started sending Mom a notice every two months, at my address, the last place she had resided.

The notices informed her — or her corpse or her soul or however they saw it — how much money was still owed for her last stay in hospital. I thought the mailings were a thoughtless intrusion and an unnecessary, cruel reminder of Mom's demise. Hopefully, this will be the last one, I thought after each notice arrived. After all, CHS had Mom's death certificate, they knew she had left no estate, and sooner or later, somebody would surely figure out that the death certificate meant this particular dead person would not be sending them a check. But no. The notices came every 60 days for nine months, were appropriately stewed over for a couple of days, and then were trashed.

In January 2015, after the insurance company had settled Mom's bill with CHS, we (or rather she) started receiving bills for the remaining $700 on her account. I couldn't believe what I was seeing, but my wife reminded me, "You know, it is Carolinas Healthcare; you read those Observer stories."

She meant a recent set of articles showing that since 2013, CHS has filed more than 2,700 lawsuits to collect unpaid bills — including a number of suits against low-income patients without health insurance, which is contrary to new laws aimed at protecting poor patients. It's a self-inflicted, public relations pie-in-the-face for CHS, which is, after all, a nonprofit system. Add on top of that everyday stories about CHS' aggressive tactics against the patients they don't sue; and the stories about the $8 billion system's top 10 executives making more than $1 million per year, and it's easy to understand CHS' image of a business with a split personality: Great treatment and service on the front end, harassment and tough-guy tactics later on.

When I received the third consecutive monthly bill for my mother's remaining $700 balance, I realized that my hopes of CHS just going away wasn't going to happen, so I called. After finding my way to a human being, I told the first person I spoke with that CHS was still sending bills to a woman who had been dead nearly a year. Her reaction was, "Oh my God, no. I am so sorry, that's awful."

She could not, however, guarantee that the bills would stop, so I worked my way up to a VP in the accounting department, Neil Wbodyka. He explained what had happened: Until the bill is settled with the insurance company, reminders are sent every 60 days to the patient, death be damned; after the insurance company pays what it's going to pay, the rest of the bill should be "adjusted," i.e., wiped out. That didn't happen in Mom's case because one of CHS' accounting reps did not follow the usual process and so she (or I, since she had died) began receiving bills for the $700 left over after insurance.

Wbodyka apologized and said, "This should not have happened at all."

I accepted his apology but asked what would be done to ensure that no other patients, or patients' survivors, would be treated in such a way.

"We will have a meeting with the rep in question and counsel him on how to handle the situation correctly," said the VP.

"And that's it?" I asked, hoping to hear of a more aggressive plan to do away with such customer-alienating practices. Yep, that was it, just counseling the one rep. And of course, the $700 due amount was wiped off the books.

And that's where the latest chapter in the long, long trail of unpleasantness ended, so maybe I should be happy. But I'm not. As I told Wbodyka, I feel it is unconscionable for CHS to keep sending bills to a dead person, whether it's a "reminder" or a demand for more post-insurance money, whether it's policy or a mistake. Better training for CHS accounting reps would seem to be in order, at least. Even a signed letter of apology from the company's CEO would help assuage bad feelings. But that's not happening.

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