Update: Marinucci No. 55 from Lori

This is an important week for prayer. I am grateful for my elders and family who have given good counsel and support. Specifically pray for:

1) The insurance company has given me a verbal denial for the next step of rehabilitation. It is Hemet Community Medical Group's intent to release Gerry home with limited outpatient therapy here in Temecula. However, when I telephoned the outpatient facility Hemet recommends, they don't handle speech/cognition and more importantly, don't even accept my insurance!!!! I will need to
file an appeal once I receive the written denial.

2) Interestingly, his treating doctors don't agree with the Hemet. Ballard believes Gerry should continue at an inpatient rehabilitation facility and one with an emphasis on cognition. They have recommended, and we have toured a facility in Escondido (30 miles south) that seems favorable.

3) Tuesday at 3:30 p.m. the Case Manager for Hemet is coming to Ballard for the team/family meeting with the purpose of encouraging them to educate/train me to have Gerry home right away. Ballard on the other hand intends to educate Hemet regarding brain injury and that further rehabilitation treatment is needed. Clarity and direction as a result of this meeting.

4) Gerry finally has an appointment with the facial surgeon on Wed morning. I am hoping they remove the braces but more importantly, for wisdom regarding the "lock jaw" episodes and a final determination, if further treatment is necessary.

5) Hemet Medical Group (making the denial) believes they can't convert the nursing home benefit in my contract to services for rehab because Aetna won't allow it. While Aetna (who only exists in a supervising capacity because of the contract they have with Hemet) claims Hemet has full authority to make such a compromise provision should they desire to do so. That Hemet will
reconsider, once the appeal is filed.

6) Guidance for whenever Gerry does come home. Should I continue to attempt to work, do rehab myself, bring in help, seek adult day care, take a leave from work, file for medical and/or other government programs etc.? For someone who has an expertise in the legal/financial aspects of spend down for medical benefits.

7) I am advised that both Hemet and Aetna may still have legal requirements they are not fulfilling, such as an ongoing obligation to provide rehabilitation as long as Gerry continues to progress (which Gerry has). Again, Ger's primary injury is his brain. Cognitive training is difficult to get on an outpatient basis. I have several potential contacts with attorneys regarding their
assistance in this regard.

8) If in fact Gerry comes home in the near future, that Gerry's primary care physician will effectively manage Gerry's care. There has been difficulty, tension and significant delays with the referral process between the doctor's office and Hemet. Communication has been a problem. That an acceptable rehab
treatment plan is immediately put in place and no lapse in treatment will occur because of these problems. That I can get an appointment to meet with Gerry's primary doctor prior to the first date available on November 9th.

9) Prayer for the girls and their adjustment to the next phase and for endurance, peace and good judgment for me. May God's will be done!

Thank you for your willingness to be faithful in prayer! Both Gerry and I can testify that our Living and True God hears and answers prayer. He does not turn a deaf ear to the cries of his children. We'll soon see what His great and good plan is for us!

Lovingly, Lori