The Value You're Looking For is Closer Than You Think

As I approached the doors to the nursing home, two automatic double doors parted and a familiar scent passed through. I continued forward, looking to the right with a smile and wave as I spotted the face of the receptionist. Quickly pivoting, I stopped at her desk to write and drop off a large check. After exchanging pleasantries, I headed deeper into the facility, passing older folks in wheelchairs and seated on old sofas and chairs. I knew these people, all of these people, but most I couldn’t tell you their name.

With my daughter still behind me, I forged ahead, passing the common area on the right with the TV that Pop used to watch. I’d often spot him there in his wheelchair when I came to visit, happy to see he was out of his room. Up next was a four-way hallway intersection and a nurse’s station where the staff could be found if they weren’t in a resident’s room. Residents were often hanging out here, in their wheelchairs or standing. Pop’s room was at the end of the hall on the left, but we were heading further in.

At the end of the hallway, need to make a left - for the elevator. The facility is only two-stories, but the staircases are at the far end of each wing. Probably not ideal for a fire, but I can’t imagine any Long Term Care Facility with bed-ridden is. Comes with the nature, I suppose. Upstairs, and to the right, I found my grandmother curled up in her bed, her dinner tray laden with some broccoli soup and an egg-salad sandwich, accompanied by some milk and a cranberry juice cup. Honestly, I wouldn't touch this meal (but they aren't all like this).

And she hadn’t touched much. “Not hungry tonight?” I asked gently. She told me she doesn’t like the food. As the survivor of a stroke affecting 80% of her brain, she’s lucky to be alive, but all of these folks have their own story and tough path. They all have many things in common, not the least of which are the health issues that earned them a trip here. But for me, one thing stands out: nearly all of these people, are in some way, dependent on the Federal Healthcare Benefit known as Medicare.

Some of them, like my “mom-mom”, as we call her, are fully bed-ridden or wheelchair bound. Most who can walk, do so with the aid of an assistive device, such as a cane or a walker. All of them have a medical need for continuous care, although Medicare has no long-term care benefit. Skilled Nursing days are subject to a lifetime limitation under "the Act”, and it’s safe to say many of these people are no longer able to be their own champion, although they are definitely loved by someone. This is the side of life no one wants to think or talk about.

As a software contractor supporting CMS for the better part of 15 years in various capacities, I haven’t often seen the context of my team’s successes. The challenges of coordination and translating AWS stacks and mainframes to better outcomes for real people can’t be overstated - it can be daunting. But at the end of the day, if we have improved one measure, or saved just one dollar through our work, we have made progress. Not just toward the Sprint Goal, or the PI Objective, or the next release, but progress toward each of these people receiving better treatment, and improved journeys in their respective diagnoses.

As I review my grandmother’s Medicare Summary Notices when they arrive by mail, I know the allowed amount shown originated from the very products that my team works exhaustively to build and maintain. Our efforts are not unnoticed, and the little steps we take create lasting impacts for real people. At the end of the day, we are advocating for those, who many times, cannot advocate for themselves. We change lives for people who have great need. Everything eventually rolls down to the beneficiary in some way - including everything we make possible. What good did you do today?