LITMIR.BIZ

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how women wound up dead.

      Connie’s phone rang out at her desk. “Shoot.” She snapped her fingers. “I came in here to tell you Mr. Limone’s son is on the phone. I hope you appreciate the fact that I came in here, in person, to warn you rather than just sending the call in here.”

      Like Kira had done to her. “You’re the best assistant ever.” Kira smiled. Then she glanced at the clock. “It’s not even noon. Will this day ever end?”

      “Do you want me to tell him you’re busy?”

      Kira shook her head. He’d only call back...even angrier for being put off. She’d learned that earlier this morning. Connie turned to leave.

      “Do me a favor?” Kira asked.

      “Anything for you.” Connie turned back around with a smile. “Legal or illegal, I’m your girl.”

      Kira smiled back, no doubt in her mind Connie meant it. “A cup of decaf, please.”

      “With a shot of Baileys?” Connie asked, hopefully. “I might have some random single serving bottles in my desk drawer,” she looked up toward the ceiling innocently, “that I received for Christmas and may have forgotten to bring home.”

      Coffee and Baileys, Kira’s favorite. “Get out.” She pointed to the door. “Stop putting unprofessional thoughts in my head and send me my call.”

      Connie shook her head and let out a disappointed sigh.

      “Oh,” Kira said. “And when you’re done with Mr. Limone senior, would you call Myra Douglas from In Your Home Health Care Services?” Their preferred Certified Home Health Care Agency for the West Guilderford area in upstate New York, where Daisy Limone lived. “Ask her why there are no home health aide services on Daisy Limone’s plan of care.” Even a few hours a few times a week was better than nothing.

      “Sure thing, boss,” Connie said. Then with a salute she turned and left, closing the door behind her.

      A few seconds later, Kira’s phone rang. With a deep fortifying breath—because Mr. Limone junior was even more obnoxious than Mr. Limone senior—she answered it. “Hello, Mr. Limone. I just got off the phone with your father. Before you say one word, let me remind you of our last conversation. The first time you threaten to sue me or curse at me or call me unflattering names I am hanging up this phone. Now what can I do for you?”

      “Doctor,” he said.

      “Excuse me?”

      “Dr. Limone. I’m a different son.”

      God help me, there are two of them.

      “Three actually,” he said, his voice deep and tinged with a bit of humor.

      Oops. She must have said that out loud.

      Thank goodness Connie chose that moment to return with the coffee.

      “What can I do for you, Dr. Limone?” She took a sip, smiled at her wonderful assistant and mouthed, “Thank you.” Although the coffee wasn’t near as satisfying without the Baileys.

      “I’m calling to apologize, on behalf of my family. Our father can be...difficult.”

      So could his brother.

      “But he’s our father,” Dr. Limone said. “He worked three jobs to keep a roof over our heads and see that all three of us went to college. While he worked, Mom managed the house, the finances and us boys. They got into a routine that’s worked for them for fifty-four years. Since Mom’s stroke, Dad’s struggling to adjust. He doesn’t do change very well.”

      Not many people did. Kira understood that. But, “You know HIPPA regulations don’t allow me to discuss Mrs. Limone’s care without a signed authorization.”

      “Please,” he said. “As a professional courtesy.”

      In the past, on a rare occasion, Kira might have given in to a request for a professional courtesy—the unwritten understanding between doctors, nurses and the like to relax the rules of confidentiality a little bit for other health care professionals. But with all the problems she’d been having with her new boss, and with the Limones having an attorney in the family, Kira would be following company procedure to the letter. “I’m sorry, Mr. Limone. Not even as a professional courtesy. Get me a HIPPA release, signed by your father, as your mother’s health care agent, specifically giving me authorization to discuss her medical status and treatment with you, by name, and then I’ll be happy to speak with you.”

      “You’re just putting me off.”

      “What I’m doing is following procedure which requires a signed HIPPA release, on file, designating who my staff and I may talk to regarding any specific patient, other than the patient and/or his or her physician.” And just because she was in a bad mood she added, “As a physician you should be familiar with HIPPA regulations, Dr. Limone.”

      “The plan of care is inadequate,” he yelled.

      If the patient was still in the rehabilitation hospital, she’d be getting the round the clock care and supervision she required. “I can’t discuss this with you.”

      “All I want is for you to explain why no home health aide services were authorized. And why hasn’t therapy started yet?”

      Kira would be looking into both as soon as she could get off the phone. “I can’t discuss this with you.”

      “Damn it!”

      “Get me a signed HIPPA release,” Kira said.

      “How the hell do you suggest I do that? My practice has exploded. Even working eighty hour weeks I can’t get everything done that I need to get done. I live three hours from my parents’ house. They don’t have a fax machine or a scanner or even e-mail.”

      “You graduated from medical school,” Kira said. “Which means you must be a pretty smart guy. I’m sure you’ll figure something out.”

      Dr. Limone slammed something close to his phone, the sound loud in Kira’s ear. “You have no idea how frustratingly difficult this is,” he yelled again.

      “Yes,” Kira said. “I do.” From a professional standpoint and from personal experience.

      He let out a weary breath. “I’m worried about my dad,” he said, sounding exhausted. “He’s not in good health. I’m worried about him or my mother falling and getting hurt because they don’t have the help they need in the home.”

      “I understand your concern,” Kira said. “From everything I’ve heard and read, I think you have every reason to be concerned.”

      “Yet you’re doing nothing to ensure my mother’s safety,” Dr. Limone yelled.

      “This case was just brought to my attention yesterday afternoon.”

      “My mother is not a case, Miss Peniglatt. She’s a sweet, kind, loving woman lying helpless in her bed with no one but my elderly father to take care of her because you won’t authorize an aide.”

      Kira came dangerously close to losing it. “It is not the responsibility of Medicare or WCHC, as your mother’s Medicare HMO, to provide round the clock, in home care. Family takes care of family, Dr. Limone.” It’s why Kira needed the large salary this job paid her and why she rarely had a free moment to herself. Family takes care of family. Kira had grown up watching her mother live those words. So of course when Mom needed care, Kira had stepped up, happily. Being the sole dependable caregiver to a totally dependent family member was not easy, Kira knew that firsthand. And she had little tolerance for family members unwilling to pitch in and help. “If you and your brothers are as concerned for your mother and father as you say you are, then maybe you all should spend less time threatening and complaining and trying to find someone else to do it, and actually go home and help.”

      Kira was out of line, she knew it. But she’d reached her limit.

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