 dear administrator and admissions review committee i am writing regarding the recent determination by hales corners care center declining richards admission based on behaviors and complexity of care i respectfully request a formal reconsideration of this decision and clarification of the specific clinical criteria used in reaching this determination based on our understanding of richards condition and daily care needs his requirements are primarily physical in nature he requires hoyer lift transfers meal setup he feeds himself independently access to fluids and occasional assistance initiating preferred television programs or tablet activities these needs are consistent predictable and task oriented at his current residence my 32 year old daughter independently manages his morning and evening care including transfers and routine daily support this demonstrates that while his care is hands on it is manageable and structured richard may occasionally vocalize discomfort during transfers these episodes are brief non aggressive and not combative in nature when asked shortly afterward he often does not recall the complaint and remains cooperative and pleasant his responses are typically attributable to momentary confusion rather than behavioral escalation or resistance that would pose safety concerns given that the denial was not based on financial considerations or bed availability i respectfully request a written explanation detailing the specific behaviors or care factors deemed outside your facilitys scope a secondary clinical review of his referral or the opportunity to participate in a care conference to address any concerns directly we were very impressed with your staff the environment and the location and we believe your facility is clinically capable of meeting richards needs it is important to us that the determination be based on an accurate and complete understanding of his condition please advise on the next steps for formal review i would appreciate a timely response sincerely michael frink 