Tolbert letter for Lanternfield

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1180 Paulmont Parkway NW
Suite 200

Tolbert & Greer Internal Medicine Cleveland, TN 37312
(423) 555-0112

Physician's Statement
June 2, 2026

Lanternfield Life & Annuity
Long-Term Care Service Center
PO Box 90218
Nashville, TN 37209

Re: Lorraine M. Pruitt, date of birth 02/11/1945. Policy LTC-04-2291847.

To the claims examiner:

I have been Mrs. Pruitt's primary care physician since 2009 and last examined her today. I
write at the request of her son and attorney-in-fact, Walter E. Pruitt Jr.

Diagnoses. Dementia, mild, most likely Alzheimer's disease, diagnosed in June 2025 by
Rohan Mehta, MD, neurology. Chronic heart failure with preserved ejection fraction. Atrial
fibrillation, on anticoagulation. Type 2 diabetes treated with insulin. Chronic kidney disease
stage 3b. Osteoporosis with a left hip fracture in February 2023. She was in hospital from May
20 to May 22, 2026 with a urinary infection and delirium.

Activities of daily living.

Activity What she needs

Bathing Hands-on help. She cannot step in and out of the shower or wash safely alone. She fell
in the shower in July 2025.

Dressing Hands-on help with choosing and ordering clothes and with fasteners. Left alone she
stays in her nightgown.

Transferring Standby help. Uses a walker and a lift chair.

Toileting Independent

Eating Independent once the meal is set in front of her

Continence Continent

Supervision. Because of her cognitive impairment she cannot manage her own medicines.
They are set out for her each week and handed to her; her bedtime insulin is given under her
son's supervision by telephone. She has left the stove on. She should not be left to manage
alone for a full day.

Duration. These needs are expected to continue for more than 90 days and are, in my
opinion, permanent.

Plan of care. A home care aide from a licensed agency, four hours each weekday morning, for
bathing, dressing, meals and medication reminders; family on weekends; medical alert
pendant. I will review this plan yearly.

I certify that this statement is true to the best of my knowledge.

Samuel Tolbert MD
Samuel Tolbert, MD. Tennessee license MD-0031774.

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Tolbert letter for Lanternfield Document · saved Jun 3, 2026

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Value	Now
lorraine.date_of_birth	1945-02-11
ltc-policy-lorraine.policy_number	LTC-04-2291847

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attachments.yaml

record: doc-tolbert-ltc-letter
template: document
org:
  name: Tolbert & Greer Internal Medicine
  lines:
  - 1180 Paulmont Parkway NW
  - Suite 200
  - Cleveland, TN 37312
  phone: '4235550112'
  color: '#2f5d7c'
title: Physician's Statement
body: 'June 2, 2026


  Lanternfield Life & Annuity<br>Long-Term Care Service Center<br>PO Box 90218<br>Nashville, TN 37209


  **Re:** Lorraine M. Pruitt, date of birth {{lorraine.date_of_birth|mdy}}. Policy {{ltc-policy-lorraine.policy_number}}.


  To the claims examiner:


  I have been Mrs. Pruitt''s primary care physician since 2009 and last examined her today. I write at
  the request of her son and attorney-in-fact, Walter E. Pruitt Jr.


  **Diagnoses.** Dementia, mild, most likely Alzheimer''s disease, diagnosed in June 2025 by Rohan Mehta,
  MD, neurology. Chronic heart failure with preserved ejection fraction. Atrial fibrillation, on anticoagulation.
  Type 2 diabetes treated with insulin. Chronic kidney disease stage 3b. Osteoporosis with a left hip
  fracture in February 2023. She was in hospital from May 20 to May 22, 2026 with a urinary infection
  and delirium.


  **Activities of daily living.**


  | Activity | What she needs |

  |---|---|

  | Bathing | Hands-on help. She cannot step in and out of the shower or wash safely alone. She fell in
  the shower in July 2025. |

  | Dressing | Hands-on help with choosing and ordering clothes and with fasteners. Left alone she stays
  in her nightgown. |

  | Transferring | Standby help. Uses a walker and a lift chair. |

  | Toileting | Independent |

  | Eating | Independent once the meal is set in front of her |

  | Continence | Continent |


  **Supervision.** Because of her cognitive impairment she cannot manage her own medicines. They are set
  out for her each week and handed to her; her bedtime insulin is given under her son''s supervision by
  telephone. She has left the stove on. She should not be left to manage alone for a full day.


  **Duration.** These needs are expected to continue for more than 90 days and are, in my opinion, permanent.


  **Plan of care.** A home care aide from a licensed agency, four hours each weekday morning, for bathing,
  dressing, meals and medication reminders; family on weekends; medical alert pendant. I will review this
  plan yearly.


  I certify that this statement is true to the best of my knowledge.


  <span class="sig">Samuel Tolbert MD</span>


  Samuel Tolbert, MD. Tennessee license MD-0031774.

  '