They weren't surprised, the hospital staff that is. "Sissy, you're back," they politely acknowledged. Some got a manic reply of jumbled nonsense from her, others got a mute response with a deer-in-the-headlights gaze.
Some of the residents on the preteen female unit saw her and were glad to see her. I said hopefully in her ear, "See! I told you there would still be girls here you knew!" My turn for the mute response from her.
Intake was a flurry and a frenzy of staff and note taking and signing papers and them gathering data, furiously writing down my words, nodding their heads, speaking in code to one another about the situation, etc. Same old, same old.
Sadly, we learned that the family therapist that attended our case in the spring, the one I thought had dropped us on our heads, passed away. She had taken and emergency medical leave and succumbed quickly to her cancer. Really, she was one of the best we've ever had, that's why we were so stunned by the sudden cessation of care. The staff at the hospital did not see fit to divulge her private information to the residents and their families, thus the reason we felt like we were getting locked out.
And potentially the reason Sissy got sent home in June. Her therapist passed two days after Sissy's discharge, the hospital and Sissy's unit was in complete upheaval. No one submitted an appeal to the review board, no one set us up on the waiver, Sissy literally fell through the cracks.
The staff, hearing of this summer's events (and actually there was a whole lot more crap that went on but so much of it was not what I considered bloggable), realized and verbalized that they need to push Sissy harder to get her to demonstrate her behaviors in the hospital. This is music to my ears because it could potentially mean that Sissy will get a longer stay. 
The rest of us are all exhausted. All I've done is sleep. My house is in shambles. It hasn't looked this disheveled since they were babies. It doesn't help that for the past three weeks I've ignored some of my own physical symptoms, putting off a trip to the doctor. Got tested for mono today - negative, thankfully. Still waiting for the CBC results but I'm not expecting to hear a "within normal" result. Started on antibiotics today. I guess the house will be messy for a few more days.
Thankfully, the 56 days Sissy was home wasn't so long that it will require a recovery time for us to get back to normal. I asked Sissy's IFI therapist to come by in a week or two to observe our family being normal. In the past, therapists have insisted that it's in my head, that Sissy couldn't possibly be driving the crazy train in our home. I want professionally documented proof that I'm not insane, Sissy is unequivocally the engineer of our family's mayhem. Tonight AB and WG were sitting on the recliner sofa, sharing milk duds and watching episodes of dinosaur programs on net.flix, both of them worried about me and trying to take care of me in their individual ways. I just smiled and let them; it's nice to be normal.
 APS medical review boards review psychiatric placement cases based on the previous 30 days of behavior exhibited while in a hospital. If the patient does not display any behaviors that need to be treated, then it is deemed that s/he has no medical necessity for the placement and therefore they are denied payment of further hospitalization. At which point, the parent/caregiver can continue paying the cost of said placement, take the child home or refuse to take the child home. A refusal is considered a psychiatric lockout and the caregivers are immediately processed through CPS abuse investigation.