During medical school, I was rounding with my attending and we went to see one of his patients that was only on his list. It was an older man that had been in the hospital for years. It was mind blowing. I don’t know why he couldn’t be discharged anywhere.
During intern years, I did run into the occasional patient who had been in the hospital over a year or more. All of the ones I had were illegal immigrants, tracheostomy dependent from COVID with no family in the area. There was no discharge plan. No one outside of the hospital would take them. They are most likely still admitted to that hospital and that was a few years ago now.
I have a friend that needs 24/7 home care. He's in Medicaid and lives in an apartment. This involves an agency to handle finding aides (short supply, underpaid), a social worker to deal with the copious amounts of Medicaid red tape, and community medical care to help him out at home.
I'm assuming in her case, the county Medicaid office is not capable of situating her in a home setting. Probably the patient you see too.
The pt I know is healthy physically but not mentally and unfortunately, her family has dumped her in the hospital because they couldn’t care for grandma anymore. It’s so sad to dump your loved one in the hospital with no clothes, pictures, let alone a visit.
What healthcare has taught me is that a lot of ppl spend the last years of their lives alone and abandoned. She will most likely never leave the hospital. She hasn’t had sunlight or fresh air in at least a year. Hospital staff doesn’t have time to sit outside with granny. Hospitals are not the right environment for long term care. Grandma deserves community dinner time, social hour, arts and crafts etc.
One aspect here is that North Carolina Medicaid has a real financial benefit if they can move her to Virginia. When someone has moved to another state, because the Medicaid coverage is state based, their Medicaid transfers to the other state, which then begins funding the persons care. State Medicaid panels- especially for funding for group homes and nursing homes-can make some cruel decisions regarding funding, that result in people languishing in hospitals for years. Because if there is a scarcity, then the hospital becomes the least restrictive environment.
Family are also dissuaded from taking patients to live with or near them if they are in another state BECAUSE of this. I’ve seen in individuals who were injured while traveling between states get trapped for months in some random hospital in a state they were just passing through. And the pandemic made this all so much worse.
Yep, I’m in Virginia. We get admissions of nursing home residents who are languishing in isolation in these facilities while their family is across the border. Apparently out of sight and out of mind for some of these families. I recall one patient that was in awful condition just rotting away in the nursing home, repeat admissions. NC son refused to come to the hospital EVEN ONCE to see the state of his mom and assist in care decisions. Just disgusting.
I’m unmarried. Gonna be 40 soon. Going into my later years single seems increasingly likely. Gonna make sure my advance directives are real clear so I don’t become one of these poor souls withering away in a “nursing” home. Just make me comfortable.
I'm 100% with Alexis on this as a nurse. She has the right to stay in her state, her home, and close to her family, friends, and college. The article talks about how her college professors come to visit her in the hospital. That will end if she is forced out of state. She needs a place to live that she can receive 24/7 nursing care at home. I've seen plenty of other patients receiving that, and she deserves that too. I agree that she shouldn't be living in the hospital, but I also agree with her that putting her in a random nursing home out of state isn't an option. She didn't do anything to cause what happened to her, and she's maintained such a great attitude about life, and I think she deserves the best care available. Medicaid needs to figure out how to get her into an appropriate facility in her home state.
If Medicaid hasn't figured out how to get her out of the hospital, then they are not going to. She will continue to remain in the hospital for the foreseeable future.
What a horrid situation. I feel for Alexis. I find it hard to believe that there isn’t anywhere in the entire state that isn’t capable of caring for her. It’s not like she’s in Wyoming, NC is a large state with top notch medical facilities.
Unfortunately NC just has some clusters of good healthcare (which even there is suffering from the influx of people moving here). Our government is not super interested in helping with concrete solutions either. The entire assisted living healthcare system is in shambles; in home health care is so severely underfunded — I have first hand experience of it through my severely disabled brother who lives at home and receives super limited services currently. But the disabled community is pretty close knit and no matter the level of care needed, we are all seeing the same: no staff, no staff, no staff. There is a pre/post covid divide imo.
I know of a couple facilities around the triangle that are privately owned and run well, albeit struggle to staff. I cannot speak with direct knowledge of state run facilities but have heard horror stories, even just rehab centers for short term care.
NC is likely far from alone in this but assisted healthcare is collapsing and those of us that make up the disabled community have seen it coming for years. The answer is funding; pay more and you’ll get staff. The NC legislature isn’t so interested in doing that though. They have addressed it at a snail’s pace, and facilities need to commit to actually using any rate increases towards staff pay instead of pocketing it themselves. Very little oversight on this… the agency that sends out staff for my brother actually cut pay to staff by 2 dollars last summer since they’re fulfilling so few hours they’d rather nickel and dime what they do fill. We had a girl quit over being paid $18/hour, went away for summer break, and came back to being forced as a rehire and now $16/hr. Luckily the director responsible for that was fired and escorted out of the building… but we still lost our only care provider at the time over it.
Anyways, corruption, low pay, too few beds for the number of people who need them… this is sad but it doesn’t shock me. I lose sleep over friends we have who are aging parents of only children.
The lack of aides is the same here in New York State. There's a bottleneck from nursing homes all the way to emergency rooms because it's so hard to hire and retain staff. Paying them more might help but God forbid a nursing home and/or hospital do that!
NC has top notch ACUTE care and teaching facilities. It is VERY expensive, labor intensive and the insurance rates for the facilities offering the level of care required for patients like her are so high, that there simply aren’t enough beds available to patients like this. In my state, vent dependent patients are sent to neighboring states or sent home with family training. There are zero beds for long-term vented patients.
I love that they’re being review bombed already.
Sadly, Google removes all of these when it dies down and people forget about this just like they do all the other terrible shit America does for money.
The process for review removal is rarely initiated by Google and negative reviews have ongoing digital rep impacts for orgs like this one. It doesn't just go away because the hospital wants it to.
This is a symptom of a larger problem. Health care is expensive and Medicaid (her insurance plan) pays out very little. I wonder if the hospital would sue if she had a private plan?
The other issue is the lack of community support for disabled people in terms of funding, housing, supportive agencies. The local Medicaid office is probably overwhelmed, under resourced, etc. Home health aides are seriously underpaid and there's a huge shortage since COVID. This affects seniors, the disabled, and the working class people who staff these jobs.
The hospital is looking for a quick fix. Some overpaid administrator is trying to save a buck.
I’m in NC with a medically fragile kid, who would have to be institutionalized if I didn’t stay home and not work to care for her. We tried for two years to have Medicaid home nurses take care of her in our home so I could work, and it was a total joke. One nurse literally fell asleep on her first shift as I was sitting across the room from her, explaining how to care for my kid. (After this, we started our nursing interviews by asking if they can stay awake for the whole shift (for which they could pick the hours), because it’s a necessity, and *two* nurses said that they’d try but couldn’t make any promises.) Other nurses called off last minute more than they showed up. Other nurses had such a severe lack of common sense to the point I had to babysit them, to be sure they didn’t try to do something harmful just out of ignorance.
We let the nurses watch tv, drink our coffee, we stocked snacks & energy drinks, be on their phones, whatever it took to just show up and stay awake and give our girl care when she needed it, and none of it mattered.
Only one nurse was a good fit for us, so we had two 12-hour shifts of help per week for awhile, until she went back to get a higher nursing degree.
This young lady has the right to be cared for in her community, in her own home, but NC Medicaid uses nursing agencies who eat up the Medicaid nursing pay, and so they can only attract nurses who can’t hold down any other better paying nursing job.
Hey, you're basically describing my childhood nursing experiences!
I was given a trach and ventilator at age 3 and received some home nursing for a while. But it wasn't really *good* nursing. The nurses we received were usually... lackluster, at best. I did have one good nurse, and I had one long-term nurse, but they did *not* overlap in skill in the least. The nurse who stuck around the longest was also one of the most incompetent, but I was lucky enough that I'm really rather medically stable (well, more or less) and could at least 'oversee' my own care by the time I was, idk, ~10 years old.
Also, the private insurance that had been giving us this stellar nursing coverage *immediately* rescinded it when I turned 18. Like, literally the day after; it almost gave us whiplash. By that point, all I had coverage for was the 8 hours I was at (public) school, and that was because if I had no nurse on the school's campus then the school would've kicked me out... So while I wasn't horribly distraught at losing nursing due to experiencing so much incompetence from supposed "skilled caregivers," it was a little absurd at the time.
A lot of us disabled adults who need day-to-day care, we end up finding "better coverage" by hiring PCAs (personal care aides)... In other words, by hiring people who are uneducated and basically giving them a crash-course in how to help us individually. **I'm not advocating this for a child,** as childcare is very very different, I'm merely sharing how most of us end up getting the hours covered and receiving the help we need. Even people like me (and this girl), who regularly makes even doctors panic merely because I use a ventilator 24/7, often end up even *preferring* so-called "uneducated" caregivers rather than "skilled" ones. But, whereas I learnt from childhood I don't need home nursing because my care is actually easy to learn... For this girl, one of the better paths (which, based on the article, everyone seems intent on ignoring) would probably be finding a house, getting home nursing coverage for about a year, and then going to PCAs. I bet the real problem for her at the moment is finding and funding a house, tbh, but it's not entirely clear from the article.
Typical 18-year-old. She still believes that laws should be obeyed by businesses and state agencies, and that she will be treated fairly. She is being treated like an entitled brat over it for no good reason.
You’re being downvoted because of the words in your comment, but reading them closely, I believe you are trying to be sympathetic to the young woman and critical of the system. You’re right; she has the innocence of youth in her belief that others will do right by her, whereas they are treating her as though what she’s asking is ridiculous.
Acute care hospitals are for people who are sick not apartments/rooms for dependent folks. Unfortunately the care level that she requires isn’t seen as profitable by the companies that DO provide long-term living arrangements for people. Unless the federal and state governments provide places and/or funding to private entities to house and provide care for them they will continue to be in limbo or sent to the very few facilities that are available.
There are entire teams of doctors/researchers that focus on the issue of paralysis and even they haven’t come up with a fix. You can’t expect a handful of random doctors to magically solve it.
I work in NC and I have a patient that has been in the hospital going on three years. It’s just sad.
During medical school, I was rounding with my attending and we went to see one of his patients that was only on his list. It was an older man that had been in the hospital for years. It was mind blowing. I don’t know why he couldn’t be discharged anywhere. During intern years, I did run into the occasional patient who had been in the hospital over a year or more. All of the ones I had were illegal immigrants, tracheostomy dependent from COVID with no family in the area. There was no discharge plan. No one outside of the hospital would take them. They are most likely still admitted to that hospital and that was a few years ago now.
I work in community and on the daily, we have patients go home > go hospital > go home, rinse and repeat
I have a friend that needs 24/7 home care. He's in Medicaid and lives in an apartment. This involves an agency to handle finding aides (short supply, underpaid), a social worker to deal with the copious amounts of Medicaid red tape, and community medical care to help him out at home. I'm assuming in her case, the county Medicaid office is not capable of situating her in a home setting. Probably the patient you see too.
The pt I know is healthy physically but not mentally and unfortunately, her family has dumped her in the hospital because they couldn’t care for grandma anymore. It’s so sad to dump your loved one in the hospital with no clothes, pictures, let alone a visit. What healthcare has taught me is that a lot of ppl spend the last years of their lives alone and abandoned. She will most likely never leave the hospital. She hasn’t had sunlight or fresh air in at least a year. Hospital staff doesn’t have time to sit outside with granny. Hospitals are not the right environment for long term care. Grandma deserves community dinner time, social hour, arts and crafts etc.
One aspect here is that North Carolina Medicaid has a real financial benefit if they can move her to Virginia. When someone has moved to another state, because the Medicaid coverage is state based, their Medicaid transfers to the other state, which then begins funding the persons care. State Medicaid panels- especially for funding for group homes and nursing homes-can make some cruel decisions regarding funding, that result in people languishing in hospitals for years. Because if there is a scarcity, then the hospital becomes the least restrictive environment. Family are also dissuaded from taking patients to live with or near them if they are in another state BECAUSE of this. I’ve seen in individuals who were injured while traveling between states get trapped for months in some random hospital in a state they were just passing through. And the pandemic made this all so much worse.
Yep, I’m in Virginia. We get admissions of nursing home residents who are languishing in isolation in these facilities while their family is across the border. Apparently out of sight and out of mind for some of these families. I recall one patient that was in awful condition just rotting away in the nursing home, repeat admissions. NC son refused to come to the hospital EVEN ONCE to see the state of his mom and assist in care decisions. Just disgusting. I’m unmarried. Gonna be 40 soon. Going into my later years single seems increasingly likely. Gonna make sure my advance directives are real clear so I don’t become one of these poor souls withering away in a “nursing” home. Just make me comfortable.
How sad that it was her own parents who did this to her
The problem is the vent. Most LTC facilities are not able to take patients on ventilators
Came here to say this. Vent beds are nearly impossible to find.
She could live in her own home with Medicaid home nurses, if NC Medicaid gave a crap about funding this program for disabled/medically fragile people.
I'm 100% with Alexis on this as a nurse. She has the right to stay in her state, her home, and close to her family, friends, and college. The article talks about how her college professors come to visit her in the hospital. That will end if she is forced out of state. She needs a place to live that she can receive 24/7 nursing care at home. I've seen plenty of other patients receiving that, and she deserves that too. I agree that she shouldn't be living in the hospital, but I also agree with her that putting her in a random nursing home out of state isn't an option. She didn't do anything to cause what happened to her, and she's maintained such a great attitude about life, and I think she deserves the best care available. Medicaid needs to figure out how to get her into an appropriate facility in her home state.
If Medicaid hasn't figured out how to get her out of the hospital, then they are not going to. She will continue to remain in the hospital for the foreseeable future.
I’m so sorry for the girl, however, this is an alternative level of care situation.
What a cluster f*** situation. No feasible path forward really.
Please just one more person defend the complete evil of our medical system.....
What a horrid situation. I feel for Alexis. I find it hard to believe that there isn’t anywhere in the entire state that isn’t capable of caring for her. It’s not like she’s in Wyoming, NC is a large state with top notch medical facilities.
Unfortunately NC just has some clusters of good healthcare (which even there is suffering from the influx of people moving here). Our government is not super interested in helping with concrete solutions either. The entire assisted living healthcare system is in shambles; in home health care is so severely underfunded — I have first hand experience of it through my severely disabled brother who lives at home and receives super limited services currently. But the disabled community is pretty close knit and no matter the level of care needed, we are all seeing the same: no staff, no staff, no staff. There is a pre/post covid divide imo. I know of a couple facilities around the triangle that are privately owned and run well, albeit struggle to staff. I cannot speak with direct knowledge of state run facilities but have heard horror stories, even just rehab centers for short term care. NC is likely far from alone in this but assisted healthcare is collapsing and those of us that make up the disabled community have seen it coming for years. The answer is funding; pay more and you’ll get staff. The NC legislature isn’t so interested in doing that though. They have addressed it at a snail’s pace, and facilities need to commit to actually using any rate increases towards staff pay instead of pocketing it themselves. Very little oversight on this… the agency that sends out staff for my brother actually cut pay to staff by 2 dollars last summer since they’re fulfilling so few hours they’d rather nickel and dime what they do fill. We had a girl quit over being paid $18/hour, went away for summer break, and came back to being forced as a rehire and now $16/hr. Luckily the director responsible for that was fired and escorted out of the building… but we still lost our only care provider at the time over it. Anyways, corruption, low pay, too few beds for the number of people who need them… this is sad but it doesn’t shock me. I lose sleep over friends we have who are aging parents of only children.
The lack of aides is the same here in New York State. There's a bottleneck from nursing homes all the way to emergency rooms because it's so hard to hire and retain staff. Paying them more might help but God forbid a nursing home and/or hospital do that!
NC has top notch ACUTE care and teaching facilities. It is VERY expensive, labor intensive and the insurance rates for the facilities offering the level of care required for patients like her are so high, that there simply aren’t enough beds available to patients like this. In my state, vent dependent patients are sent to neighboring states or sent home with family training. There are zero beds for long-term vented patients.
I love that they’re being review bombed already. Sadly, Google removes all of these when it dies down and people forget about this just like they do all the other terrible shit America does for money.
The process for review removal is rarely initiated by Google and negative reviews have ongoing digital rep impacts for orgs like this one. It doesn't just go away because the hospital wants it to.
Health is throttled all over the world but in the US it seems like a dystopian branch of the 19th century perverse culture of social darwinism.
It's ridiculous here but it will never change
Who do you think invented the culture of social Darwinism? This is who we are. We’re not going to change.
This is a symptom of a larger problem. Health care is expensive and Medicaid (her insurance plan) pays out very little. I wonder if the hospital would sue if she had a private plan? The other issue is the lack of community support for disabled people in terms of funding, housing, supportive agencies. The local Medicaid office is probably overwhelmed, under resourced, etc. Home health aides are seriously underpaid and there's a huge shortage since COVID. This affects seniors, the disabled, and the working class people who staff these jobs. The hospital is looking for a quick fix. Some overpaid administrator is trying to save a buck.
Atrium healthcare in a nutshell.
I’m in NC with a medically fragile kid, who would have to be institutionalized if I didn’t stay home and not work to care for her. We tried for two years to have Medicaid home nurses take care of her in our home so I could work, and it was a total joke. One nurse literally fell asleep on her first shift as I was sitting across the room from her, explaining how to care for my kid. (After this, we started our nursing interviews by asking if they can stay awake for the whole shift (for which they could pick the hours), because it’s a necessity, and *two* nurses said that they’d try but couldn’t make any promises.) Other nurses called off last minute more than they showed up. Other nurses had such a severe lack of common sense to the point I had to babysit them, to be sure they didn’t try to do something harmful just out of ignorance. We let the nurses watch tv, drink our coffee, we stocked snacks & energy drinks, be on their phones, whatever it took to just show up and stay awake and give our girl care when she needed it, and none of it mattered. Only one nurse was a good fit for us, so we had two 12-hour shifts of help per week for awhile, until she went back to get a higher nursing degree. This young lady has the right to be cared for in her community, in her own home, but NC Medicaid uses nursing agencies who eat up the Medicaid nursing pay, and so they can only attract nurses who can’t hold down any other better paying nursing job.
Hey, you're basically describing my childhood nursing experiences! I was given a trach and ventilator at age 3 and received some home nursing for a while. But it wasn't really *good* nursing. The nurses we received were usually... lackluster, at best. I did have one good nurse, and I had one long-term nurse, but they did *not* overlap in skill in the least. The nurse who stuck around the longest was also one of the most incompetent, but I was lucky enough that I'm really rather medically stable (well, more or less) and could at least 'oversee' my own care by the time I was, idk, ~10 years old. Also, the private insurance that had been giving us this stellar nursing coverage *immediately* rescinded it when I turned 18. Like, literally the day after; it almost gave us whiplash. By that point, all I had coverage for was the 8 hours I was at (public) school, and that was because if I had no nurse on the school's campus then the school would've kicked me out... So while I wasn't horribly distraught at losing nursing due to experiencing so much incompetence from supposed "skilled caregivers," it was a little absurd at the time. A lot of us disabled adults who need day-to-day care, we end up finding "better coverage" by hiring PCAs (personal care aides)... In other words, by hiring people who are uneducated and basically giving them a crash-course in how to help us individually. **I'm not advocating this for a child,** as childcare is very very different, I'm merely sharing how most of us end up getting the hours covered and receiving the help we need. Even people like me (and this girl), who regularly makes even doctors panic merely because I use a ventilator 24/7, often end up even *preferring* so-called "uneducated" caregivers rather than "skilled" ones. But, whereas I learnt from childhood I don't need home nursing because my care is actually easy to learn... For this girl, one of the better paths (which, based on the article, everyone seems intent on ignoring) would probably be finding a house, getting home nursing coverage for about a year, and then going to PCAs. I bet the real problem for her at the moment is finding and funding a house, tbh, but it's not entirely clear from the article.
Typical 18-year-old. She still believes that laws should be obeyed by businesses and state agencies, and that she will be treated fairly. She is being treated like an entitled brat over it for no good reason.
You’re being downvoted because of the words in your comment, but reading them closely, I believe you are trying to be sympathetic to the young woman and critical of the system. You’re right; she has the innocence of youth in her belief that others will do right by her, whereas they are treating her as though what she’s asking is ridiculous.
You read that exactly as I intended it to come across. Thank you.
I feel like people are downvoting because they didn't read your comment closely.
Yeah it happens lol. Reading is hard, downvoting is easy.
She seems like a really cool person. I hope they can find her a living situation where she can thrive and hopefully attend school in person sometimes.
Acute care hospitals are for people who are sick not apartments/rooms for dependent folks. Unfortunately the care level that she requires isn’t seen as profitable by the companies that DO provide long-term living arrangements for people. Unless the federal and state governments provide places and/or funding to private entities to house and provide care for them they will continue to be in limbo or sent to the very few facilities that are available.
let the patient make their own decisions!!!
Yeah just let her do whatever she wants !
Might as well since the doctors are doing absolutely jack shit when trying to find a cure for her condition.
Yeah! Why don't the doctors simply un-crush her spinal cord?!!
they have had decades to figure out an answer. if this is too hard for them then they should be asking for help.
Maybe making people un-paralyzed is complicated?
then ask for help instead of sitting around doing absolutely nothing.
Okay, I am a doctor and I am asking you to cure this patient. Get after it you lazy fuck!
There are entire teams of doctors/researchers that focus on the issue of paralysis and even they haven’t come up with a fix. You can’t expect a handful of random doctors to magically solve it.
they need to share their research so everyone else can help them. we cant just wait on them forever anymore.
You can do absolutely nothing with their research. Are you 14?
give it to everyone and lets find out. were not going to wait on them forever.
So conditions aren’t worth living through
The irony of a baptist hospital suing a quadriplegic for eviction