Author Topic: Life turned upside down: dad has stroke and has no insurance  (Read 4803 times)

CrustyBadger

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #50 on: September 12, 2018, 07:16:53 PM »
Ahhh the great USA - didn't you know you now deserve your life to be in ruin and your father deserves to suffer on the street until he dies?


Our health care system in the US has a lot to answer for, but this really seems to be very much a Texas problem.  They have made it so very hard for people to qualify for Medicaid.

Emergo, I think you have done all you can do, to convince the hospital that you cannot and will not pay for your father's care.  When I read about how many uninsured people in Texas there are, and how many do not qualify for even the basic safety net of Medicaid, I cannot imagine what kind of care is available for people in your father's condition.  It sounds like Texas is in the middle of an indigent care crisis.

I do think the very best possibility for your father would be to somehow qualify for Medicaid.   I was reading about this case two years ago, where everything looked hopeless but then by contacting state legislators, the patient was approved for Medicaid.    It seems there may be some wiggle room.

https://www.newyorker.com/news/news-desk/poor-and-uninsured-in-texas

Perhaps while you cannot care for your father yourself, you might be able to to bring his plight to the attention of some local lawmakers?


lhamo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #51 on: September 12, 2018, 08:41:03 PM »
If you are anywhere near the eastern or western borders of the state, you might want to look into what the income cutoffs are for expanded medicaid in New Mexico, Arkansas, and/or Lousiana.  Here in WA, expanded medicaid is an excellent program (my family has been on it for two years) and you can sign up immediately in the month when your income drops to $0. 

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #52 on: September 14, 2018, 05:09:10 AM »
Here's the latest...

My dad called me and said the social worker told him he will be discharged in a couple days and that the therapist will drop him off at his boarder house (where no one will take care of him) in two days. Wow.

Apple_Tango

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #53 on: September 14, 2018, 07:36:17 AM »
Call the social worker and put her on the spot- itís not your responsibility to pay. But it is her responsibility to put together a good discharge plan. Remind her that if he doesnít receive services he will likely have a fall and wind up back in the the hospital for a readmission. Ask about setting up services for him and how to apply for social welfare programs for him. I would make a big stink about it and work your way up the administrative ranks. They are going to be very frustrated with you- they will fight you, they will try to make you take financial responsibility. Just keep turning it back on them. Itís their job to set him up with an appropriate discharge plans. Ask to see the therapy notes and recommendation/discharge plan. If the hospital is not following the recommendations of the therapists. Confront them as to why not.

Also call the boarder house- let them know all the care he needs- can he walk by himself? Change his clothes? Go to the bathroom? Clean himself? Eat a normal diet? Make it very clear all thehelp he will need. Ask them if they are providing that help. If they are not, paint a picture of what it will be like for your father to live there and how much of a liability it will be for them. Try to get THEM to refuse to take him unless appropriate services are provided. Talk about the liability they are getting into a LOT.

Itís going to be tough going for a while.

If nothing else at least try to delay the discharge- every day heís in the hospital is a day he is recieving medical care and support. Yes the charges will rack up, but honestly thatís the bed Texas as made for themselves by refusing to provide appropriate services to the poor- the costs are still there no matter what- itís not like refusing to provide services keeps costs down. (People just keep getting readmitted to the hospital instead of appropriately being able to transfer out safely)  The people suffer more.

If nothing works and he is still discharged without services, then it will be up to you to step up to the plate in any way you can, as a moral obligation to your father. But DONT let them know this. Act like you cannot help in any way.
« Last Edit: September 14, 2018, 02:58:03 PM by Apple_Tango »

Another Reader

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #54 on: September 14, 2018, 08:00:20 AM »
+1 to Apple Tango's advice.  They are responsible for the appropriate discharge plan.  Don't forget to mention that if he is seriously injured or dies as the result of their actions, they are liable.

Tris Prior

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #55 on: September 14, 2018, 10:53:51 AM »
I've been in a similar situation with social workers. Unlike the fine folks here who have commented on your post, I didn't know any better and thought I was responsible for my relative's care, when the social workers told me I was. This was incorrect. Do not do this!

So, right now, the social workers are indirectly guilting you by saying they're going to drop him off with no care. They're banking on you saying, "no, no, don't do that, I'll take care of him." Because who wants to think of their parent being alone with no care? Social workers pulled this on my mom once too, when my father was still alive (he had dementia and repeated strokes, among other problems, and was an abuser.) She said she wasn't able to bring him home and take care of him and they said, "OK, we'll drop him off at a homeless shelter then." She caved, and basically gave up her life to care for him. Do not do this!

The exact words that you want to use with the social worker is "unsafe discharge." They are not allowed to discharge him into a situation where he will not receive care, when he needs care, because it will not be safe for him. It sounds like they're trying to push their jobs onto you, which unfortunately is a thing that happens with some - not all! - social workers.

Does he by chance have, um, a strong personality or any issues with stubbornness? My relative did, and I strongly suspect that the social workers simply did not want to deal with them and decided to push them off on the next of kin (me) instead. As if I had any more hope of convincing them to accept their illness and follow doctors' orders simply because I was related!

mm1970

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #56 on: September 14, 2018, 11:28:44 AM »
+1 To Apple Tango.

If you are talking to the social worker at the hospital - make sure you talk to the city/ county social services department, open up a ticket or whatever.  At least, that's how it works in CA.  If there is an open investigation, they are not allowed to discharge.

Apple_Tango

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #57 on: September 14, 2018, 12:53:31 PM »
Oh also- ask for anyoneís name you talk to and make them put their statements in writing. ďCan I have that in writing?Ē Is a magical phrase. I know that *with* insurance there is an appeal process for being discharged. I donít know the process with no insurance, but definitely ask about an appeal proces because this is an ďUnsafe dischargeĒ
« Last Edit: September 14, 2018, 12:58:50 PM by Apple_Tango »

rubybeth

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #58 on: September 14, 2018, 01:01:08 PM »
I just want to chime in and say this is such a valuable thread of advice.

lizzzi

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #59 on: September 14, 2018, 01:09:54 PM »
 As mm1970 says, if the hospital is insisting on making an unsafe discharge, call your county's Adult Protective Services (may have a different name where you live) and report it. They will want to know what is the specific threat or danger to your father, so be prepared to answer that question.  Also keep some documentation of who you've spoken to, dates and times, brief re-cap of conversation--so if you need to reference the discharge process in the future, you've got some reminders for yourself and for any other agency people you might talk to.

Candace

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #60 on: September 14, 2018, 02:16:24 PM »
I just want to chime in and say this is such a valuable thread of advice.
+1. Best of luck to the OP and his dad. Thank you to everyone who contributed. I learn so much on this forum.

formerlydivorcedmom

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #61 on: September 14, 2018, 02:29:25 PM »
What about the estranged wife? Even if she "wants nothing to do with his finances", does she necessarily have a choice? If they're still married, can't the hospital (and/or eventual care facility) go after her assets anyway?

Texas is a community property state.  Florida is not. 

Her income may or may not impact what benefits he qualifies for, since they are legally married and in Texas it is assumed that ALL income belongs to both parties.

If the social worker calls you again, you may want to deflect back to the wife.

wenchsenior

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #62 on: September 14, 2018, 02:49:49 PM »
I just want to chime in and say this is such a valuable thread of advice.
+1. Best of luck to the OP and his dad. Thank you to everyone who contributed. I learn so much on this forum.

Absolutely. 

This thread is invaluable.

The OP is essentially living the nightmare scenario that kept me sleepless for about 15 years prior to my mother qualifying for Medicare. Her situation was nearly identical to this in terms of long-term lack of health insurance, low wage jobs with no benefits, no assets at all, etc. I didn't really understand how risky that situation was until I was starting grad school and had had several years of dealing with my own health insurance issues/medical bills and managing my own money in college. From that point, it was never off my mind and was a constant nagging source of worry.  And in fact, she did become seriously ill in her mid 50s and almost died for lack of insurance (though as it turned out her illness was highly treatable for relatively little cost).  It would have had minimal effects, if caught early, which it was not b/c she put off visiting doctors b/c she couldn't even afford co-pays or lab work...had to borrow money to finally get the simple tests/ treatment that saved her life, though she ended up with permanent side effects.

Now, she is on Medicare, for which I am thankful every single day.  But the OP's scenario is still a variant on one we very well might have have to face in the future, in some respects.

bestname

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #63 on: September 14, 2018, 03:26:21 PM »
My husband and I got this treatment when my MIL was hospitalized in Dallas (and she had medicare!). They threatened to release her to a homeless shelter and we folded and brought her home. I wish I could go back in time and read this thread then!

Tris Prior

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #64 on: September 14, 2018, 03:53:14 PM »
My husband and I got this treatment when my MIL was hospitalized in Dallas (and she had medicare!). They threatened to release her to a homeless shelter and we folded and brought her home. I wish I could go back in time and read this thread then!

You know, no one ever believes me when I tell them that the same thing happened to my mom! People say, "oh, a social worker would never say that!" Yes. Yes, they do. I'm so sorry you had to go through that.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #65 on: September 14, 2018, 10:06:26 PM »
An update I have tonight... Called my dad and he claims he's more physically able to use a walker on his own and go to the restroom. Granted he's quite prideful at times and he may be just blowing smoke.  Do I have less of a case now that he's more able? The hospital dropping him off is no issue?

ShoulderThingThatGoesUp

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #66 on: September 15, 2018, 05:23:32 AM »
Maybe go verify that yourself, if you can.

BicycleB

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #67 on: September 15, 2018, 05:57:00 AM »
Concede nothing. Stick to your script.

Even if he can do these things once, can you prove he will be able to them every day without assistance?

Require documented proof of his abilities. Remember, you need assurance because you don't have the time and money to give any care at all!

Get signatures from whoever certifies that he is not going to have an unsafe discharge when they send him somewhere. Who is attesting that any new skills on his part are permanent?

lhamo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #68 on: September 15, 2018, 11:10:24 AM »
Tell them you will report them for an unsafe discharge unless a qualified Occupational Therapist evaluates his abilities and signs off.  Make sure the OT's name is printed on the paper (not just an illegible signature.

My mom was evaluated 3x by an OT before she was released, and she had not had a stroke.  They have them in house for this purpose.

Apple_Tango

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #69 on: September 15, 2018, 02:40:34 PM »
The other thing you can do is to discuss the case with the Hospitalís ombudsman. Maybe they can assist you so youíre not going through this by yourself.