Author Topic: Life turned upside down: dad has stroke and has no insurance  (Read 10685 times)

Emergo

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Life turned upside down: dad has stroke and has no insurance
« on: September 09, 2018, 06:11:12 PM »
- we live in Texas
-he's soon to be discharged since he has no insurance
-entire left side is weak, he is unable to walk
-he is 58 y.o.
-has no properties
-worked "side errands", meaning paid no taxes and basically unemployed
-has a wife, but in Florida. Technically separated. She doesn't want anything to do with his finances
-going to sign him up for Medicare, Medicaid, SSI, disability, etc. Social worker said he is not eligible for Medicare or Medicaid since he has no kids and the doctor has not deemed him unable to work for 12 months
-hospital bill is currently $45000 and rising
-i am in a hurry to find him an assisted living home since he cannot stand or get up on his own. These range from $2500 -$3500! I simply cannot afford this. I found one for $900 but it looks suspicious
-i live in a 400 sq ft home and I work a full time job I cannot take care of him
-physical therapist thinks with proper rehab he may return to 90% of his original form and we will know in three months the extent of his permanent damage
-he has a $2000 car paid in full, a large TV, laptop, a gun as assets
-he lived in a group home where no one will take care of him there
-i cannot just abandon him. Therefore I am screwed. I just turned 30
-what does the hospital do if I don't show up to take responsibility for him?
« Last Edit: September 10, 2018, 03:10:35 PM by Emergo »

AMandM

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I am so sorry! I take it you don't have siblings who can help?

This may be different in Texas, but I recently helped someone who had no insurance and a lot of medical bills from an ER visit that led to surgery. The hospital's billing office had an application for medical assistance. We filled it out, certifying that the patient had no income (she was a refugee and not allowed to work), and the hospital waived *all* the charges. Your father's hospital might have a social worker who could help.

If he is not eligible for Medicaid, can you sign him up for insurance on the marketplace?

Can he move either into a group home or into your apartment with some kind of paid care? If it doesn't have to be round-the-clock, it might be easier to find and to afford than an assisted-living facility. Or maybe it could be in another shared flat?

Best of luck to you.

Frznrth

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I'm sorry - that sounds like a horrific situation.  I used to work in healthcare in the states as a therapist  The rehab centre I was at would take Medicaid patients.  I never had anything to do with how they qualified for Medicaid but the requirement of having kids doesn't make sense to me.  I was reading on this site

https://texas-benefits.org/Medicaid/Medicaid-Qualifications.html?msclkid=cf3da5625fb018a46f18fef792798e1b&utm_source=bing&utm_medium=cpc&utm_campaign=Search_TX_Benefits_Medicaid_Geo&utm_term=%2Bmedicaid%20%2Beligibility&utm_content=Eligibility%20-%20BM

and didn't see that.  Hopefully the social worker was wrong about this. 

Best of luck. 

CrustyBadger

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Well, without money or insurance he isn't going to get proper rehab, so I think it is very optimistic that your dad's physical therapist thinks he will regain 90% of his functional capacity.

I think his best bet may be to apply for SSI.  To qualify with a stroke as a listing condition they do need to believe his condition will last over 12 months though, and the effect of the stroke needs to either be difficulty speaking or writing; or pronounced difficulty controlling two limbs.

At his age it might not be that difficult for him to be approved for SSI, and with SSI comes Medicaid, I believe.

mrmoonymartian

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So... was he mentally ill before this stroke, or what? Opioid addict maybe?

I'm struggling to understand how he got to 58 with no assets besides a car, TV, laptop and plan B.

former player

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So... was he mentally ill before this stroke, or what? Opioid addict maybe?

I'm struggling to understand how he got to 58 with no assets besides a car, TV, laptop and plan B.


Look, approximately 40% of the adult population in any developed country couldn't lay their hands on more assets than this, it's very common.  You are lucky if you've lived a life insulated from these realities.

Of course, in most of the developed world rehab from a stroke would be a given, too.  OP's father's situation is just one result of the stupidities and cruelties of the USA political system.


OP: first thing is: don't do or say anything to anyone which suggests that you can or will take responsibility for your father, or provide housing for him.  In particular, don't sign any papers on his behalf, no matter how innocuous they seem or you are told they are.   I'm not saying abandon him, I am saying don't let yourself be tricked into any financial or legal obligations.  This is partly to protect you, but it is also because if your father is totally without resources there may be assistance available to him which would not be available if you are listed as one of his resources.

Second thing is: forget the hospital bill: it will never be paid and the hospital already knows this, so it is irrelevant.

What you can do is hit the phones and the internet to find your father the help he needs.  He needs a social worker or advocate who knows the system, knows what options are available and can work through the bureaucracy on his behalf, rather than you having to do this starting from a position of ignorance.  There  will be local charities which will have good knowledge about available options.  Stroke is a common condition: I'm betting there is a local, regional or national stroke charity which will give good free advice.

I understand a little of what you are going through.  My father had a disabling stroke in the UK: his hospital treatment was free, his rehab was free, he had a house and pension and a younger able-bodied wife to care for him, and the stroke didn't happen until he was in his late 70s.  It was still a hard thing for all of us to go through.  You have my best wishes and I hope you find a better outcome for your father.

CrustyBadger

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I'm sorry - that sounds like a horrific situation.  I used to work in healthcare in the states as a therapist  The rehab centre I was at would take Medicaid patients.  I never had anything to do with how they qualified for Medicaid but the requirement of having kids doesn't make sense to me.  I was reading on this site

https://texas-benefits.org/Medicaid/Medicaid-Qualifications.html?msclkid=cf3da5625fb018a46f18fef792798e1b&utm_source=bing&utm_medium=cpc&utm_campaign=Search_TX_Benefits_Medicaid_Geo&utm_term=%2Bmedicaid%20%2Beligibility&utm_content=Eligibility%20-%20BM

and didn't see that.  Hopefully the social worker was wrong about this. 

Best of luck.

I think it was correct.  The situation in Texas for adults who are unemployed, ill, and lack health insurance is not a good one.

https://forabettertexas.org/images/2016_HW__Adults_with_Serious_and_Chronic_Illnesses.pdf

Emergo

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So... was he mentally ill before this stroke, or what? Opioid addict maybe?

I'm struggling to understand how he got to 58 with no assets besides a car, TV, laptop and plan B.


Look, approximately 40% of the adult population in any developed country couldn't lay their hands on more assets than this, it's very common.  You are lucky if you've lived a life insulated from these realities.

Of course, in most of the developed world rehab from a stroke would be a given, too.  OP's father's situation is just one result of the stupidities and cruelties of the USA political system.


OP: first thing is: don't do or say anything to anyone which suggests that you can or will take responsibility for your father, or provide housing for him.  In particular, don't sign any papers on his behalf, no matter how innocuous they seem or you are told they are.   I'm not saying abandon him, I am saying don't let yourself be tricked into any financial or legal obligations.  This is partly to protect you, but it is also because if your father is totally without resources there may be assistance available to him which would not be available if you are listed as one of his resources.

Second thing is: forget the hospital bill: it will never be paid and the hospital already knows this, so it is irrelevant.

What you can do is hit the phones and the internet to find your father the help he needs.  He needs a social worker or advocate who knows the system, knows what options are available and can work through the bureaucracy on his behalf, rather than you having to do this starting from a position of ignorance.  There  will be local charities which will have good knowledge about available options.  Stroke is a common condition: I'm betting there is a local, regional or national stroke charity which will give good free advice.

I understand a little of what you are going through.  My father had a disabling stroke in the UK: his hospital treatment was free, his rehab was free, he had a house and pension and a younger able-bodied wife to care for him, and the stroke didn't happen until he was in his late 70s.  It was still a hard thing for all of us to go through.  You have my best wishes and I hope you find a better outcome for your father.

Thank you.  I haven't signed anything other than the fact that I provided my first name and told them I was his son and gave my number for emergency contact. Other than that, I went to the hospital's financial office and the lady gave me a hint that if my dad made an "effort to pay", she could provide me a form to waive the bill. So at the time I didn't have cash, so I paid with my own card to pay her $25 and used my signature on the device. I haven't signed any forms.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #8 on: September 10, 2018, 03:11:22 PM »
Just seeing if there are any more thoughts. Thank you

fuzzy math

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #9 on: September 10, 2018, 03:35:03 PM »
So... was he mentally ill before this stroke, or what? Opioid addict maybe?

I'm struggling to understand how he got to 58 with no assets besides a car, TV, laptop and plan B.


Look, approximately 40% of the adult population in any developed country couldn't lay their hands on more assets than this, it's very common.  You are lucky if you've lived a life insulated from these realities.

Of course, in most of the developed world rehab from a stroke would be a given, too.  OP's father's situation is just one result of the stupidities and cruelties of the USA political system.


OP: first thing is: don't do or say anything to anyone which suggests that you can or will take responsibility for your father, or provide housing for him.  In particular, don't sign any papers on his behalf, no matter how innocuous they seem or you are told they are.   I'm not saying abandon him, I am saying don't let yourself be tricked into any financial or legal obligations.  This is partly to protect you, but it is also because if your father is totally without resources there may be assistance available to him which would not be available if you are listed as one of his resources.

Second thing is: forget the hospital bill: it will never be paid and the hospital already knows this, so it is irrelevant.

What you can do is hit the phones and the internet to find your father the help he needs.  He needs a social worker or advocate who knows the system, knows what options are available and can work through the bureaucracy on his behalf, rather than you having to do this starting from a position of ignorance.  There  will be local charities which will have good knowledge about available options.  Stroke is a common condition: I'm betting there is a local, regional or national stroke charity which will give good free advice.

I understand a little of what you are going through.  My father had a disabling stroke in the UK: his hospital treatment was free, his rehab was free, he had a house and pension and a younger able-bodied wife to care for him, and the stroke didn't happen until he was in his late 70s.  It was still a hard thing for all of us to go through.  You have my best wishes and I hope you find a better outcome for your father.

I think the mental illness question was posed due to the OP stating that he lived in a group home.

OP I agree with what advice you’ve been given. Don’t sign for anything else. If you hadn’t paid, they’d still likely have written it off. They recognize if he has no ability to pay. Do not offer to take him, pay for him etc. ask for a social worker and tell them you lack the ability to help. Ask them what they plan to do with your dad upon discharge. Talk to the dr, explain that he will be permanently disabled without rehab and see if they will change his status.

Aside from finding resources or you paying, there are not many options. Social workers deal with this sort of thing fairly often.


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CindyBS

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #10 on: September 10, 2018, 03:37:13 PM »
What does the group home say?  Do they have someone who can offer advice?  If they don't have a social worker who can work with you, they may be able to direct you to someone who can.  - Adult protective services? Local senior center?   

Is that group home for a pre-existing condition like being intellectually disabled or an addict?  If so, can he qualify for services based on that disability?   My mom went on medicare in her late 50's for a disability she got in her 20's.  She had not been on it or Medicaid in the previous decades.

Also, I'd immediately take away the gun.  That is the last thing anyone needs - a person who just had a neurological event, possibly on a bunch of medications, in a new environment, with shakey/weak hands/trigger finger. 

You may need to take FMLA to care for him, hopefully you won't.  However, if you are not familiar with it, there is a provision of FMLA called intermittent FMLA that allows you have a lot of flexibility on when you take days off.  I have a son that is ill and I stay home to take care of him and my DH works.  Even though DH doesn't take a lot of time off, when he does, it is helpful to have that intermittent FMLA set up and prevents a lot of political push back if he has to miss an "important" meeting or something.   Once you sign up it is valid for a year. 

Long term - it may be better to move him to state with Medicaid expansion. 

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #11 on: September 10, 2018, 04:00:16 PM »
Let me elaborate on the group home:

It was just a place where people boarded the different rooms in the house and he was one of the tenants.

lizzzi

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #12 on: September 10, 2018, 04:47:28 PM »
Former public health nurse here. Believe it or not, his situation, dire though it seems, is not that uncommon. The hospital is mandated by law to make a safe discharge plan. It is their responsibility, not yours. There are plenty of people in bad shape and with no money living in rooming houses and being cared for by a range of county services. The hospital social worker will know how to coordinate the discharge, so let her do her job. What you want to do is to be aware of what they're doing--, but making it clear that while you are very concerned, and can have some minimal involvement (very minimal), you cannot provide the care or financial support. You need to sound like you can be of some help in a dire emergency (like bring some food over to him if his aide gets killed on her way to work) or whatever...but don't take responsibility for much more than that. They like to have a family member as an emergency contact--but make sure you are very firm with them about what you can and (mostly) cannot do. It sounds like they're going to have to get him some emergency Medicaid tied in with public assistance, some Food Stamps, put him in a homeless shelter maybe for a while as they look for more suitable housing--maybe get Adult Protective Services involved--set up a home care plan that involves skilled nursing, PT, OT, maybe a Voice of Help button--but as I said--they'll know how to do this--make sure they know who you are and where you are, but don't muddy the waters and get in the way of him getting his benefits. As far as the hospital bill, your father can work out a "payment plan" with them--where he pays $1.00 a month forever or something like that. They'll probably want a payment plan, but they know perfectly well they are never really ever going to get paid. Hospitals set a certain amount aside in their budgets for these situations. It's another thing they are required to do by law. Again, it's the hospital social worker's responsibility to pull the discharge plan together...and "Home with family" is not the discharge plan...so stand your ground  Good luck with all this.

mm1970

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #13 on: September 10, 2018, 05:05:20 PM »
Former public health nurse here. Believe it or not, his situation, dire though it seems, is not that uncommon. The hospital is mandated by law to make a safe discharge plan. It is their responsibility, not yours. There are plenty of people in bad shape and with no money living in rooming houses and being cared for by a range of county services. The hospital social worker will know how to coordinate the discharge, so let her do her job. What you want to do is to be aware of what they're doing--, but making it clear that while you are very concerned, and can have some minimal involvement (very minimal), you cannot provide the care or financial support. You need to sound like you can be of some help in a dire emergency (like bring some food over to him if his aide gets killed on her way to work) or whatever...but don't take responsibility for much more than that. They like to have a family member as an emergency contact--but make sure you are very firm with them about what you can and (mostly) cannot do. It sounds like they're going to have to get him some emergency Medicaid tied in with public assistance, some Food Stamps, put him in a homeless shelter maybe for a while as they look for more suitable housing--maybe get Adult Protective Services involved--set up a home care plan that involves skilled nursing, PT, OT, maybe a Voice of Help button--but as I said--they'll know how to do this--make sure they know who you are and where you are, but don't muddy the waters and get in the way of him getting his benefits. As far as the hospital bill, your father can work out a "payment plan" with them--where he pays $1.00 a month forever or something like that. They'll probably want a payment plan, but they know perfectly well they are never really ever going to get paid. Hospitals set a certain amount aside in their budgets for these situations. It's another thing they are required to do by law. Again, it's the hospital social worker's responsibility to pull the discharge plan together...and "Home with family" is not the discharge plan...so stand your ground  Good luck with all this.
My friend's sister went through this.  The hospital tried to discharge her, but she had no job, no home, and no place to go.  Her mother was put into a home.  My friend made sure the hospital knew they were not allowed to discharge her until they found a place for her.  California, no TX, but she had a social worker assigned to her and a case.

frugaliknowit

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #14 on: September 11, 2018, 01:27:28 PM »
Also, I'd immediately take away the gun.  That is the last thing anyone needs - a person who just had a neurological event, possibly on a bunch of medications, in a new environment, with shakey/weak hands/trigger finger. 

YES YES YES YES YES and YES, DEFINITELY!!!

This sounds "spot on" to me:

Former public health nurse here. Believe it or not, his situation, dire though it seems, is not that uncommon. The hospital is mandated by law to make a safe discharge plan. It is their responsibility, not yours. There are plenty of people in bad shape and with no money living in rooming houses and being cared for by a range of county services. The hospital social worker will know how to coordinate the discharge, so let her do her job. What you want to do is to be aware of what they're doing--, but making it clear that while you are very concerned, and can have some minimal involvement (very minimal), you cannot provide the care or financial support. You need to sound like you can be of some help in a dire emergency (like bring some food over to him if his aide gets killed on her way to work) or whatever...but don't take responsibility for much more than that. They like to have a family member as an emergency contact--but make sure you are very firm with them about what you can and (mostly) cannot do. It sounds like they're going to have to get him some emergency Medicaid tied in with public assistance, some Food Stamps, put him in a homeless shelter maybe for a while as they look for more suitable housing--maybe get Adult Protective Services involved--set up a home care plan that involves skilled nursing, PT, OT, maybe a Voice of Help button--but as I said--they'll know how to do this--make sure they know who you are and where you are, but don't muddy the waters and get in the way of him getting his benefits. As far as the hospital bill, your father can work out a "payment plan" with them--where he pays $1.00 a month forever or something like that. They'll probably want a payment plan, but they know perfectly well they are never really ever going to get paid. Hospitals set a certain amount aside in their budgets for these situations. It's another thing they are required to do by law. Again, it's the hospital social worker's responsibility to pull the discharge plan together...and "Home with family" is not the discharge plan...so stand your ground  Good luck with all this.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #15 on: September 11, 2018, 03:46:20 PM »
Former public health nurse here. Believe it or not, his situation, dire though it seems, is not that uncommon. The hospital is mandated by law to make a safe discharge plan. It is their responsibility, not yours. There are plenty of people in bad shape and with no money living in rooming houses and being cared for by a range of county services. The hospital social worker will know how to coordinate the discharge, so let her do her job. What you want to do is to be aware of what they're doing--, but making it clear that while you are very concerned, and can have some minimal involvement (very minimal), you cannot provide the care or financial support. You need to sound like you can be of some help in a dire emergency (like bring some food over to him if his aide gets killed on her way to work) or whatever...but don't take responsibility for much more than that. They like to have a family member as an emergency contact--but make sure you are very firm with them about what you can and (mostly) cannot do. It sounds like they're going to have to get him some emergency Medicaid tied in with public assistance, some Food Stamps, put him in a homeless shelter maybe for a while as they look for more suitable housing--maybe get Adult Protective Services involved--set up a home care plan that involves skilled nursing, PT, OT, maybe a Voice of Help button--but as I said--they'll know how to do this--make sure they know who you are and where you are, but don't muddy the waters and get in the way of him getting his benefits. As far as the hospital bill, your father can work out a "payment plan" with them--where he pays $1.00 a month forever or something like that. They'll probably want a payment plan, but they know perfectly well they are never really ever going to get paid. Hospitals set a certain amount aside in their budgets for these situations. It's another thing they are required to do by law. Again, it's the hospital social worker's responsibility to pull the discharge plan together...and "Home with family" is not the discharge plan...so stand your ground  Good luck with all this.

I had The most cringiest phone conversation with the case manager. She kept pushing me to take responsibility for my dad. Kept asking if I can up my range. Kept saying if I have any friends or family. I must have said no twenty times. She said he can't stay at the hospital and he can't stay at the shelter because he can't stand up. She said she will call tomorrow again. Also said if I can stay home and stop work and take care of him. Should I still stand my ground?

Apple_Tango

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #16 on: September 11, 2018, 03:59:22 PM »
STAND YOUR GROUND. He “can’t” stay at the hospital because a hospitals number one job is to discharge as quickly as possible. In reality he can and will stay there until they find a place for discharge. The costs will rise but that is a later battle. Do not become any form of financial support for him- the hospital will come for your blood. And he will get better rehab care in the short term while at the hospital than at a low budget nursing home, in my opinion. I’ve worked in both settings. I know you don’t want to feel like you are abandoning him- you are not. If you say you can bring him home he will be denied other services and will get intermittent home health care rather than daily rehab. Do not do this. Once he is placed in a rehab center, you can help by visiting and being his advocate.
« Last Edit: September 11, 2018, 04:01:20 PM by Apple_Tango »

lizzzi

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #17 on: September 11, 2018, 05:05:22 PM »
Yes. Stand Your Ground. The case manager is "playing the game." She is trying to get you to take responsibility so she and the hospital don't have to do their jobs. Don't listen to her psychological manipulation of you. Stand Your Ground.

Another Reader

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #18 on: September 11, 2018, 05:19:56 PM »
The answer is no, there is nothing more I can do.  No I can't stay home and take care of him, I have to work.  They need to place him.  That's their job.  Don't answer the phone if she calls again.  Leave her a voice mail reply after hours that you can't do anything else and that you are at work during business hours.

I hope you read whatever you digitally signed.  Who knows what lies she told to get you to sign.  Handing over that $25 may be the start of your problems.

dcheesi

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #19 on: September 11, 2018, 05:33:51 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?

I'm a red panda

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #20 on: September 11, 2018, 05:43:51 PM »
You may need to take FMLA to care for him, hopefully you won't.  However, if you are not familiar with it, there is a provision of FMLA called intermittent FMLA that allows you have a lot of flexibility on when you take days off.  I have a son that is ill and I stay home to take care of him and my DH works.  Even though DH doesn't take a lot of time off, when he does, it is helpful to have that intermittent FMLA set up and prevents a lot of political push back if he has to miss an "important" meeting or something.   Once you sign up it is valid for a year. 

Assuming you qualify for FMLA.  A huge portion of the American public, even those in jobs with otherwise excellent benefits, does not. It's very limited.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #21 on: September 11, 2018, 07:24:50 PM »
The answer is no, there is nothing more I can do.  No I can't stay home and take care of him, I have to work.  They need to place him.  That's their job.  Don't answer the phone if she calls again.  Leave her a voice mail reply after hours that you can't do anything else and that you are at work during business hours.

I hope you read whatever you digitally signed.  Who knows what lies she told to get you to sign.  Handing over that $25 may be the start of your problems.

It was on one of those devices where you insert or swipe your card. Didn't say anything. I didn't put my printed name or address or anything.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #22 on: September 11, 2018, 07:31:47 PM »
Another Reader you have me really paranoid now. She seems like a really sweet lady who just wanted to help.

BicycleB

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #23 on: September 11, 2018, 07:48:57 PM »
Wow, @lizzzi, great answer!!

Emergo, stand firm. Your best way to support is follow Lizzi's instructions no matter how hard or sweetly the hospital pushes you. You have to consistently refuse the responsibility.

Your real responsibility will be to check up on dad while other people do their jobs. And to make other people do their jobs - again, without you officially taking responsibility. And, of course, provide emotional support when you can, as long as it doesn't interfere with his benefits or your ability to make a living.

My dad went through years of medical problems and emotional turmoil when he got sick. Then (not to be a downer) he passed away. Making sure his logistics were squared away WITHOUT us paying the bills or giving primary care? It was the best thing my sister and I did.
« Last Edit: September 11, 2018, 07:52:02 PM by BicycleB »

Another Reader

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #24 on: September 11, 2018, 07:51:18 PM »
Why did you give the hospital $25?  What was that for?

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #25 on: September 11, 2018, 08:04:44 PM »
Why did you give the hospital $25?  What was that for?

Her words were that the hospital doesn't like it when patients don't make an effort to pay. If the patient makes an effort, the hospital may be more inclined to forgive the bill. I told her I was going to the ATM because I didn't have cash, she pointed it out that there were several in the area. She then said it should be no issue if you paid with your card because your name won't be on record. I expressed to her my hesitance to pay with my card because I didn't want to be liable for the bill. She said it would be alright. Then when I paid a random amount of $25, she gave me a form for financial assistance.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #26 on: September 11, 2018, 08:08:42 PM »
Why did you give the hospital $25?  What was that for?

Also, after I paid, she gave me the receipt (with no sign of my name just my dad's) and pointed out that it has an account number that goes in a field on the financial assistance form. I think this was key to being accepted to forgive the bill.

Another Reader

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #27 on: September 11, 2018, 08:12:47 PM »
I defer to lizzzi on this one.  Perhaps because this happened before the discharge issue came up, there is no importance beyond what she stated. 

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #28 on: September 11, 2018, 09:02:16 PM »
Thanks for all the tips. I hope everything goes well... (Especially with that $25 payment ugh)

bogart

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #29 on: September 11, 2018, 10:33:45 PM »
I'm so sorry to hear about your dad, and your situation as it's shaped by what's happened to him.

Just wanted to join the "stand firm" crowd.  My dad had a stroke years ago and we went through pretty much exactly the same thing (although fortunately he had somewhat more resources -- older, so on Medicare, and able to qualify for Medicaid).  Getting the hospital to embrace the reality that they had to find a place to release him to was a ... challenge.  You do not want to (and cannot -- don't kid yourself about what would be involved and it would absolutely be impossible for an individual to do safely FOR THE PATIENT'S SAKE, never mind your own well-being) be responsible for providing care for your dad.  It is 100% in his interest that you stand firm on this.  GL.

former player

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #30 on: September 12, 2018, 02:23:01 AM »
About that $25 - does your father have $25, or something worth $25, that he could agree to give you in return?  That would bolster the argument that you were paying on behalf of your father, as his agent, and have been reimbursed - it would be a further argument that you have not accepted responsibility as primary but were only acting on his behalf.  It's the same principle of paying an insurance agent for insurance- the agent doesn't have to pay the claim, the insurance company does, because the agent is acting on behalf of the company not for themselves personally.  So what you say is that the hospital wanted "the patient" to make an effort to pay so you paid as agent on the patient's behalf and either have or expect to be reimbursed by your father when he is able to do so.  Say that the hospital were clear that the bill was the patient's and that it was the patient they wanted to make an effort and that you were paying as agent for the patient.  Of course, only say all this if the hospital does come after you, don't start any unnecessary conversations.


And I agree with everyone else that the best thing you can do for your father is not to take him home to your small flat where you will be gone all day, but ensure that he stays in hospital until proper arrangements are made by the hospital for his future care and rehabilitation.  If there are any further attempts at getting you to take responsibility just shut them down immediately.  "No." is a complete sentence.   If someone does not respect your "no", it is perfectly all right for you to say "I have said no and cannot continue this conversation" and walk away or put the phone down.

Fig

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #31 on: September 12, 2018, 03:32:55 AM »
It's the sweet lady's job to encourage families to take on care and save the hospital money. The hospital staff are just earning a living like anyone else but don't assume they're acting in you or your dad's best interests inless they are making things happen.

So, +1 to everyone saying standing your ground. I've been in a similar position and the hospital had to provide help rather than just discharging a vulnerable person.

FIRE47

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #32 on: September 12, 2018, 09:05:13 AM »
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?

This is all your fault - should have prayed more.

The $25 sounds like a standard play to get you on the hook by the hospital.
« Last Edit: September 12, 2018, 09:09:13 AM by FIRE47 »

saguaro

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #33 on: September 12, 2018, 10:32:08 AM »
I agree with the others, stand firm.   

IME, hospitals don't always consider the safety of the patient when they discharge to home with family.  Even when the family wants it. 

During my mother's final months, I personally saw upfront and personal how willing hospitals are to discharge a patient to family care when it's the easy solution but not realistic or safe for the patient.  My mom was on Medicare and BC/BS supplemental insurance so the financials were not an issue.   My sisters and I all had jobs, quitting those jobs was not an option and my father, who was the so-called primary caregiver, was not up to the job as he had his own health and mobility issues, plus being 10 years older than Mom (late 80s).   

In our case, however, my dad wanted her home and my two other sisters felt they had to go along with it, in spite of their misgivings (and that the care would largely fall to the 3 of us anyway), I was the only one with the unpopular opinion that saying "no" was an option and to push back on the hospital taking what I saw was not a safe solution.   She was a considerable fall risk.  She would not take medications when at home, she was cooperative in the hospital, but at home, taking meds was very optional and her condition would worsen as a result.  Each time Mom went home, she was back in the hospital within days due to either a fall or some complication that developed because she was without the constant care she got in the hospital.  It was only after she went back a 4th time, that my family put their foot down on being discharged to home again and she went to a care facility.

Just another consideration in a situation like this.  Sometimes the best place to ensure the patient's safety is not for them to be at home in family care but hospitals don't always do this.  Just my experience.   
« Last Edit: September 12, 2018, 10:44:49 AM by saguaro »

mm1970

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #34 on: September 12, 2018, 12:32:07 PM »
Yes. Stand Your Ground. The case manager is "playing the game." She is trying to get you to take responsibility so she and the hospital don't have to do their jobs. Don't listen to her psychological manipulation of you. Stand Your Ground.

This.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #35 on: September 12, 2018, 01:23:37 PM »
So I screwed up. As part of my cringe conversation with the social worker , I forgot to mention to you guys that I provided  a number I thought was unrealistic to afford an assisted living place. This was $300. Now the social worker called today that they will find a care home they are vetted with and thats what they'll help with. Theyll pay the remaining balance subtracted from $300  I screwed up badly didn't I? Should I not call back? They don't have anything  from me. No address. Nothing but my number. The bad thing about this is that this is just care home and no rehab.
« Last Edit: September 12, 2018, 01:31:27 PM by Emergo »

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #36 on: September 12, 2018, 01:31:21 PM »
So I screwed up. As part of my cringe conversation with the social worker , I forgot to mention to you guys that I provided  a number I thought was unrealistic to afford an assisted living place. This was $300. Now the social worker called today that they have vetted and thats what they'll help with. I screwed up badly didn't I? Should I not call back? They don't have anything  from me. No address. Nothing but my number.

I'm not clear, were you saying that you would find an assisted living place if you got $300 (a month?) in assistance?  Have you made any other "offers" to the social worker.

My default approach for you in this situation would probably be to call the social worker back, say "sorry I misunderstood the situation, I am unable to help at all.  My father requires full assistance from the hospital and you for his future needs".  You need to put a stop, as soon as possible, to any idea that you can do anything for your father.


Edited to add: you are obviously a nice guy trying to do the best for your father.  Please remember 1) that the best you can do for your father is for him to have all the public support that is available and that any help you offer will be a deduction from the publicly available help and 2) "No." is a complete sentence.
« Last Edit: September 12, 2018, 01:33:32 PM by former player »

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #37 on: September 12, 2018, 01:32:34 PM »
So I screwed up. As part of my cringe conversation with the social worker , I forgot to mention to you guys that I provided  a number I thought was unrealistic to afford an assisted living place. This was $300. Now the social worker called today that they have vetted and thats what they'll help with. I screwed up badly didn't I? Should I not call back? They don't have anything  from me. No address. Nothing but my number.

I'm not clear, were you saying that you would find an assisted living place if you got $300 (a month?) in assistance?  Have you made any other "offers" to the social worker.

My default approach for you in this situation would probably be to call the social worker back, say "sorry I misunderstood the situation, I am unable to help at all.  My father requires full assistance from the hospital and you for his future needs".  You need to put a stop, as soon as possible, to any idea that you can do anything for your father.

It's that I could only pay $300 to anything. say they find a care home that charges $3000. I pay $300 out of that and the hospital pays the rest.

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #38 on: September 12, 2018, 01:35:23 PM »
You can't get any help or a room at $300.  The way she phrased this is that they will help you solve "your" problem.  It's her problem to solve, not yours.  Call her back and say your number was an unrealistic guess because you know nothing about this.  You have to work and your father cannot come to live with you and you have no money to help him, so the hospital social worker will have to find an appropriate discharge solution.  No other discussion.  Do not get drawn into further conversation.  I cannot take him, I can't help you solve your problem and I cannot help financially.  I'm sorry, but I have to go now.  And hang up.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #39 on: September 12, 2018, 01:40:04 PM »
You can't get any help or a room at $300.  The way she phrased this is that they will help you solve "your" problem.  It's her problem to solve, not yours.  Call her back and say your number was an unrealistic guess because you know nothing about this.  You have to work and your father cannot come to live with you and you have no money to help him, so the hospital social worker will have to find an appropriate discharge solution.  No other discussion.  Do not get drawn into further conversation.  I cannot take him, I can't help you solve your problem and I cannot help financially.  I'm sorry, but I have to go now.  And hang up.

I think the idea for the hospital is if I bite with this (them helping with placing him in a care home) they'll leave the rehab responsibility to me.

BicycleB

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #40 on: September 12, 2018, 01:40:04 PM »
Emergo, I suggest using Another Reader's post to write yourself a phone script. Write down on a  piece of paper the words you're going to say on the phone. Call them, say the script, get off.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #41 on: September 12, 2018, 01:45:21 PM »
What happens if I don't answer and block her calls instead?

Could they continue with this plan and tell their upper management that I said I could contribute this much and then leave him there while assuming I will take responsibility for his rehab?
« Last Edit: September 12, 2018, 01:48:00 PM by Emergo »

Cassie

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #42 on: September 12, 2018, 01:49:57 PM »
As a former social worker as long as you didn’t agree to anything in writing you should be fine. This is their problem and not yours. Shame on them for what they are doing.

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #43 on: September 12, 2018, 01:50:59 PM »
I can't be grateful enough for all the responses you guys have given me. I don't know what crap I would be in without this forum. THANK YOU

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #44 on: September 12, 2018, 02:14:36 PM »
What happens if I don't answer and block her calls instead?

Could they continue with this plan and tell their upper management that I said I could contribute this much and then leave him there while assuming I will take responsibility for his rehab?

I think the longer you leave it open that you are prepared to pay anything the more it will be "baked into the cake" of the arrangements being made for your father and the harder it will be to stop the assumption that you will be paying.  So I would call back as soon as you can and just say "sorry, I misspoke, I can't afford to pay anything.  You need to make arrangements without any further input from me.  I can't talk to you about this again.  Goodbye."

Apple_Tango

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #45 on: September 12, 2018, 06:00:04 PM »
Ah notice what they did? Sneaky sneaky. You made a guess that you could help with $300. Magically they found one “ solution” that involves you paying exactly $300. Imagine that. If you say “that was just a number I threw out without looking at my true budget because I was feeling overwhelmed. Unfortunately $300 is not workable when I looked at my finances- I am having extreme financial difficulties (you can lie!) and I can’t contribute any amount.” Or something to that effect.
Magically they will find a solution where you pay $0.

Also, you need to push for rehab- make it very clear that you are unable to assist because of your full time job and other responsibilities and that you can’t be responsible for his rehab. VERY IMPORTANT STEP. Rehab is the key to any chance of him getting out of this situation. Hopefully he makes a nice recovery.

Repeat this to yourself as a mantra “ I’m not abandoning my dad. I am getting him the social services he needs.” Any time you are feeling bad.
« Last Edit: September 12, 2018, 06:05:33 PM by Apple_Tango »

Emergo

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #46 on: September 12, 2018, 06:07:41 PM »
Ok, I left a voicemail to the social worker:

I would just like to let you know this message is being recorded
I'm letting you know that I will not be contributing financially to my father's care
this decision is final
I do not authorize my name to be used in any hospital forms
since I have let you know my final decision, please do not contact me again regarding financial matters

Another Reader

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #47 on: September 12, 2018, 06:24:45 PM »
Decisions are changeable.  You are saying you could help but you won't.  This won't work and won't be the end of the conversation.  Maybe you will help if the they heap a bit more guilt on you.

You need them to conclude you cannot participate in his care.  A decision not to participate does not cause them to conclude that.  You have to set the boundaries that result in the proper conclusion.  This is what has to be conveyed.  "I have to work so I cannot care for him.  No one else in my family can care for him.  I have no money to contribute to his care.  I cannot assist in finding him a place to go.  That is your responsibility.  Please advise me when and where he is sent upon discharge and what rehab arrangements have been made."

Cassie

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #48 on: September 12, 2018, 06:43:48 PM »
Don't return their calls. 

CrustyBadger

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Re: Life turned upside down: dad has stroke and has no insurance
« Reply #49 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?