Nowhere to Go, Patients Linger in Hospitals, at a High Cost

Sam Roberts, New York Times, January 2, 2012

Hundreds of patients have been languishing for months or even years in New York City hospitals, despite being well enough to be sent home or to nursing centers for less-expensive care, because they are illegal immigrants or lack sufficient insurance or appropriate housing.

As a result, hospitals are absorbing the bill for millions of dollars in unreimbursed expenses annually while the patients, trapped in bureaucratic limbo, are sometimes deprived of services that could be provided elsewhere at a small fraction of the cost.

“Many of those individuals no longer need that care, but because they have no resources and many have no family here, we, unfortunately, are caring for them in a much more expensive setting than necessary based on their clinical need,” said LaRay Brown, a senior vice president for the city’s Health and Hospitals Corporation. Under state law, public hospitals are not allowed to discharge patients to shelters or to the street.

Medicaid often pays for emergency care for illegal immigrants, but not for continuing care, and many hospitals in places with large concentrations of illegal immigrants, like Texas, California and Florida, face the quandary of where to send patients well enough to leave. {snip}

But even if Medicaid pays for some care, taxpayer dollars are ultimately being consumed by patients who could be cared for in nursing homes or other health facilities, and even at home if supportive services were available. Care for a patient languishing in a hospital can cost more than $100,000 a year, while care in a nursing home can cost $20,000 or less.

Patients fit to be discharged from hospitals but having no place to go typically remain more than five years, Ms. Brown said. She estimated that there were about 300 patients in such a predicament throughout the city, most in public hospitals or higher-priced skilled public nursing homes, though a smattering were in private hospitals.

{snip}

New York Downtown serves a largely immigrant population, and many patients have no insurance or proof that they are in the United States legally, which is necessary for discharge purposes and eventual reimbursements, said Chui Man Lai, assistant vice president of patient services at the hospital.

{snip}

New York Downtown spends about $2 million annually for such patients out of an operating budget of about $200 million. An acute-care patient can cost the hospital more than $1,500 a day.

{snip}

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  • Shawn_thefemale

    Create a snafu that mistakenly registers them for Medicare; not Medicaid, and register them as whites.  Then the hospitals will kick them out after 3 days.

  • Sincerely Concerned

    This was and is happening at a hospital where my friend USED to work.  After years of hard work, study, and sacrifice she earned her RN standing and was hired to perform her dream job.  About two or three years into her work she left, very disgruntled, disallusioned, and hurt.  Sandi (not her real name) cited her reason as being fed up with watching illegal immigrant adults fill the pediatric ward where she was stationed.

    Flash forward several years.  My mom is retired and now volunteers at this hospital once a week.  While her eyes were already opened from watching what is happening to the country for decades, she is having a harder and harder time continuing her work there.

    Isn’t this sad?  We already have a shortage of beds and shortage of medical workers yet we add to it by allowing and encouraging illegals to be here and stay here IN OUR HOSPITALS.

    I used to say that no American has the right to a job (amongst a lot of other things).  What I meant by that statement is that no one, especially, not the government, actually owes anybody anything other than representation and the basic services that our tax dollars pay for (can you tell I am a proponent of small government?).  Can you imagine what I think about those here illegally?  Honestly, what should be done is to round them all up and place them on buses or Amtrak with a one-way ticket back to Central America.  But we all know that’s never going to happen.

  • Anonymous

    “Under state law, public hospitals are not allowed to discharge patients to shelters or to the street.”

    So an inefficient and unrealistic bureaucracy is the problem here.  But they talk about this issue like it’s some impenetrable riddle as to how it happened.  It’s just another self-inflicted wound, another instance of government lamenting a problem it created itself.

    • Southern Man

      I do like your comment, that is just as it is in this country. We talk around a problem, maintaining our political correctness and destroying our hope for a better future.

      In a rush to find an empty ICU bed for an illegal Haitian, my mother was scheduled to be sent to a hospital floor with less care. She had arrived in the hospital, a tax supported institution in South Florida, with a slight case of pneumonia. She was seen by a foreign born doctor who did not follow procedures and did not sterilize his stethoscope. He gave MRSA to 5 elderly patients and they now filled the ICU beds. Now this is in a hospital that the tax payer supports through property taxes. The cost of service however is charged just like any other hospital. All of those patients, including my mother, paid full prices through their insurance. I was tipped off that my mother, who was on a ventilator, would not receive proper care on another floor. I promptly went to the administration office and asked to see the administrator. Of course he wasn’t available but I left word that my mother was being moved and would not receive proper care and that would mean a call to a wrongful death attorney. She was not moved and got better to live another five years. Unfortunately, one of the other whites in the ICU was moved out so that an illegal Haitian could receive care. I tried to inquire about the lady moved out of the ICU but was told that under law I couldn’t intervene. She had no family and a nurse told me a week later she had passed. Medical professionals have told me there is nothing unusual about this in that this happens a lot in South Florida.

    • Foo

      The hospital needs to create a halfway house to discharge illegals to… all the hospitals can chip in to cover it. The house covers the illegals for 10 days, plenty of time for them to figure out what to do with their lives…

  • flyingtiger

    The Chicago Tribune had an immigrant sob story a few months ago about a Polish Illegal immigrant who couldn’t be discharged from the hospital because she had nowhere to go.  She had been in the hospital for a year at that point. I informed them that they could discharge her to her son, who was mentioned in the article. The other choice is to put her in the medicar and drop her off at the embassy. I gave them the address of the embassy. I wonder if they followed my advice. 

    • How about the Salvation Army or some other charity?  Maybe the Soros Foundation would take her.

  • Anonymous

    This is another Washington insanity. How about suing their home counties for the cost of their treatment, then tell said country that their citizens are coming home? We once had a brave President who demanded that illegals leave, but their hasn’t been a President since who cared enough, or had the courage to do that. How sad. The invasion will continue until we elect another Dwight Eisenhower.

  • O7h7on

    The first place to cut the deficit is aid to illegals!!

  • Anonymous

    I know that Ben Taub Hospital in Houston and Parkland Hospital in Dallas each, spend over $100 milllion a year taking care of illegal aliens and their children. This sorry state of affairs repeats at all large hospitals accross the country. This information adds new $$$’s to the outflow of our resources in the wrong direction. Whatever has happened to our culture? Where are we headed as a nation? We are certainly not strengthening the nation or knitting together the fibers that make for the continuation or our exceptionalism!!!!