Healthcare News & Insights

Patients who no longer need care costing hospitals millions

Patients in New York City hospitals who are well enough to be discharged are sticking around longer – like for months or years, according to one health official.

LaRay Brown, a senior vice president for New York City’s Health and Hospitals Corporation, estimates there are 300 patients currently residing in the city’s public hospitals who are either well enough to be discharged or would benefit more from specialized care, the New York Times reports.

Reason: Under state law, public hospitals cannot discharge patients without proper housing.

Each of these patients, many of whom are illegal immigrants, cost hospitals about $100,000 per year. Thing is, many would be better off in other types of facilities, such as nursing homes, which would cost just $20,000, Brown says. While Medicaid often covers emergency care for elderly patients or illegal immigrants, it won’t cover continued care, so the hospitals and taxpayers are footing the bill.

And finding a solution is challenging. One option involves hospitals covering the cost to admit these patients to nursing homes or specialized care facilities. However, these facilities are reluctant to take patients without medical insurance for fear of missing out on reimbursements, hospital executives say.

Other issues: Hospitals don’t want to appear callous by trying to get rid of these patients, and elected officials are wary of trying to get federal programs to reimburse hospitals for their care for fear of being seen as encouraging illegal immigration, according to the New York Times story.

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  1. Lee Larkin says:

    It would be very helpful if you would just focus on the problem itself rather than the immigration status of those involved. While “many” may be illegal immigrants, the majority of the patients are poor uninsured legal citizens. Shift the focus back to the problem itself, highlight the conditions of the legal citizens, show that they are trying to find the best, most practical resolution and get started on identifying a solution. The rest are just excuses.

    The person that brings up the immigration status never has a practical alternate solution, they just want to derail the project. Identify and advertise the result of their proposed course of action ie:
    Either do nothing and all the patients stay in the hospital at great expense.
    Deport the illegals at great expense while not addressing the situation with the legal citizens.
    Or change the law at great expense and take the patients to the nearest park bench and leave them in their hospital gowns to fend for themselves (inhuman).

    These people need to grow up, come to the table to identify a realistic solution they can live with and be part of the solution. If we don’t require that, then we have only ourselves to blame.

  2. @ Lee Larkin- “Or change the law at great expense and take the patients to the nearest park bench and leave them in their hospital gowns to fend for themselves (inhuman)” I’m not saying that all these people are in the same boat, but I guarantee you there are those in this situation who have never worked or just will not get out and work and contribute to society. These people need to be taken out to the park bench…maybe if they are hungry enough they will work. If these people are afraid of the back breaking stuff, they can go to school to get education to try to get a desk job. And for the illegal immigrants, they don’t need to be here in this country anyway much less in our healthcare facilities.

  3. Lee Larkin says:

    An STILL the original problem is not addressed while you choose to focus on complaining about people who don’t “deserve” it.

  4. one way ticket out of the country $500-$1,000! Start there so costs stop accruing for the people who don’t belong and then focus on writing new legislation for those that do. If anyone is able-bodied enough to be discharged then get them out of the hospital…this will speed up the lazy lawmakers and maybe get something accomplished.

  5. @Lee Larkin- Sure the original problem is in a lot of cases ones like these. What do you suggest, for everyone else in society to bear these people on their backs? Not fair my good sir. However, this goes on up the ladder into our high offices- congressmen, senators, and the like who do nothing to contribute to society. I’m sorry but people who choose not to contribute to society do not deserve healthcare. I mean if they wanted it, they would get out and work for it. Now I’m not talking about the worthy poor who are elderly, truly disabled, and who really want to work but in most cases, it’s just obvious. So Lee, what do you suggest is the problem really? I know healthcare costs is an issue and the economy, but something tells me that a lot of these people, even if the economy was good and healthcare costs were reasonable, they would still want healthcare free and charge it to those who contribute. I wholeheartedly agree with the statement, “they that will not work ought not eat.”

  6. Lee Larkin says:

    Who gets to decide who is worthy? You?
    If a US citizen is crabby, distrusful and abusive to the final caregiver are they then considered “not worthy” because they don’t show the appropriate level of gratitude?
    If a non-US citizen is pleasant, does as much as they physically are capable of to take care of themselves and shows their appreciation to the caregiver are they still considered “not worthy”.
    Although you don’t appear to appreciate it, most US residents, citizens or otherwise care about their neighbors in need and offer help when they can. No one I know asks about immigration status before performing CPR.

    As far as the original problem you need to accept the fact the US government will never have an official policy to refuse to assist a human in need in everyday life. If you keep pursuing that, you will get your wish and won’t have to address the first problem at all.

    Once you accept that:
    1. Assess patients medical needs and physical capability.
    2. Assess patient family support availability.
    3. Assess patients financial capability.
    4. Determine what level of care each patient needs, ie: assisted living; nursing home, health aide within their own home, etc.
    5. Determine which existing programs each patient qualifies for to meet these needs.
    6. Once proof of these criteria are met and no other program qualifies, authorize payment for caregiver/facility.
    7. Once the patient is in the less expensive care situation, you can pursue your need to determine their immigration status, work with their country of origin to take them back, defend the lawsuit they file to attempt to stay in this country and whatever other steps you need to meet your own personal goal.

    You already have your wish for “they that will not work ought not eat”, they are called the homeless and bring their own issues with them, crime, begging, communicable diseases, discourage access to public areas, etc. Even then, it is often not that they “will not work” but that they “cannot work” due to mental illness and other problems.

    Face it, sometimes spending a little money on the front end solves expensive problems on the back end.

  7. al yearty says:

    So Lee you think the original problem is that the US government will not address a policy allowing a person to suffer. It would seem that you may be right however isn’t that mind set the reason we have the economic problems we have now. We can not as a country solve everyones problems or keep everyone from suffering. Once we began entitlement problems it became a lot like charity which steals a persons pride, with out pride in one’s self you start to become simply a taker and not a contributer. Maybe a better solution is to let people fend for themselves for a while restrict homeless invasiveness and direct services to the contributers. It may seem heartless but the cycle has to stop

  8. Lee Larkin says:

    No, the reason we are where we are now is that the financial industry was allowed to make their own rules, ignore the rules they didn’t want to follow; create mythical financial instruments and basically treat all the mortgages they were entrusted with as though they were poker chips.

  9. Lee Larkin says:

    That and tax cuts were given without developing corresponding revenue and/or spending cuts to offset them. For almost a decade this country: banks, businesses and citizens were basically running up their credit cards to appear more prosperous than they were. Big surprise, the bill came due and we are all paying for it.