Home News Local news All Healed Up and No Place to Go: Long-Term Patients Tie Up Hospital Beds

All Healed Up and No Place to Go: Long-Term Patients Tie Up Hospital Beds

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March 9, 2008 — Gov. Juan F. Luis Hospital has 16 extended-care patients tying up beds and costing the hospital millions because they no longer need treatment, but have no place to go for long-term care.
"There are 16 more here than should be," said Gregory Calliste, the hospital's president and CEO, in a recent Source interview. The issue has been around since the 1990s, said Calliste, who became CEO in 2004.
The hospital is a licensed acute-care hospital, not an extended-care facility. Acute-care facilities have the goal of discharging patients as soon as they are healthy and stable with discharge instructions.
But in recent years, this goal at Juan F. Luis Hospital has been stymied. One patient has been in the extended-care unit for six years. And the hospital has found itself with as many as 35 beds filled with patients who should be moved on.
They actually came in ill, got better, were discharged and had no home or long-term facilities to go to, Calliste said. In some cases, families have refused to take them home.
There are various reasons for the people being left at the hospital, said Dr. D'Michelle Dupre. The patients may not have the resources or family here to help them move to a more appropriate facility, she said.
Leroy Vidale, who has no family here, has been in extended care since May 2007. He is from Trinidad. His wife died and the couple didn't have any children to look after him. He went into the hospital with a foot problem caused by diabetes, necessitating an amputation below his knee. Vidale is also blind. He has his own apartment, and is hoping to get out of the hospital next week and have custodial care come in to help him.
"I have friends who drop in and help when they have time," Vidale said.
Efforts are underway to resolve the issue, Calliste said.
"We are having a lot of dialogue with the government and the Department of Human Services about the need for the expansion of funded beds," he said. "On St. Croix we need 100-plus beds and more nursing homes."
One facility on St. Croix is trying to help. The government-subsidized Herbert Grigg Home has 35 beds and is expanding. The work should be completed soon, said head nurse Lowell Smith, but he was not sure how many more beds the facility will have.
The problem is not as bad as it could be, Smith said. West Indian cultural tradition calls for relatives to take care of their elderly family members.
Herbert Grigg Home currently has a waiting list, Calliste said. The home isn't giving priority to disposed patients because it feels the hospital is taking care of them, he said.
"We want families to take the responsibility for loved ones," Dupre said. "We try to make families aware and educate them about the services available to family members when they take them home. Home-care services provide nurses, homemakers, hospice and Continuum Care."
The hospital has taken measures to stop the influx of patients with nowhere to go after treatment.
"We have frozen admissions" in the extended-care unit, Calliste said. "We are forcing people to comply."
The hospital spends $2 million a year on disposed patients, according to Calliste. The hospital could generate $6 million from the beds tied up by patients who no longer require treatment, he said, and the patients eat up hospital resources such as food, nursing care and medicine.
Some patients' Social Security checks go the hospital, but they may be $250 a month, while a bed costs $1,700 a day.
"A sad thing that happens is family members sometimes keep patients' checks," Calliste said.
Some patients aren't even eligible for Social Security.
"This is a cash-flow problem," Calliste said. "Some have the ability to pay and some have refused to pay."
The hospital is pursuing legal action against those who are able to pay and working with the Social Security Administration, he said.
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