By Kate Snow, Janet Klein and Dustin Stephens
Rock Center
For Barbara Latasiewicz, home was a hospital room. The Poland native, who had cleaned homes in the Chicago area for 20 years, suffered a stroke while on the job in September 2009. An ambulance took her to Adventist La Grange Memorial Hospital in Illinois.
"I was thinking that after a few days, that I'm just gonna get better," Latasiewicz told NBC’s Kate Snow through a translator in an interview airing April 25 at 9pm/8 c on Rock Center with Brian Williams.
Latasiewicz suffered paralysis on one side of her body, but eventually became well enough to leave the hospital. However, more than two years later, the 62-year-old was still in the hospital.
“She hasn’t needed to be in this acute facility for a long time,” said Richard Carroll, the hospital’s chief medical officer.
When asked about Latasiewicz’s more than two year stay at the hospital he oversees, Carroll said, “That’s really a function of how our health care system is working right now, which is it’s not working very well at all, particularly in cases like this.”
Carroll said that Latasiewicz belonged in a skilled nursing facility where she would receive a more appropriate rehabilitation, but she had no way to pay. Latasiewicz had no insurance and was an undocumented resident with no access to government safety-net programs like Medicaid. Without payment, no facility would take her.
NBC News
Barbara Latasiewicz
The end result? Latasiewicz stayed at La Grange. Her care cost the hospital $1.4 million. A skilled nursing facility would have been a fraction of the cost.
An NBC News investigation discovered that cases like Latasiewicz’s are not unusual, but the result of current health care policies and guidelines. They are known as “permanent patients” and are hidden in plain sight in hospital rooms across the country. That’s because under federal law, hospitals must treat any patient who needs emergency medical attention even if they have no way to pay. Nursing and rehab facilities are not required by law to do so. At the same time, hospitals cannot discharge a patient without a plan in place for his or her ongoing care. The result is patients stuck in the hospital in need of long-term care but with nowhere to go, large medical bills, and no way to pay – a cost that is usually covered at the hospital’s expense.
“It would be cheaper to take these patients and send them to the Ritz Carlton,” said Harvard University School of Public Health Professor Ashish Jha. “They could get room service all day, and that would be cheaper.”
Jha estimates there are tens of thousands of these patients stuck in the hospital with no clear place to go. Some stay an extra week, some months, and some like Latasiewicz even years. NBC News spoke with officials at dozens of hospitals across the country who confirmed housing patients who didn’t need to be there for extended periods.
Many patients are stuck because they have no money or insurance to pay for long-term care. Other patients may have insurance, but their medical needs are too complex for most skilled nursing facilities to accept. Then there are those in limbo at the hospital waiting sometimes for months to qualify for Medicaid. Once they’re approved, Medicaid will cover the nursing or rehab facility they need.
A spokesperson for the American Health Care Association which represents skilled nursing facilities says that the industry works with hospitals to find facilities for such hard-to-place patients.
According to data from the National Inpatient Sample database at the Agency for Healthcare Research and Quality, the problem of permanent patients appears to be on the rise. From 2005 to 2009, the last years for which data was available, uninsured hospital patients with no access to Medicare or Medicaid in need of long term care increased 20 percent.
NBC News
Garrick Amato
“Most of them are Americans,” Jha said. “And if they get hit by a bus, they get sick, they’re in this situation.”
Garrick Amato, 59, arrived at Banner Heart Hospital in Mesa, Ariz., after suffering a heart attack. A few days later, he was ready to leave the hospital for a rehab facility. However, Amato, who said he worked part-time at a local discount store, had no health insurance and no way to pay for his rehab.
“I guess no nursing home will take me cause I don’t have insurance,” Amato said.
Furthermore, as a single adult without dependent children, he did not qualify for Medicaid in Arizona. Amato spent most of March and much of April at the hospital. Banner Hospital eventually found charity care for him that placed him in a skilled nursing facility where he belonged.
Other patients linger in hospitals despite their best efforts to find charity care. Fatima Khydarova, a professor from Uzbekistan, has been at Maimonides Medical Center in Brooklyn, N.Y., for more than two years. Khydarova arrived there after suffering an incapacitating stroke while visiting her grandchildren in New York. While Khydarova will never walk or talk again, doctors say she does not need to be in a hospital.
NBC News
Fatima Khydarova
“In a perfect world she should be either at home with her family caring for her or in a nursing home,” Maimonides CEO and President Pamela Brier said.
Khydarova’s grandchildren said that they cannot take care of their grandmother at their mother’s small apartment and at the same time make a living to support all of them.
“I’m working, I’m working.” said granddaughter Nigina Abdullaeva who works at a doctor’s office.
Dr. Jha of Harvard University says that the costs for treating permanent patients are passed on to other consumers through higher medical bills and insurance premiums.
“The bottom line is we’re all paying for it,” Jha said.
To mitigate the cost of these patients, some hospitals have paid out of their own funds to move them to skilled nursing facilities. Once there, the hospital could pay for their care for the rest of their lives.
“Hospitals don't want to widely advertise that they will pay for your care elsewhere,” Jha said. “But in select situations, they look, and they realize, instead of spending tens of thousands of dollars to keep the patient in the hospital, it's probably cheaper for them to send them somewhere else.”
Back in Illinois, case workers at La Grange Hospital also struggled for years to find a more appropriate medical facility for Latasiewicz. They eventually found one, but it was in her native Poland.
Wiping tears away from her eyes, Latasiewicz told Kate Snow through a translator that she did not want to leave. Latasiewicz lived in the United States for 20 years and has a son and grandchildren living nearby. However, her son, Peter Latasiewicz, said he could not take his mother into the small apartment he shares with his children and another family.
“I wouldn’t be able to provide as much help and support and care for her,” Peter Latasiewicz said, “she’s got a lot of medical conditions where she requires 24/7 care.”
The hospital eventually went to court for permission to send Barbara to the medical facility in Poland.
The hospital won and on March 1, Latasiewicz boarded a flight back to her native Poland.
In Brooklyn, Khydarova, the professor from Uzbekistan, remains at Maimonides and the hospital is still working hard to find a solution for her family
“She’s going to stay in the hospital unless we can find a spot for her,” CEO Brier said, “She could stay here potentially for the rest of her life.”
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I am sorry for everyone of these people, but i am a american who can not afford health care. I am having issues and need help and peace of mind. Which is not an emergency, as far as i know. About illegals it angers me what all they get from our country and so easy and we worry, lie, cry, pray and more hoping we will get help. We are going broke and people dying that have earned the right for help. My husband and i both work and in that process we help pay for millions to have free health care, homes, phones, checks and more. Not just to illegals but also to people who are Americans and too lazy to work. There is a law against that, welfare fraud, problems no one checks and investigates whatever doctor says rules..Doctors make more money off constant repeats and government(tax payers) patients than any patient. Without tax payers there would be nothing so why are we not protected?. Many of the ones who get these great gifts are pissed at the tax payers when we get angry seeing someone with food stamps and a top of the line iphone. Excuse me they should be grateful. again without tax payers there would be nothing..
Sounds like your a complainer who is envious and wants more for free!
You know what pisses me off it's all you holier than thou people on here blah, blah, blah! Oh she is illegal boo hoo; oh I have to pay for her. Man may dismiss compassion from his heart, but God never will!
You're obviously a right-wing, God-fearing, self-righteous idiot.
Then get God to pay for them.
healthcare is not a right. It is a priviledge I have enjoyed because I have worked my entire adult life to retain it. I paid for my own way through college ( twice) and was a single parent for years without any type of public assistance. This country is just chock full of lazy people without the brains or means to provide for themselves. DARWIN was right, WELFARE is wrong!
Your wrong! You don't know what others go through all your pissed about is you had to work bummer.
Super Bon, sorry, jimi is right.
first, your sentence is unclear.. as for being pissed? no, I'm not pissed, I am proud of all of the things I have accomplished. Maybe you should try setting some goals for yourself. You are right, I don't know what others go through... but i am sick of having so many use that expression as a crutch! get over yourself and make something of your life. Look at Stephen Hawking, I couldn't think of a more miserable life to live, but he has made the most of it.. get off yo ass and help contribute!
If most of these patients are American why are two of three examples in the story foreigners? Couldn't the writer have used some of the abundant Americans for the article?
Seems that these people have family who aren't willing to step up because they know that the govt or others will take care of them. Time was when you took care of your own no matter the hardship. Govt handouts have deteriorated the moral fiber of the family to the extent that people find excuses not to care for their own family.
Obviously you didn't read the article numbnut! Oh but we sure get your ignorant two cents.
Been asleep awhile saravabob? This isn't the 1960s anymore
This is 21st century America. Many well paying jobs have been offshored to maximize profit. Wall Street tanked the economy while stealing billions from the taxpayers. Many of these families are unemployed or working long hours at low paying jobs without benefits. Even people who have manged to do better still cant afford the huge cost of long term care. Government "handouts" have nothing to do with this.
Amazing! In all the comments I don't think I saw one mention of "Obamacare." Curious as to why everyone isn't blaming Obamacare for all the problems with our severely broken healthcare system. The problem is, the Affordable Healthcare Act doesn't begin to fix problems. We need a single payer, socialized system in this country. The Right says government can't run anything. Well DoD and the VA run pretty smooth systems with a fraction of the overhead costs that our corporate-controlled healthcare system has. And then there's the profits that are spun off to the insurance companies. And so many people claim the US has the "best healthcare in the world." Look at our world rank on infant mortality, life expectancy, and satisfaction ratings. We are not the best. Wake up Americans and quit worrying about corporate profits in healthcare. Capitalism should have no place in healthcare. It's been allowed to go on for way too long!
We were waiting for another ignorant moron to bring it up........your the lucky winner of the stupid award!
Wow. How grown up you are.
Al S., the VA, until recently, was doing an abominable job and if we stop the oversight or the defense cuts hit the VA they will return to that abominable job. The DoD and the VA do as well as they do because of the limited clientelle, they do not have to take patients who walk off the streets into their emergency rooms. Comparison invalid, your argument fails.
If you have failed to take the responsible steps of providing for yourself, hospitals should be permitted to kick you out the door, without recourse. I have no real problem with true emergency medical, but once you are stabilized, hit the bricks. If you die, well you planned poorly. Why should someone else foot your bill? Sucks to be you.
Your disgusting! How the hell do you know what these people did or didn't do! I hope you die there will be oneless ignorant moron.
Super Bon, take his place, one less ignorant moron who cannot type, punctuate or proof-read.
This is a social problem that has no immediate, acceptable solution. As with most things it boils down to "who is going to pay?". We shouldn't be paying for visiting immigrants healthcare aside from emergency treatment. Politicans won't touch it for fear of alienating voters. Here's a suggestion. Instead of awarding plaintiffs in lawsuits not involving catastrophic injuries milliions of play money, assess their tax free awards a 25% surcharge to fund these cases. Worse case scenario, build charitable long-term facilities designed to provide no treatment, just sustinence and pain meds on a cost-effective basis. You can't provide steak on a hot-dog budget.
This is only one aspect of the medical mess in our country. We need to have single payer insurance - in other words Medicare for everyone. While our healthcare is generally 3 times (and in some cases 4 times) more expensive than anywhere else in the world, we are 23rd in the world (somewhere behind New Zealand). "Frontline, Sick Around The World" is a good documentary on the subject. We are the only Western nation that doesn't have health care for everyone. Canadians love their healthcare system. I personally know a Canadian who worked in my city who had fabulous healthcare through his employer and would still return to Canada when he was ill. He didn't trust the doctors in the US. I have spent some time in the UK, and their system is also excellent. Everyone is cared for and the medical community still does very well. Friends who were traveling in France and in need of medical care received outstanding treatment which was of no cost to them. We are being raped by the insurance companies, doctors, hospitals and other medical facilities. Obamacare barely scratches the surface of the problems. He caved to the medical community before he even began his Obamacare campaign.
I know several Canadians who abhor their healthcare system as their relatives have died on waiting lists. Whoever promulgated the idea that Canadians love their system must have cherry picked the data.
Interesting that most people miss the point entirely. I am a Republican, a Dentist in private practice, and I understand well the dilemma of the hospital. I strongly disagreed with the powers that be in the Republican party about mandatory health insurance. The case is before the Supreme Court regarding Obamacare. The problem with mandatory health insurance is that there was no 'stick'. Here is the way it should have been explained. Ok, you want to have a choice? Fine. If you 'choose' not to have health insurance and you show up at the door of the ER, we will no longer automatically take care of you unless you put up everything you own as collateral before treatment begins, no sympathy...you rolled the dice and you lost.
While that sounds mean spirited and 'unethical' it is in the end a reasonable response to someone who wants the 'Right' not to be forced to do something by the government. That 'Right' is fine for them until they need the health care system. Then they want you to do if for free because it shouldn't cost them their life savings? Who says? The rest of us have to pay for you...No, the way to do it would've been the same way we do your payroll deductions for medicare and social security. If you are 16 and working part time you are paying into the health care fund. My plan would be that for every hour you work you contribute 1/40 of 1/3 of your premium. I as your employer do the same and the government does the same. You have 3 jobs and work 40 hrs? You have full coverage.
Insurance Companies are better at some things than the government. One is making sure they aren't getting ripped off. But there is no mechanism to control their profit. I would propose they get 10% profit the first year you are paying in with this system. Each year they keep you by providing good customer service they get 2% more profit to a max of 20%. No pre-existing conditions or any of that. Only general age based premiums. They must e pay in 5 working days. They can challenge a claim. They win, they don't pay. They lose, they pay the independent review panel 10% of the disputed claim. Same applies to the Drs and Hospitals. Further, they can only have one fee. Everyone pays the same fee for the same service. If you put everyone into this system you get a fee for service program that has a free market base to it, but a nice set of rules to play under. If you don't work, you could choose not to participate, but we will take your house and not even blink an eye if you can't pay...it is America, if you want to be able to choose, choose wisely or suffer the consequences...
The problem is, we'll pay for the uninsured either way. Those who can't afford it because they're unemployed, hurt, disable, underemployed, etc... will get a free ride, as will those who "gambled."
All a "gambler" needs to do is say he's/she's not working because he/she recently lost his/her job or come up with some sob story, and the ER is going to treat him/her anyway. Then when the bill comes, we'll be bogged down in a quagmire of all kinds of excuses and red tape. Are we going to force the onus of employment verification and income earnings upon ER administrators to determine who's really working and can afford coverage but just opted not to pay it? Are we going to force ER admins to become certified at accepting all kinds of collateral (houses, cars, boats, jewelry, home electronics, cows and other livestock) like you mention before treatment? Seriously?
Let's not kid ourselves, we're going to pay for the "gamblers," deadbeats and the illegals no matter what. The administrative nightmare you're proposing is preposterous.
Everyone is missing the point. Hospitals cannot turn away EMERGENCY treatment.
But, once that person is no longer in an EMERGENCY situation they should be released. The hospital is NOT the hotel. As for being illegal; deport after the emergency passes.
Nursing homes should have the same rules as the hospitals but don't...of course THEY don't have the EMERGENCY treatment condition either. Get the point?
ALL of them should have to pay back the hospital though. Some small amount per month plus some form of work service at the normal hourly rate until paid. This should become a NEW law though and not be retroactive. Care after the hospital stay should be something the patient has to deal with. I have insurance and still can not have a surgery I need until I save for my part of the cost...that's just how it is.
Obama Care has the death panel clause in it. Ever read it? It's not the best for people over 76 years of age.
Healthcare wouldn't cost so much either if people didn't defraud it by going to the emergency room when what ails them could've been treated at an urgent care or regular clinic visit, or by asking for meds for getting high by telling the doctor lies. Additionally, generic meds cost less and have the same active ingredients so why pay for brand names? Furthermore, if everyone just contributed $5 per week into a general healthcare fund, a lot of these medical bills would be reduced. Doing all of these things would get healthcare costs down considerably. Finally, if our doctors and hospitals patterned more after the Mayo Clinic, they would find their costs cut waaaaaay down. And if hospitals, actually priced things appropriately that too would cut down the costs. How many of you have seen a $100 tacked on for a band-aid to cover a needle hole? Or how about a Dr. call that the patient did not have a discussion with? I had a bill once with a huge amount added on by a doctor that just poked his head in and asked if I was doing ok...he wasn't the doctor that treated me. Everyone should check over all emergency room bills...the more the insurance has to pay; the more YOU have to pay. Peace and God Bless.
Kathyern,
Tell me how someone pays back over a million dollars? Do you know how many people would go broke? How many families would be thrown on the street?
Not everyone has insurance, Kathyren. Hence the reason the mandate makes sense. If hospitals HAVE to provide emergency services to anyone regardless if they have insurance or not then everyone should be required to carry insurance. If not...then the policy should be that hospitals can not except any patient that does not have insurance....no matter the emergency.
Because it would absolutely horrible to see bodies piling up outside of the hospital it makes sense we should go with option 1....the mandate. The Republicans know it makes sense....they came up with the idea for a reason. It will stop freeloaders from being able to pass the cost of their care on to the premiums of those who carry insurance.
I will go with option 2 and help carry the bodies away for disposal.
Katheryn
In oncology I have never seen a government run death panel. However, I have been through numerous peer to peer conferences, reviews and appeals with the private death panels run by the insurance industry.
Neal,
I'm sure you would...
That's what separates real Americans and the trash of our society. I'm sure that all of those who died for your freedom would love the way you view your fellow American. The sooner that people like yourself get an education and heart the better America will be off.
To provide healthcare for all citizens, the government only needs to REMOVE the age requirement for Medicare. But the Republicans do not want to do that because they are protecting the interests of the hospitals, insurance companies and other businesses involved in the healthcare industry. Republicans scared americans that it would be socialism and the health of all citizens should be involved in capitalism. Hallelujah.
Your a moron! Oh it's just Obama please! Like this hasn't been going on for a zillion years and morons like you come in and make a ignorant statement. You and your kind are the reason this country is going to shi!
What happens when Medicare costs more than the total amount of taxes collected?
The doctors and surgeons seem to make a profit why shouldn't a hospital be able to at least break even? Find a charity or tell the family to take them home.
Another genius God what would we ever do without the morons with all the answers!
Well considering you can't qualify for the Affordable Care Act if you are here illegally, it doesn't solve the problem. I does help US citizens who can't afford care or who have preexisting conditions.
What if they were inmates? does anyones answer change? guilty of murder, confessed and serving life without parole? just throwing it out there..
So what sumbag! They are still human beings! Not sure about you though.
she should be able to get some help from her embassy..like why aren't they helping?
They did not want here either.
So this is brought about by federal policies, but more federal policies are going to fix it and make everything work efficiently. I'd laugh if it wasn't so sad ...
Everybody in the U.S.A. should be required to watch Michael Moore's "Sicko" to understand why this country has no universal health insurance: Nixon was urged to let HMOs begin and flourish ("Everybody pays for insurance, but of course, not everybody gets care"). Like bank mortgages, credit cards, and student loans, health insurance was designed as a money maker for the rich by ripping off everyone else. Despite Obama's call for "hope" and "change," we will have no hope for any change until "the system" is completely revamped.
Oh please. He's a liar. It was LBJ's fault for starting Medicare - see a prior post of mine. Michael Moore doesn't have a clue.
I think this story is bull, because there maybe some patients like this but the hospitals are far from overrun with them. Hospitals are making record profits, so I guess they want to make even more and these people are not that profitable. So, no simpathy for the humongus health care billion dollar profit machine.
They're making profits because they shift the cost of the uninsured onto the insured.
This is way better than Obamacare because the uninsured would have to pay something under Obamacare. This way, they get it free and you have to pay for it.
The hospitals also write it off on taxes, and it helps the hospitals get govt grants for new equipment and construction.
randy - Most hospital are 501(c)3 organization and don't pay income taxes. They do however pay tax through the lousy reimbursement from Medicare & Medicaid.
In all the comments I read, I agree with Jason Underhill, Healthcare in this country should be a [basic] human right.
Our government give hundreds of billions of dollars each year to foreign countries, paying for and buying friendships an alliances while the people in this country suffer. The money the USA gives away in one year could support the healthcare system in this country for years.
The USA's priorities are so screwed up until it's not funny. If the rich, and the ultra rich paid their fair share of the taxes, the burden on the middle class wouldn't be so heavy.
If the Congress would pass laws to help all of Americans and not just the few, we'd be able to provide the care our senior citizens and the sick need to survive their lives.
The problem isn't the laws, it's the law makers in this country that refuse to right a wrong, and it's our fault for allowing them to remain in office so they can continue to make our lives a living hell, just so they can say "NO" to what matters in aiding all of America and not just the few.
What's happening in this country isn't just their fault, it's our fault for putting them in office so they can abuse us while fattening their wallets and bank accounts at our expense. As Americans we can fix this, we shouldn't vote for a party, but for the person willing to put politics aside and work to fix America's problems, people willing to work together for a common cause, for all of us, not just the richest of us.
wrong place
StanGee,
I agree with not voting for a party but a candidate; but did you know that we aren't even "allowed" to see all the candidates?
That's right, we only get to see the candidates the news media wants us to see. Check out the 2012 Presidential Candidates website and you'll see what I mean.
There were actually over 300 candidates this time around and that was just for the Presidential office.
Its called "Foreign Welfare".
The article didn't quantify in dollars the total magnitude of the problem. An increase of 20% uninsured permanent patients over 4 years appears significant but you should quantify the number of cases and the estimated dollars. The emotion and the public's passion shouldn't drive the debate over health care coverage or costs. We need to know how big a problem these folks are in relation to the overall uninsured and what each potential option will do to mitigate the cost burden. Lets get rational.
Doctor J,
You must have been typing while I was. Good ideas in that post. Combine mine and yours and we just might have a winner! :)
my jaw literally dropped when I read some of these comments. Those of you advocating for "death panels" for the elderly are seriously messed up and there should be an amendment that strips you of your citizenship and deports you to some isolated island in hell. The Nazi's advocated this way of thinking. The worst part is you're probably a Republican and Pro-life. I wonder, would you be pro-life to an "illegal" who crossed the border to abort her baby? Or would you make her keep it and take that chance that maybe the baby will end up being one of those "border baby's" you all hate so damn much. Hypocrites all of you. How pathetic and un-American. I am a white mother of three who is a second generation American on my mothers side and my father's family came here with the pilgrims in case you were going to stereotype me by my opnion.
Jennifer,
Not every Republican candidate endorses the party line; just as not all Democratic candidates endorse the pary line. Each candidate should be looked at individually and chosen for the plan he/she has for America.
That 2012 Presidential Candiate website will show you many more candidates than what we are "allowed" to see on TV, and there is an ENDING SPENDING website that will show you which congressmen/women voted for fiscal responsible bills and which voted for free spending. The responsible ones they label as "sheriffs" and the irresponsible ones they label as bandits. Regardless of the labels, it is a quick way to find out who is and who is NOT working for us.
No one has the right to decide when a person dies...not abortion clinics, pregnant women, evil men, or corrupt government.
Peace and God Bless!
If they're illegal, let them die.
Signed,
Jesus.
Wingnuts will manifest their usual anti-Christian hate-filled Nazi philosophy. They will say this Human Being should die because she/he hasn't been born into our country inheriting weatlth, like George Bush or the Koch brothers. Health Care for the rich; born poor or lost healthcare due to layoff, too bad. Only those of "means" are entitled to descent health care.
Reading these naive comments ONLY eloborate the reason I see that hhealthcare reform is still so taboo in the United States as of 2012. DAMN!