Other states

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But getting rid of patients once they’re well enougbh to leave can be the University ends up with a number of patientsd from Kentuckyand Indiana. Sometimes they’re injurex or become ill whilein Cincinnati; other times they’rs referred. The issues arise when such patientss are medically cleared for release from acute care but have no insurancr and need continuing care such as in anursint home. Often, because of Kentucky and University is stuck with officials with thehospital say. “Ir truly is a misuse of Ohio resourcesx by statesthat don’ty seem to be taking care of theirt own,” said Lee Ann Liska, executivse director of University Hospital.
“It’s creating a little bit of ill will betweejnthe states.” The hospital is on track to rack up 300 “avoidable days” involving 50 out-of-statde patients this fiscal year, officials said. Last year, it had 135 days with 37 The true numbers are probablh double ortriple those, Liska said, because doctors are reluctant to give the all-cleadr until they know a patient has a discharge Costs typically run $1,000 to $1,500o a day per patient.
Elizabeth spokeswoman for , said that when Indiana Medicaideis approved, it is retroactivew three months, so that “if Medicaid applicatiojn is made at the time of there should be no issue with payment for “Indiana has never refused to pay a legitimate claimj for a member,” she said. “The hospitall can facilitate this for Indiana patients and can be assuredx they will be reimbursed if the individual isfounx eligible.” In the past, patients hospitalizexd in Ohio for more than 30 days could often sign up for .
But changees starting in July 2008 have made that Kentucky and Indiana do notoffer “pendinb numbers” for Medicaid applicants, Uni­ver­­sit y said, and take several months longefr to process applications than Ohio. Kentuck y tightly controls nursing home beds and licenses few forMedicaid patients, making it hard to dischargd there, according to hospitalo officials. “You have an uninsuredc patient occupying an acute bed which they nolonger need, whichy means we can’t get the next Hamilton Countt patient in,” said Liska. One Indianqa patient stayed 115 according toUniversity officials.
Kentucky officiales said its nursing homex accept patients with Medicaixd applicationsin process. “We’re not aware of anythintg that would be a barriee to returning citizens back to Kentucky toa long-term facility,” said Betsy Johnson, commissioneer of . She said she hadn’ty heard from University. “They’re a very important provideer for the KentuckyMedicaid program,” she said. “We’d be more than happyu to talk.” Trauma is the most commoj reason patients find themselvexs in limboat University. Sometimes, however, they arrive througu referrals whenthey can’t get problems resolved in their home state.
Othedr factors: homelessness, alcoholism and psychiatric And, of course, lack of And facilities equipped tohandle high-needse patients, such as those with are few. Sometimes Universituy offloads patients tothe , a fellow hospital that providess medically complex and rehabilitative care. It also triess more creative solutions. Case managers might make 15 to 30 callsdto facilities, but nursing homes are loathe to take assuming they won’t get paid until the patient gets on said Peggy Sogar, director of social work for the hospital. Sometimesw family members provide home Or case managers suggest moving to Ohio to wait outresidenchy requirements.
“We put tremendous pressure on familiez to come up witha solution,” Sogaer said. University officials are hoping fora high-level solutiojn – a meeting of the governors.Until then, they’rwe looking more closely at who gets in. “Idf we have the right level of care, we try to managde them,” Sogar said. “We’re more carefully lookin at access points, including outpatient clinics and transfers.
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