Friday, August 12, 2011

NC Medicaid : 'You've got MRSA and All We Can Offer You Is Someone To Help You Take Your Bath": Haywood Regional Medical Center On The Skids

There's a fight to the death here and it's being identified by the New York Times (NYT). Yeah, literally to the death. See:

People with 'proper health insurance' would never be serially dismissed from regional hospitals on the basis of "you seem good enough now.....guess you should go on home where you'll be 'more comfortable.'" It is frankly galling to see this level of lack of care and homilies when really the matter should be (may be?) reported to the hospital accreditation agency, JACHO (the accrediation agency for hospitals).

And so, more specific to the matter at hand, today I spoke w/ my client who is in Haywood Regional Medical Center. I visited that client day before yesterday in the hospital (psychologists cannot be paid for work done in hospitals unless they are on staff which is mostly unheard of). I am a clinical / health psychologist and boy do I know more than I need to know about hospital procedures. Need to get your pain medication actually given to you on time? Call on your hospital room or cell phone to the nursing supervisor who will put a hurt on the nurse that can't find time to give you the pain med.

The client is in a room with cap/ gown/ mask procedures. Cellulitis post surgical is now spreading up the fascia of the client's belly indicating that the bacterial infection has not been bought under appropriate control. Imagine a million microbes chewing your flesh, from the inside out. Think you'd hurt?

If the client had been in a charity hospital (the ones that take good care of everyone, such as Grady Hospital in Atlanta), the client would have been isolated and given appropriate care for such an infection. But hey, this is a 'MedWest' private hospital in western NC. On the other hand, those hospitals have been going broke for a long time due to the severity of illnesses of their patients that no other hospital will touch.

The client had surgery at Harris Regional Medical Center in Sylva, NC; 'got' MRSA (Methecillin Resistant Staphylococcus Aurea as associated with said surgery. This is a very, very serious infectious disease running rampant amongst hospitals). One assumes that the Infectious Disease nurse/ department at that hospital was advised that their operating theatre is perhaps passing on this deadly bacteria but who knows give the lack of communication amongst medical personnel and institutions. This being said, I'd wager a bet that JACHO would be interested in the matter, for whatever that's worth.

This is, of itself, amazing. A major hospital in western NC is spreading MRSA or so it appears. Hospitals, contrary to what the human eye believes it can see, are the filthiest places on the planet.

The client has extreme pain related to the surgical incision which client describes as leaking through bandages "like the Texas Chainsaw Massacre." It should be malpractice that this is allowed to take place. It should be malpractice that the client is not given sufficient pain relief prior to wound dressing taking place.

It does not matter that this is a person in 'physical' pain though they also have an overlapping mental health challenge. Pain is pain. Interestingly, when this psychologist strongly recommended to the Harris Hospital nursing supervisor that the client 'not go home after two days of major surgery' this was summarily dismissed. The client was actually queried as to whether it would be useful to go a psychiatric unit. Duh, no. The client was not experiencing a mental health challenge; the client had just had surgery and Medicaid had, apparently, no capacity to appreciate the severity of the surgery .

That's NC Medicaid for ya. They must really recoup some money when a re-admission takes place and the patient sits in the ER for about a dozen hours at some amazing rate charged to Medicaid.

So, there's no money saved; there's just the illusion of savings. And heck, did I tell you that someone will lose their life over these silly administrative parryings?

More recently, as per this current visit at Haywood Regional Hospital, and as per a social worker, assumably from Haywood Regional Medical Center, the Medicaid client has been advised that the 'only services' available to this MRSA----very contagious medical illness but we are still going to get you out of the hospital------are 'probably associated with someone to come over to the house to help you with your shower and getting dressed.' I have to wonder how the client's 4 children will cope with this matter. Will THEY get infected?

The person to be assigned to the 'bathing and dressing' obviously would not be a trained individual associated with 'wound care' such that the MRSA matter is addressed in a systematic manner.

Imagine the dismay you might experience if the hospitalist walked it your room and said, 'Have you ever heard of MRSA?' The client used an available cell phone to take pictures of the incision and was scared to death as research indicated on the cell phone what the seriousness of the matter was.

What happens when you get a MRSA infection? You commonly die a long, prolonged death associated with pain and septicemia (the bacteria overwhelms your immune system). You can bet that that the hospital has a keen desire to 'get rid of' the client as quickly as possible prior to such a scenario taking place. Nevermind that the person will be back pretty soon...with a life-threatening septicemia sure to take a life. Is it treatable? Sure, if you have enough money or health insurance. Even if you're a dually insured Medicare/ Medicaid client.

But heck, Medicaid clients have no recourse to asking for appropriate services and that is what the case moving towards the US Supreme Court is about. The NYT stays on the story (their banner states: "All the News That's Fit To Print")

"A Scalpel, Not an Ax, for Medicaid

....Medicaid is one of their (states') biggest, fastest-growing expenses. The risk is that injudicious cuts could harm their most vulnerable citizens....It should not be particularly hard for any state to demostrate that it cosidered all the facors mandated by law---not just access, but effects on quality and effiency as well----in making necessary cuts to Medicaid spending...."

"....Something's happening here.....what it is ain't exactly clear...." (Buffalo Springfield)


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