In Kentucky, family says brain-injured man abandoned by Medicaid, dumped at hospital ER

From the Louisville Courier-Journal:

The family of a man disabled by a brain injury alleges that he was abandoned Sept. 14 at the University of Kentucky Hospital by a private company the state Medicaid program paid to care for him.

Mary Ibold of Paducah said the family is demanding to know why her brother, Michael Knue, was left in his wheelchair at the hospital’s emergency room by staff members from a Somerset group home.

She said the family was not told he was being moved, and he was not ill. Hospital officials initially refused to admit him, she said.

Ibold said she and other family members spent Tuesday frantically trying to locate Knue, who suffered a severe brain injury in a 2007 motorcycle accident and had lived at the group home for 16 months. It was only after she called police with a missing person’s report that she determined he was at the hospital.

“They dumped Mike at the UK Hospital,’’ said Ibold, who drove from Paducah to Lexington Tuesday night after locating her brother. “I am outright furious, and I feel that somebody needs to be held accountable for this.”

When she and several other family members arrived at the hospital, they found Knue alone in the emergency room and staff unsure what to do with him.

Emergency room workers told her two employees from Community Opportunities brought him in and left, Ibold said.

“The doctor told us this had never happened,’’ Ibold said. “How can you do this to a human being?”

Justin Smith, executive director of Community Opportunities Inc., which operates the group home where Knue lived, did not respond to requests for comment.

Ibold said she complained to state officials. The Cabinet for Health and Family Services is investigating Community Opportunities and can’t comment further, said spokeswoman Gwenda Bond. The cabinet oversees Medicaid-funded services for more than 300 people with brain injuries.

Ibold said her brother remains at the hospital because he has nowhere else to go. Kristi Lopez, a hospital spokeswoman, confirmed Knue is a patient.

Mary Hass, a longtime advocate with the Brain Injury Association of Kentucky, said she is working with Knue’s family to find a new home for him. She said the case demonstrates oversight problems for the Medicaid program that funds services and residential placements for people with brain injuries.

Hass, who lobbied for changes in state law that led to more such services, said several other families have complained to her that their loved ones were abruptly discharged by such residences.

“It’s inhumane,’’ Hass said. “It’s dumping in my book.”

Hass said she believes companies discover they aren’t equipped to handle some brain-injury clients’ complex health and behavioral needs. In such cases, the provider may discharge a client, although it is supposed to ensure that services are provided elsewhere, she said. Private companies get about $25,000 to $75,000 a year to care for residents with brain injuries.

“I know providers are cherry-picking,” Hass said. “Families call me.”

Marsha Hockensmith, director of Kentucky Protection and Advocacy, said her state watchdog agency also is looking into Knue’s case. She said it points to a problem with the system, which is supposed to provide a smooth transition to new placement if an individual is discharged.

“Dumping somebody off wherever is not an appropriate discharge,” she said.
State regulations require facilities that care for people with brain injuries to give 30 days’ notice before discharging them and continue to serve them until a suitable placement is found.

Ibold said Community Opportunities had given her family such notice — citing Knue’s aggressive behavior and emotional problems — and the 30 days was to end Sunday.
Ibold said she was in regular contact with staff at the group home in an effort to find a new residence and had no warning Community Opportunities planned to discharge her brother before they succeeded.

But Ibold said she became concerned after she called the group home several times Tuesday to check on him and a staff member told her he was out on a “sightseeing tour.”

When he still hadn’t returned to the group home by Tuesday evening — and staff couldn’t explain why — Ibold she filed the missing persons report with the Kentucky State Police.

Don Trosper, a state police public affairs officer, confirmed that Ibold filed the report and said state police determined Knue was at the UK Hospital, then notified Ibold.

Ibold said her main concern is to find someplace outside the hospital for her brother who uses a wheelchair and needs supervision and help with tasks such as bathing, dressing, eating and taking medication.

Terra Lackey of Campbellsville, whose husband, John, was disabled by a 2005 brain injury, said he has been discharged twice in two years from group homes and is currently at Central Baptist Hospital in Lexington while she tries to find a new place for him to live.

“People should not have to go through this — it has been a two-year, absolute nightmare,’’ Lackey said.