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Nursing facility 250 miles away from family is not acceptable

Most of the names in these stories have been changed to protect privacy.

Because he has quadriplegia from an accident, Leroy Nowlan has spent more than 10 years in nursing homes. He has bounced back and forth between nursing homes and acute care hospitals because the community nursing home could not keep him healthy. He is eligible for both Medi-Cal and Medicare benefits.

Mr. Nowlan had been in a hospital for about a month. When the time came for him to leave, the sending nursing home refused to take him back. The hospital then tried to send Mr. Nowlan to a nursing facility more than 250 miles away - far from the family that visits him regularly.

To prevent his being transferred that day, Mr. Nowlan’s cousin called the Los Angeles office for help. She also wanted our help to bring Mr. Nowlan home.

That same afternoon, one of the senior attorneys in the Los Angeles office faxed a letter to Mr. Nowlan and his cousin at the hospital. The letter explained Mr. Nowlan’s right to return to any currently open bed, or to the next available bed in the sending nursing facility, under the federal Nursing Home Reform Act and under State licensing regulations.

Her letter explained that the hospital had an obligation to provide discharge planning for Mr. Nowlan, which should include:

  • Assessing the cousin’s home to identify barriers;
  • Identifying and arranging for any equipment needed in the home;
  • Getting help from a Medicare home health agency for Mr. Nowlan's transition to his cousin’s home;
  • Ensuring that the cousin gets the training she needs to meet Mr. Nowlan’s health care needs; and
  • Expediting the In-Home Supportive Services (IHSS) application process.

The community hospital delayed discharge for a few days in order to:

  • Allow time assess the cousin’s home;
  • Arrange for delivery of needed equipment, including a Hoyer lift;
  • Arrange for transitional home health care; and
  • Arrange training for Mr. Nowlan’s cousin.

Mr. Nowlan is on the nursing facility waiver waiting list. Processing continues for his IHSS benefit. It was delayed in part by the nursing facility, which refused to take him back but continued to bill Medi-Cal as if he were still a resident.