Hot Topic: Nursing Homes for Sex Offenders & Violent Offenders

NY- Hospitals forced into holding pattern

7-2-2008 New York:

Keith Shortsleeves knew he was going to have to stay in Glens Falls Hospital for at least a few weeks when he checked in on Jan. 20 for diabetes-related problems.

Circulation problems required partial amputation of his left leg.

But within a few weeks, Shortsleeves had recovered to the point he was ready to be discharged.

"I thought I'd just be going home," he said.

Nearly five months later, Shortsleeves is still in the hospital, despite the fact he is no longer in need of treatment there.

The hospital's staff won't let him go because he doesn't have a home that meets his needs for post-hospital care, he said during an interview in his room last week.

He is a Level 3 sex offender who can't go back to his former apartment in Fort Edward because of handicapped accessibility issues, but can't find an accessible apartment anywhere else because of laws that dictate where sex offenders can live.

So since February, Shortsleeves has stayed in a variety of hospital rooms, most recently in a third-floor corner room overlooking the front parking lot, waiting for a solution to his housing woes.

"I don't want to be here, but I got no choice," he said. "I ain't got no place to live."

Shortsleeves is the poster boy for a little-known state law that requires hospital patients to show they have somewhere to go that meets their care needs before they can be discharged,

His presence for such an extended period of time has raised the hackles of many hospital employees on the heels of job cuts there, according to two hospital staff members who spoke the condition of anonymity. (They could not be identified because they are not allowed to discuss patient issues with the media.)

Many hospital employees refer to them as "custodial" patients because many of them want to leave but they aren't allowed to by hospital administrators.

"People wonder why the hospital is losing money," said one of the staff members. "This guy (Shortsleeves) isn't the only one. We get lots of them. We've got a lot of little old ladies who are there (in the hospital) for months when they don't need to be."

"There's nowhere for them to go, so they stay here," the other staff member added.

The tab for many of their stays falls to taxpayer-funded Medicaid or Medicare.

But Ray Agnew, a hospital spokesman, acknowledged some stay past the point where those programs will pay for their hospitalization, so the hospital has to absorb the cost of their stay.

"We can't discharge a patient unless their discharge plans meets their needs," he said. "It happens from time to time. In these cases, we rely on community resources. We really leave no stone unturned."

Agnew said he could not discuss specific patients. He also said the hospital could not say how many patients were required to stay past, or how much it was estimated to cost the hospital to house them.

Hospital "discharge planners" and physicians determine whether a patient's plan is appropriate. The most basic requirement is to have a home to go to.

"Most of the time, it's people who need to be discharged to a nursing home, but often there is no (nursing home) space available," Agnew said.

Beth Goldberg, a spokeswoman for the state Department of Health, said the state Compilation of Rules and Regulations governing hospitals spells out the procedures and requirements of hospitals

"The hospital is required to release a patient to the least restrictive environment that meets their post-hospital needs," she said.


One of the two anonymous employees, a nurse, said the hospital sometimes sees people drop their elderly parents off when they can't care for them or find nursing or adult homes that will take them.

"Children aren't legally responsible for their parents, so sometimes they're just dumped at the emergency room," the employee said. "We had an intoxicated guy left with a mattress outside the ER door."

These patients who can't leave cost the hospital money because staff members must attend to them, even if they don't need medical care. Their rooms need to be cleaned, they must be fed and the elderly, sick or injured who need assistance but not full hospitalization have to be catered to as well, one employee said.

Many are frustrated at their situations, and take it out on hospital staff members, one of the employees said.

One employee said "custodial" patients were also problem at Albany Medical Center when the employee worked there a number of years ago.

Greg McGarry, a spokesman for Albany Medical Center, said patients having to stay after they could be discharged has long been a "significant issue" at Albany Med. He said the costs of those patients are part of the $35 million-a-year in charity and unreimbursed care for which Albany Med picks up the tab.

"It was an issue when I got here 23 years ago, and it's still an issue," he said. "Part of the problem is nursing homes are getting pickier and pickier about who they will take."

A bill introduced in the state Assembly last year would change the law relating to patient discharge.

It would require the state Department of Health to create "transitional units" with 4,000 beds for use by Medicare patients who no longer need to be treated in the hospital but can't go home, either. It was sponsored by Assemblyman Tom McKevitt, a Nassau County Republican.

However, the bill was first put in last year, and has not passed the Assembly either this year or last year. Companion legislation has not been introduced in the Senate.

Reluctant resident

Shortsleeves is a Level 3 sex offender because of a 1995 conviction for sexually abusing a 12-year-old girl and a 2002 conviction for having child pornography. He served nearly 8 years in state prison between the two cases, but is no longer on parole.

He weighs more than 300 pounds and is wheelchair-bound, with part of his left leg amputated, and part of his right foot amputated as well. He said he has asthma and heart problems.

"I'm not going to hurt anybody. I'm in a wheelchair for gosh sakes," he said.

Shortsleeves said he has a number of relatives in the region, some of whom would take him in, "but they're all in the red zone." He has two former roommates, who he calls "Ma and Pa," who lived with him in Fort Edward, but they have to leave their home because it has been sold.

He said hospital staff have done everything they can, and he recently put an advertisement in The Post-Star seeking housing.

"I know they want to get rid of me because there are other people who need the room," he said. "They've been really good to me and they're trying to help me, but they just can't find nothing."

Shortsleeves had lived on Mosher Hill in Hudson Falls until a few weeks before he was hospitalized.

The state sex offender registry still lists that address for him. Glens Falls Police Sgt. Marty Chittenden, who monitors the Glens Falls Police Department's registry, said he was aware of Shortsleeves' location at the hospital, but he has not had to register as a resident of the hospital because it's not his permanent residence.

Hudson Falls Police Chief Randy Diamond said his office has gotten a number of calls from Washington County Adult Protective Services looking for assistance in figuring out what parts of the village he can live in.

A law that spells out where sex offenders can live has resulted in much of the village being off-limits. Shortsleeves was grandfathered under the law at his prior village residence, but when he moved out, he could not return.

"They (Adult Protective Services) has been trying to find a place for him," Diamond said. "He's always been very cooperative with us. But there are laws that say where he can go.

"It seems like it's one of those situations where it's kind of falling between the cracks," Diamond added. ..News Source.. by Don Lehman

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