Discharge policy disagreement leads to lengthy battle over hospital stay bill By: Kevin Rollason Posted: 7:00 PM CDT Thursday, Mar. 23, 2023

Hey there, time traveller!
This article was published 23/03/2023 (902 days ago), so information in it may no longer be current.

A Winnipeg family says it faces collection of a $7,800 hospital bill, after refusing to have an elderly relative sent back to the personal care home where she had broken her hip and threatened to kill herself.

Halina Fracz, 96, was charged by Concordia Hospital for spending a further 39 days in the Winnipeg facility (September-October 2019), after it had deemed her ready to be discharged to Maples care home to recover from hip surgery.

Fracz’s daughter-in-law, Grace, said the family didn’t want Fracz to go back to Maples (a Revera Inc.-run home on Mandalay Drive). The woman had been there recovering from an earlier hip operation, before she fell and broke her hip.

“She had been living at (her own) home, with home care, when she (initially) fell,” Grace said Thursday. “Concordia… put a metal screw in.

“Because she lived by herself, they sent her to the Maples. They said she need physio and could get it there.”

Weeks later, Grace said, her mother-in-law still hadn’t received any physiotherapy and staff were slow to respond when she buzzed for help. While trying to go to the bathroom by herself, because staff didn’t come fast enough, Fracz fell and broke her hip, Grace said.

“We wanted her to go to River East (care home) and when a social worker visited her (at the Maples), she was crying in bed. She was in so much pain, she said: ‘I don’t know if I want to be alive. I want to end my life.’”

The woman had been squirrelling away some of her medication, so she could overdose, Grace said, and she showed the social worker a napkin hiding 10 pills. The social worker told the Maples staff, and the woman was subsequently taken to Concordia, where they operated on her broken hip.

By the time the hospital had determined the woman was ready to be discharged, only the Maples, Parkview Place or Heritage Place were available to further her recovery, Grace said.

“They said, back to the Maples; and I said no, she wants to kill herself there.”

When the family checked out Parkview Place, they didn’t like the conditions. (In August 2021, Ontario-based owner Revera said it would close the facility. Its last resident was transferred in 2022.)

The family said it turned down Heritage Place, another Revera facility, because it was too far to visit, had four seniors per room and only one bathroom.

The hospital told them Fracz could stay while the family waited for space at a care home they selected, but at a cost of $200 per day, Grace said.

When the bill rose to $7,800, family decided to bring Fracz back to her residence and begin home care again. About three months later, Fracz moved to River East, where she still resides.

The family has been battling the bill ever since.

Late last year, they received a final notice letter, saying if there was no payment alternative collection procedures will begin.

A Sept. 18, 2019, letter to the family from Katherine Graham, Concordia director, access and transition, said the hospital’s goal is for individuals to receive care “in the most appropriate setting… Since your mother’s acute medical needs have been resolved, a more home-like personal care home is a more appropriate setting.”

The hospital could have started charging $200/day earlier, but allowed a reasonable amount of time for an opening to come up at a care home the family wanted, the letter said.

Sue Vovchuk, executive director of the Long Term & Continuing Care Association of Manitoba, said hospitals do have the option of billing people for their stay after determining there is personal care home availability.

Vovchuk said family may have a certain care facility in mind, but hospitals have to free up much-needed beds for ill patients.

“There is a discharge policy,” she said Thursday. “If patients are ready to discharge, the hospital does have the option of charging.

“If they have been panelled for long-term care, and they have been offered a PCH, then the hospital has the option of implementing the discharge.”

Vovchuk said there are personal care homes a senior can be moved into immediately, but it might not always be their first choice. “But you will always get to your preferred choice. It just will take time.”

A Revera spokesperson could not be reached for comment.

“While we understand patients may not want to be placed in the first available bed, this move is imperative to ensure other patients with immediate medical needs receive treatment and have access to a hospital bed.”–WRHA spokeswoman

A Winnipeg Regional Health Authority spokeswoman said when patients no longer need hospital treatment, but can’t go home while waiting placement into a personal care home, they are transferred to the first bed available within the region.

“While we understand patients may not want to be placed in the first available bed, this move is imperative to ensure other patients with immediate medical needs receive treatment and have access to a hospital bed,” the spokeswoman said.

“All patients and their families are notified of this policy, which states that if, for any reason, the move to the first available bed is not accepted, they will be charged daily for their hospital stay.”

The spokeswoman said, in this particular case, “Our clinical care teams worked extensively with the family to find a solution to their concerns and offered numerous placements, all of which were declined.”

The WRHA said, as of Thursday, there were 23 people in Winnipeg hospitals waiting to be moved into a personal care home and another 177 waiting in the community for a PCH bed.

kevin.rollason@freepress.mb.ca