CORNELIUS, N.C. — Despite North Carolina being under a ‘Stay-at-Home’ order, an elderly veteran in poor health is about to be kicked out of his rehabilitation facility in the middle of a global pandemic because of an insurance payment dispute.
“It’s been hard,” Andrea Gorman, the daughter of Sanford Hummel, said in tears.
“You lose sleep over something like this,” said Hummel’s granddaughter, Kelly Wimmer.
Hummel, 88, a Korean War veteran, was transferred at the beginning of March from Lake Norman Regional Medical Center to Autumn Care in Cornelius to recover from pneumonia, Wimmer said. The Air Force veteran and lung cancer survivor is an amputee and confined to a wheelchair. Unless something changes, Gorman says her dad will be discharged on Thursday, April 2.
“I asked them, you know, how come they didn’t let us know sooner so that way, you know, we’d be more prepared?” asked Gorman. “And they said they only need to give a 48-hour notice.”
If so, that would likely be improper. In most cases, a 30-day notice must be given when discharging a patient, according to the Centers for Medicare and Medicaid Services. A proper transfer plan must also be in place, arranged in consultation with the patient or guardian, that ensures the “safe and orderly transfer of the resident to a location capable of meeting the resident’s individual needs.”
Gorman says they were given just two days notice. The family says they were told if they want to appeal to Medicare they would have to do it on their own.
“I called two weeks ago and I asked them to give me a call back because I want to know what the update was with him, how they’re going to release him, how that can even be possible because of the coronavirus,” said Wimmer. “And they never called us back.”
“And then with the coronavirus going on,” said Gorman from her home in Huntersville, “they said it didn’t matter.”
Autumn Care did not respond to three phone calls requesting comment Tuesday. On the third call, a woman who answered the phone said an administrator was “unavailable at this time” and hung up.
Gorman says she doesn’t know where her dad would go. Her 1,000 square-foot home is not handicap accessible, she said. Because of the coronavirus, she can’t tour any nursing homes at this time.
FOX 46 is working to get results. A spokesperson for Tricare, the military’s health care program that covers retired service members, declined to comment. The North Carolina Department of Health and Human Services and the Centers for Medicare and Medicaid Services did not immediately respond. Senator Thom Tillis’ office says they are investigating.
“Appreciate you flagging this for us,” said Tillis’ spokesman Adam Webb. “Our office has been in contact with the family and has opened casework on their behalf to look into the matter.”
Late Tuesday, the family says Autumn Care called them back to tell them Hummel could stay – if they pay $270 a day out-of-pocket. It’s a price the family can’t afford.
They aren’t sure why TriCare or Medicare won’t pay for him to stay, given the circumstances, and worry moving him at this time would jeopardize his health and safety.
“He’s just scared because of his health,” said Gorman. “You know, with him having pneumonia all the time and bronchitis and COPD and he just thinks it’s not safe for him to move right now.”
If you can help get results, contact email@example.com or your local lawmakers. This story was reported from Charlotte.