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SHERIDAN — A resident at the Green House Living for Sheridan nursing home was involuntarily discharged from the facility yesterday afternoon. Gillette resident Tom Johnson said his wife, Jan Johnson, 61, was metaphorically booted from the facility on less than amicable terms.
Green House Administrator Chris Szymanski confirmed there was a dismissal at the facility yesterday, but cited medical privacy policies in declining to confirm the name or circumstances of the elder involved. She indicated the discharge that took place was executed in accordance with established federal regulations.
Johnson said that while he was told the official reason for his wife’s dismissal was that she did not have a primary care provider, he believes the real reason has more to do with political backlash for his previous complaints about his wife’s care.
“She’s a tar baby,” Johnson said, referring to a 19th century children’s tale, “Uncle Remus.” Today, a “tar baby” represents a precarious situation that is aggravated by additional interaction.
He said he believes another motivating factor in his wife’s involuntary dismissal from the Green House is that she is an expensive patient for the nursing home, and even with Medicaid, she represents significant financial disadvantage to the institution.
Jan Johnson has type I diabetes, polycystic kidney disease and multiple sclerosis. Over the course of her life, the severity of impact of her conditions has fluctuated, but she has been consistently judged eligible for Medicaid since 2003. Tom Johnson has become an unofficial layman for issues related to nursing home care and has been active in the community of Gillette advocating for elder issues, sometimes to what has been called an extreme extent.
Part of Jan Johnson’s care involves the use of an insulin pump, which the Johnsons believe represent a significant medical expense that would have to be absorbed by the GH.
“They wanted to get rid of her and get someone in that just needs oatmeal and aspirin,” Johnson said.
Jan Johnson had been receiving nursing home care at Pioneer Manor in Gillette fore three years immediately before moving to the Green House in late 2012. A new assessment performed by Public Health Nurse Susan Feck shortly after her arrival at the Green House, per standard procedure, rendered her ineligible to receive federal Medicaid. In other words, she was not determined by Feck to be disabled enough to need full-time nursing care or qualify for federal financial assistance.
The Johnsons were immediately aware of omissions in the assessment process that changed the ultimate determination in the new evaluation. The Johnsons believe the test was a blatant attempt to make Jan Johnson “score out” of eligibility for Medicaid and render her unable to pay to live at GH.
Because of the new score, Jan Johnson was informed she would have to either privately pay for Green House services to the tune of $280 per day or leave the facility. After a lengthy appeal and grievance process, Jan Johnson was reassessed and allowed to remain in the facility at that time with Medicaid funding.
The Johnsons sought the help of several governmental and social agencies, only to be caught dealing with agencies that shared a common monetary source — federal funds. Johnson believes officials at the Centers for Medicaid Services, the Wyoming Department of Health, Sheridan County Public Health and the Green House colluded an effort to disqualify his wife for medical services because of financial motivators.
“The ugly fact underlying all actions past and present is that if I was private pay…none of the abusive actions against me would ever take place,” Jan Johnson said in a letter to the GH Family Council this month.
During the course of fighting what the Johnsons considered to be a faulty Medicaid eligibility examination, Jan Johnson remained in the GH. She was reassessed for Medicaid eligibility more than six months later and found then to be eligible for funding.
However, last month,Tom Johnson said they were again notified by GH staff that Jan Johnson had failed to meet other eligibility requirements to remain in care, and it was alleged Johnson was not following her physician’s instructions and had been dropped as a patient. While Tom Johnson denied the case as presented, this time, administrators executed Jan Johnson’s involuntary removal from the facility.
Szymanski did not speak specifically about the Johnsons’ situation, but said that all clients are required to meet multiple criteria in order to be accepted as GH clients.
“Without referring to individual factors, there are certain requirements that have to be met in a long-term care facility,” Szymanski said. “If people don’t meet them, we are out of compliance.”
When asked further about the discharge that occurred yesterday, Szymanski asserted required protocols had been followed.
“We have followed procedures in accordance to what is required by federal regulations for a discharge,” she said, adding that the GH is committed to providing exceptional, humane and non-institutionalized nursing home care to its clients.
“We always try to make this the best home elders can have away from their original home,” she said.
While the Johnsons moved from the nursing home in Gillette to Sheridan following the vision and dream presented at the inception of the Green House as a modernized, more personable approach to nursing care, Tom Johnson said they were almost immediately entangled in a web of bureaucracy. While Jan had initially applied to be a resident of the Green House before it was built and available to accept clients, it was another year before the facility began accepting Medicaid. At that time, Jan Johnson became one of the first Green House elders to be served at the Green House via government subsidy.
Tom Johnson contacted The Sheridan Press yesterday morning indicating he believed his wife was going to be arrested and escorted to the edge of the property. While that scenario never played out, she was transported away from the GH campus under the supervision of social service agencies.
Johnson has reached out to a multitude of entities in hopes of keeping eyes on his situation, including his local state legislator, Rep. Eric Barlow, R-Gillette.
“I don’t think this happens very often,” Barlow said, indicating it’s even more of a rarity that someone is publicly vocal after being involuntarily discharged from a nursing home. “I think a lot of people are scratching their heads as to how to go about this.”
Barlow indicated his role in the Johnsons’ case is one of oversight and that as a state legislator, he has no jurisdiction or authority over how the situation is settled.
Tom Johnson indicated an email Barlow sent to executives at the Wyoming Department of Health and Department of Family Services generated a more comprehensive response from the agencies during the event of his wife’s dismissal.
This morning, Tom Johnson confirmed with The Sheridan Press that he and his wife have been notified that Jan Johnson can return to the Green House when she secures a primary care doctor.
The Johnsons indicated they are unsure what their next course of action will be, but did not rule out returning to Sheridan’s Green House.
“The Green House has a great vision, but visions are only as good as the people who operate them,” he said.