Miller County Nursing Home resident, Dujuan Dubose, 28, originally from the Bronx, NY, was one of those rolling the streets and enjoying his $100 scratch-off win. He was seen talking with the youth in the parking lot later that evening. Residents on the loose If you’ve seen folks in wheelchairs rolling around town, let me explain who they may be.

The Chief of Police called Friday, February 26, to tell us about three residents wheeling around town. I went down to Geer Street, and there were two wheelchair residents from the local nursing home headed toward the “Bottom.”

I asked where they were from, and one said he was for New York. The other said he was from Albany.

I asked what they were doing away from the nursing home, and the New York man, both young, said “We have the right to go and come as we wish.”

I urged them to head back to the nursing home, since it was getting late. Last time I saw them they were going deeper into the “Bottom.”

It didn’t take long for the nursing home residents to head for the “Bottom” to get Residents on the loose “refreshments”, and it wasn’t to go to church. I called the nursing home director of nursing, Jessica Dunnigan, who was not available.

The next day, Robin Rau, Miller County Hospital and Nursing Home CEO, called and asked if I could meet with her and Miller County Hospital board chairman, Ray Henley.

I asked Ms. Rau what she knew about this, and how this happened and why.

CEO Rau stated, “As you know many regulations regarding nursing home placement have changed significantly over the past five-seven years. At one point nursing homes throughout the state of Georgia and across American were filled with elderly residents who were mildly confused and in need of some form of supervision with daily living activities, such as dressing, cooking etc. Placement of a loved one in long-term care was a fairly easy process; every nursing home was full, and we all had waiting lists of people looking for placement.

Since then, and in an attempt to reduce health care spending, the government has placed a renewed emphasis on alternatives to nursing home care, such as assisted living facilities or other types of community living environments. The reimbursement for nursing homes has changed dramatically, and we are now reimbursed based upon the acuity of the residents in which we serve. What we now see in long-term care are very sick individuals who require medical treatment and care, and the age of the resident in nursing homes has decreased substantially.

As a result of these regulatory changes, Miller Nursing Home, like most other facilities, has been faced with empty beds. When I first came to Miller County Hospital and Miller Nursing Home we were challenged with two consecutive years of financial losses in excess of $1 million, and like most small rural hospitals we had a genuine concern of our ability to keep the doors open. We are a 25 bed Critical Access Hospital, and a little more than a year ago 23% of our nursing home beds were empty. It was clear to me that in order for our health care system to remain viable that we need our nursing home full and profitable to help sustain the hospital.

In order to accomplish this we had to change from providing custodial care for the elderly, to being able to care for sub-acute care patients recently discharged from hospitals. We had to be prepared to accept any medically complex patient that was referred to us. This required adding RNs and LPNs with hospital levels of experience to our staff, respiratory therapists, around the clock management and some medical equipment.

We have been successful and are able to consider for placement in our skilled nursing facility any patient referred to us by other hospitals that we feel we are medically equipped to care for. Our patients are referred to us from as far away as Grady Hospital and Emory University Hospital. We have established a reputation for excellence in being able to care for brain injury patients and other patients requiring complex care. All of our patients are referred to us from Georgia hospitals, and our plan is to provide them with excellent medical care and rehabilitation, and ultimately discharge them to alternative care facilities or to a home environment. All of our patients come to us by request of hospitals, unless they are residents of our community.

As a result of these efforts, our nursing home is generally full, and has remained so for the past year. In addition it brought in almost $1 million dollars in additional revenue last year to help support the hospital.

But what you see when you come into our nursing home now is different; some of our patients are younger. Some of them are not confused, and they have the ability to make decisions or choices, even if they are the wrong ones. As a nursing home, we have rules which are there to protect all the residents of the facility.

Last Thursday, one of our young residents challenged the nursing home and refused to abide by our rules and discharged himself from the facility. The problem for him was that he was transferred from an Atlanta Hospital to Miller County, and, therefore had no local family or place to go. In our effort to rectify this, we contacted the State Ombudsman to help us and to help the resident.

The Ombudsman came to our facility and instructed us that we must allow any resident who had not been adjudicated incompetent, and was reasonably able to make decisions the right to leave the facility as they so choose.

We may not agree with this logic, but the reality is that health care facilities are not prisons as was pointed out to us, and that even though we may not agree with the decisions our residents make, they have the right to make them.

Friday three of the residents demanded to leave the facility; they were warned about the potential harm that could come to them if they left the facility, the risk of injury from motor vehicles, and risk to their medical condition. Despite our counseling, three of the residents did leave the facility and found their way to the IGA and around the community. They made it back to the nursing home without injury.

By Sunday morning, we called the police to the nursing home to help us deal with two of the residents who had some unknown substance. As a result of the freedom to make choices, these two residents jeopardized the facility, violated the law and are no longer residents of the nursing home or Miller County.”

The case of the wheelchair trio was turned over to the drug squad for investigation of where the residents purchased the illegal drugs. That is still under investigation.

The laws, regulations that allowed this to happen should be under investigation. This not only puts those who choose to leave at risk, but those residents who do not have that option to have to put up with illegal drugs and alcohol being brought back into the facility.

One nurse stated that they are not allowed to pull up the side rails on the residents’ beds according to regulations.

Two calls were made to Georgia Department of Human Resource representative, Becky Grantham, concerning the rules/laws that allow a resident to come and go from the facility, with no response.

The question was raised of who was libel if the “checked out” resident was injured crossing streets and highways to go into an area that is known for crime.

Those in charge have an idea who would be libel, and if taxpayers would pay.