A Catch-22 might drive Patrick Durkin to spend years in an costly nursing facility simply to qualify for a waiver to return to his own residence, the place he desires to remain.
BETHESDA, Md. — A North Bethesda man who spent a quarter-century in service to the U.S. authorities says he’s battling that authorities for an opportunity to maintain residing.
Patrick Durkin — paralyzed by a wave in Ocean Metropolis in 2009 — says Medicare and Medicaid are forcing him out of his residence and right into a nursing facility the place he’s satisfied he’ll die.
He is nonetheless hoping for a miracle.
“Proper now he is off the ventilator for the evening,” says nurse Judy Pangborn, simply earlier than she suctions out his throat by means of his tracheotomy.
Patrick Durkin has a lot life for a person who struggles even to breathe.
“Feels nice, Judy, excellent,” he says after she finishes his remedy.
Durkin spent 28 years as a particular agent for the IRS and the FDA, the place he was acknowledged for serving to hold counterfeit most cancers medicine from making their option to American pharmacies.
“It’s in all probability my proudest accomplishment,” he mentioned.
In 2009, he was physique browsing in Ocean Metropolis and bought slammed by a rogue wave. It’s a narrative he tells in a public service video for the Nationwide Climate Service. “And it crashed and knocked my brow into the sand,” he mentioned.
He describes floating face down within the water till his fiance rolled him over and dragged him to shore.
Durkin was left a quadriplegic, paralyzed from the neck down, however nonetheless capable of really feel ache.
“See the shoulders spasming, in case you pull it out too far? Most likely simply be simple with it,” mentioned Pangborn, whose company is named Samaritan’s Manner Nursing.
Pangborn has cared for him tenderly for a dozen years, proud that it has been seven years since he is needed to even go to the hospital.
“Judy mentioned she was not solely going to maintain me alive, however she was going to provide me a life,” mentioned Durkin. And he or she has, taking him in a wheelchair elevate van to hockey video games and household dinners.
“It is fabulous, what I can do on this chair,” sipping and puffing by means of a straw that directs his wheelchair to show left and proper, forwards and backwards.
For a decade, Durkin paid his nursing company from his pension, his financial savings, non-public insurance coverage, and long-term care insurance coverage. However when he turned 65 he had to enroll in Medicare. And Medicare is not going to pay for 24-hour in-home care.
“I’m very afraid of going right into a nursing facility. … It would result in my loss of life,” he mentioned. Two medical doctors testified that he seemingly would not survive if he has to go to a nursing facility.
Durkin has exhausted his financial savings to qualify for Medicaid. However, get this: He says a Maryland administrative decide instructed him he needed to be in an establishment to use for a waiver for Medicaid to pay for the 24-hour in-home care he wants.
It’s like a Catch-22. He’s bought to be in a nursing residence to use to return residence, mentioned Pangborn. He can’t apply from in own residence to remain there, she mentioned. He’s bought to enter a nursing residence first.
Andy Owen, spokesman for the Maryland Division of Well being, says privateness legal guidelines stop him from speaking particularly about Durkin’s case, however he mentioned it’s a precedence to maintain individuals in their very own houses in the event that they need to keep. However “people should meet a cost-neutrality take a look at.”
Pangborn says she might hold caring for Durkin for 1000’s of {dollars} a month lower than sending him to a nursing facility. She says she and her nurses might take care of him in his own residence for $16,000 to $18,000 a month. She estimates a mattress in a talented nursing facility would value not less than $21,000 a month — if they might discover an obtainable mattress. There are lengthy ready lists for house for Medicaid sufferers.
As a result of Medicaid’s not paying, Pangborn has been caring for him virtually free of charge for the final 12 months.
“I’ve cried. I’ve screamed. I’ve yelled … I simply can’t afford to remain right here,” she mentioned, preventing again tears. “I really feel like I’m placing a member of the family out the door.”
However she mentioned she’ll lose her enterprise if she retains caring for him, often placing in seven shifts every week, free of charge.
A lawyer for AARP Basis says forcing Durkin out of his residence and into an establishment would violate the Individuals With Disabilities Act.
“The thought of placing any person right into a nursing facility with a purpose to get the care that he wants on its face violates the Supreme Court docket precedents in Olmstead versus LC, which is, to me and to different advocates the Brown versus Board of Training for individuals with disabilities,” she mentioned.
“This robust man who has fought drug sellers is decreased to tears due to what this Medicaid regulation goes to drive him to do. It’s pitiful. It’s pitiful,” mentioned Anne Engel, considered one of dozens of volunteers from St. Jane Francis de Chantal Catholic Church in Bethesda who’re making an attempt to assist him.
Durkin says he by no means quits. “I’m nonetheless optimistic that I’m going to remain residence. God keen,” he mentioned.
Should you will help, a few efforts are underway to help Durkin. You could find a GoFundMe arrange by Durkin’s household and pals right here. There may be additionally a marketing campaign with HelpHopeLive to assist to pay for uninsured medical bills related to catastrophic harm.