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WASTE WATCH: Ohio Medicaid Money Misspent
COLUMBUS (Brooks Jarosz) Its a system set up to help, but for some its more of a hurt because patients are forced into care they dont need and we pay the price.
Millions of tax dollars are pumped into the Ohio Medicaid system every year and ABC 6 Investigators exposed how that money is being misspent.
Dale Kennison feels trapped as hes forced to live away from his home and instead live at a nursing home. Its tubes and a wound vac that keep him from going home.
"I could be at home with this," Dale Kennison said. "This machine's the only thing that's stopping me from being at home."
Kennison recently had major surgery and he expected to spend five days recovering at the nursing home, however, hes spent well over five months.
Kennison is 52 and can eat, bathe and take care of himself. But Medicaid makes Kennison to live at the nursing home since its the only way the government program will cover the cost of his wound vac.
Disability Rights Ohio has been fighting what its advocacy director calls an inflexible system.
There's many, many people who are under the age of 60 that shouldn't be in nursing facilities that are, Kerstin Sjoberg-Witt with Disability Rights Ohio said. And this gentlemen is just one example of that."
Its called fee-for-service. Medicaid will pay a flat fee for the nursing home to take care of Kennison, but it will not cover the cost if he were to go home. Instead, he would have to pay out of pocket.
"I personally cannot afford that. It's just beyond what I can do," Kennison said.
Kennisons home has sat empty. Hes still paying rent and hes away from his best friend, his dog.
ABC 6 Investigators found if he was to go home he would have to pay $20 a day for a wound vac. But on average nationally, Medicaid will shell out more than $200 a day for Kennisons treatment at the nursing home.
"It's thousands and thousands...millions of dollars probably that are being wasted on individuals that could be served in the community for no more and likely much less money than is being spent in institutions," Sjoberg-Witt said.
ABC 6 Investigators repeatedly asked Medicaid why it wouldnt cover the wound vac at home. A spokesperson says the department cant comment on specific cases, citing privacy protections. However, Medicaid did supply a list of things it would cover at home including gauze, bandages and wound fillers. Still, medical equipment like the wound vac is missing.
We made nearly a dozen phone calls trying to get Kennison help and ultimately home with his dog. Disability Rights Ohio is looking into taking on Kennisons case and questioning the legality.
"What's happening here is a symptom of a bigger problem in Ohio where there's significant concerns about whether or not they are in compliance with the Americans for Disabilities Act," Sjoberg-Witt said.
Since Kennisons considered disabled, this rights group says hes being discriminated against since theres no other affordable option for coverage.
"I'm just one little dot in the system but can you imagine if you put a puddle together, and add all that up, oh my gosh," Kennison said.
Kennison has since gone against doctors orders and left the nursing home without his wound vac. He claims hes recovering the best he can without the medical equipment.
Disability Rights Ohio is still looking into Kennisons case.