HIGH HEALTH CARE COSTS CREATE VETERANS HOME PREDICAMENT; VETERANS WAIT DESPITE MANY EMPTY BEDS

When doctors recommended to Pauline Gibson early this year that she put her ailing, 74-year-old husband, Russell, into a nursing home, she knew immediately where she would take him.

As a veteran, she reasoned, he could be cared for at the Missouri Veterans Home in Cape Girardeau.

But when she tried to get him admitted in January, officials at the home told her that although only about 100 beds in the 150-bed facility were filled, they couldn't admit him. His condition, they said, required a high level of care, and they lacked the funds and nurses to care for him.

Like hundreds of other veterans across the state whose medical conditions require a high level of care, Gibson is on a waiting list for admittance into one of Missouri's four veterans homes. And, in most cases, the veterans are being turned away despite the fact that beds in the homes are empty.

"They've got this space there, and they can't use it," Pauline Gibson said.

Russell Gibson, who is afflicted with Alzheimer's disease, is a "total care" patient, who requires assistance to walk, eat, bathe and even dress himself.

But because the staff at state veterans homes can care for only a limited number of these total-care patients, regardless of how many spaces at the facilities are open, the ailing veterans are being turned away and told to seek temporary care in nursing homes.

Robert R. Buckner, executive director of the Missouri Veterans Commission, calls it a nationwide problem.

"It has to do with the cost of health care," Buckner said. "For the highest-level patients, the cost is much higher."

Buckner said there are many heavy-care patients on waiting lists to get into veterans homes in the state.

"We just can't afford to take care of so many heavy-care people," he said.

Terry Ford, administrator of the Cape Girardeau home, said 35 percent of the home's patients require "level-three" or heavy care, the highest percentage allowed under state regulations.

He said 64 people are now on the waiting list to get into the home, most of them heavy-care patients.

"Right now we are recruiting light- and intermediate-care patients," Ford said. "As the population of light- and intermediate-care patients increases, we'll be able to take more level-three patients."

Only 104 of the home's 150 beds are currently filled, Ford said. State regulations mandating how many heavy-care patients each home can admit are based on financial and staffing resources, he said.

"A lot of applicants are asking for specific time frames as to when they may be admitted," Ford said. "But it's hard to say right now. It's very difficult to tell."

Ford said the home currently employs 120 people. At full capacity, it will employ 139. Since the home admitted its first patient June 25, the admittance rate has gradually slowed. Forty-six of the beds in the $9 million facility are empty.

Buckner, of the Missouri Veterans Commission, said in order to fill the home's remaining beds, an appropriate mix of first-, second-, and third-level patients must be maintained.

"Otherwise we wouldn't have enough staff to fill their needs," he said. "If we go ahead and admit them, we won't have the revenue to pay for their care."

Teresa Russell, assistant superintendent of the Missouri Veterans Administration, said that on average level-three patients require 3.6 hours of nursing care per day. The figure, she said, does not include time spent on physical therapy.

Patients whose conditions place them in the level-two category, require 2.5 hours of care per day, and level-one patients require an average of two hours per day.

Buckner said the Veterans Commission is studying staffing levels at all state veterans homes.

"In next year's budget we'll be requesting even more staff and more dollars to provide the care that's needed," he said.

But for now, Buckner concedes that the only option for veterans who are being denied admittance is temporary nursing home care.

The Gibsons say that's an option they don't like.

"It's just a waste of taxpayers' money," said Jackie Gibson, Pauline and Russell's daughter. "I realize they've got guidelines, but it's a shame that all those beds are there and they can't use them."

She said her father, who fought in World War II, "never asked for anything.

"At a time of need," she said, "we can't get anything for him."

For now, Russell Gibson is a patient in a VA-approved nursing home in Jackson. His care is being paid for by a grant from the Veterans Administration that runs out in July. Pauline Gibson said she was told there is little chance he will be able to be admitted to the Missouri Veterans Home by then.

"I'll have to try to get another grant or go through Family Services to be able to keep him there," Pauline Gibson said. "I have no savings, just my home, and I don't like asking for anything."

Pauline Gibson said that although her husband receives good care at the nursing home, the veterans home would be closer and more convenient for her. She said she's visited the veterans home and liked what she saw.

"It's very new and clean; the people are friendly; and they have the right facilities for him," she said. "If I could take care of him myself, I would."

She said that when he still lived with her, he would sometimes wander away from their home and get lost. Once, he took their car and was gone for several hours. He couldn't remember how to get back home.

"He's my husband," she said, "but he's like a child. I just want what's best for him."