Jerry Ginter has a house, a truck and two beloved dogs he dotes on.
But because the 54-year-old man with cerebral palsy can't currently stand on his own after a series of illnesses, Ginter is afraid that he could lose his home and his independence.
Ginter awoke one day in March and could no longer stand — most likely a reaction to a new medication. He went to Saint Joseph Hospital and then was sent to Cardinal Hill Rehabilitation Hospital. But an infection in his foot sent him to University of Kentucky Chandler Hospital for surgery.
He ended up at Tanbark Health and Rehabilitation Center to recover from surgery and get physical therapy. But Medicare, a federal health care program, will no longer pay for physical therapy to help him get back on his feet.
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He tried to appeal the decision, but it was denied.
On Monday, Ginter was sent to a nursing home in Carrollton to a Medicaid bed — a state-federal program for the poor and disabled. That means that all but $40 of the disability check he now receives will probably go to Medicaid to help offset the cost of his care. He can't pay his expenses and could lose his house.
"And Medicaid doesn't pay for physical therapy," Ginter said.
Theresa Warren, Ginter's niece, said it seems that the health care system is pushing her uncle into an institution because he's disabled.
"People think because he has cerebral palsy, he's not smart," Warren said. "That's just not true. They just want to shove him aside."
Grace Evensen, Ginter's third-grade teacher, said what's happening to Ginter is particularly cruel, given his life story. "He has had to fight for everything," Evensen said. "He's been taking care of himself since he was in the third grade. ... For this to happen to him now is unthinkable."
Ginter has fallen through the cracks before. And each time, he has made his way back. But to advocate and take care of himself, he needs to walk.
"I have a home; I have worked most of my life," Ginter said through tears during an interview Monday. "I'm not asking for a handout. I just want physical therapy."
A rough start
In June 1986, when he received a high school diploma at age 25, a Herald-Leader story chronicled his quest:
Ginter was born in East Chicago, Ind., but he grew up in Versailles. He has limited use of his left arm and a speech impediment. He spent several years at Cardinal Hill as a child and then was sent to public school when he was 6.
In 1970, when he was 9, his mother died, and his hard-drinking father failed to take care of him.
Four years later he was removed from his home and became a ward of the then-Fayette County Bureau of Children's Services.
William Stewart, a social worker at the time, told the Herald-Leader in 1986 that Ginter, at 13, had struggled to care for himself.
"I went to his house, and Jerry had nothing to eat except Cocoa Puffs. He wore the same clothes to school every day," Stewart said in 1986.
Ginter was sent to the Methodist Home in Versailles and attended Woodford County High School. Evensen said he was a popular student and earned Bs and Cs. "He's very funny, and the kids all looked after him," Evensen said.
But social workers decided to remove him from high school during his sophomore year and sent him to a rehabilitation center at Thelma in Johnson County — now the Carl D. Perkins Vocational Training Center. Ginter needed job training, they argued.
Ginter received a GED but not a high school diploma, and he found it difficult to find a job after he left the center in 1980.
He began his own campaign to get that diploma, calling people for help and taking night classes at Fayette County schools. He spent more than $2,512 on tuition, transportation and other expenses, according to the 1986 article.
He graduated from Woodford County on June 7, 1986.
Ginter told the Herald-Leader that he had promised his mother that he would graduate. "It took me six long years, but I made my mother's dream come true," he said.
He bought his house in Lexington that same year. A longtime dog lover, Ginter said he was tired of trying to find an apartment that would allow him to keep his pets.
Ginter worked various jobs over the next several decades — sometimes working multiple jobs to make ends meet. He cleaned airplanes at the airport, worked at UK as a security guard, bagged groceries at Kroger, was a bus monitor for Fayette County schools, worked for various veterinarians, and at one time was a "pet detective" who looked for lost dogs.
He also volunteered as a Big Brother in the Big Brothers Big Sisters program.
In 2006, while visiting his brother in Maine, Ginter fell down some steps and injured his leg. Several pins and screws were placed in his right ankle and foot.
At the time, a doctor said he should be placed on disability. But Ginter resisted.
"I got back up and I tried," Ginter said.
He returned to his job as a janitor at Temple Adath Israel for several weeks. But it was too much. He went on disability in 2007.
Unable to stand
In February, Ginter was having problems with his legs and went to see an orthopedist. That doctor eventually put him on some medicine that caused his legs to swell. He was bounced from his primary care physician to other doctors, and he woke up one morning in early March and could not put any weight on his legs.
He was taken to St. Joseph Hospital, where doctors diagnosed cellulitis.
He was eventually discharged to Cardinal Hill Hospital, where he spent several weeks. But Ginter was having problems putting weight on his legs, largely due to swelling, and while there, the screws in his foot began to push through his skin. He was eventually taken to UK Hospital, where doctors discovered that those screws were causing the infection, he said. They removed the plates and the screws. Ginter was put on high-dose antibiotics to rid his body of the infection. He was eventually discharged to Tanbark.
But because Ginter had spent so long in a bed and with so many complications, his legs were weak. Doctors cleared him in mid-July to start physical therapy. After about two weeks, Medicare said he wasn't improving and might not walk again, and the agency ceased payment on his physical therapy, which was cut off Aug. 8. He tried appealing the decision, but a snafu on where to call to make that appeal meant Medicare's decision was final.
"I was making improvement," Ginter said.
Warren, his niece, agreed.
Because Ginter can be difficult to understand over the phone, Warren has been trying to advocate for him, filing his appeals and trying to navigate insurance road blocks and a Byzantine health care system. Warren also is taking care of her two elderly parents.
"If my house was set up for it, I would bring him home with me," she said.
Because Medicare will no longer pay for physical therapy and Ginter can't afford to pay for a bed at Tanbark out of his own pocket, he had to move to a Medicaid bed in a nursing home. He owes Tanbark thousands of dollars for the week he stayed there while they searched for an available Medicaid bed.
Medicaid decides how much people can pay based on their income. Ginter has been told that it's likely that he will have to give all but $40 of his disability check, which is a little more than $1,000 a month, to Medicaid.
He's scared that he will end up at a nursing home the rest of his life and will have to sell his home.
"And I won't get to see my dogs," Ginter said, crying. "My dogs are like my kids."
Neighbors have been taking care of his two dogs since his hospitalization in March and have brought the dogs to Tanbark so he could see them. His neighbors won't be able to bring his dogs to the nursing home in Carrollton — the closest Medicaid bed.
Sherry Culp, the state long-term care ombudsman, said there are options for Ginter.
Culp said she has seen other patients who have had their Medicare services terminated and have had to go to a nursing home but were eventually able to return home. As the ombudsman, Culp helps patients and families of patients in long-term care centers advocate for themselves.
"He can get rehabilitation services through Medicaid," Culp said. "If his goal is to return home, they have to meet those needs. It may not look like the physical therapy he has received in the past."
Culp said Medicaid won't require Ginter to sell his home for at least six months. If he still wants to go home, he can make that request during a review at that six-month mark. But Culp said she knows that some people run into problems making house or utility payments because much of their money — if they have income — goes to Medicaid.
Culp also said there are Medicaid programs designed to keep disabled people in their homes.
"Once he is on Medicaid, he may be able to qualify for a federal program called money-follows-the-person, or in Kentucky it's called Kentucky Transitions, which will help create a plan to help him get home, " Culp said.
Donovan Fornwalt, the CEO of the Council on Developmental Disabilities in Louisville, said he understands Ginter's frustration and concern about moving into a nursing home. His council is a nonprofit that advocates for people with intellectual and physical disabilities.
"The more time you spend in a nursing home, the harder it can be to get out," Fornwalt said.
Fornwalt agreed with Culp that Ginter is probably eligible for other Medicaid programs that could help him return home.
"He may even be a candidate for home health care that could pay for some physical rehabilitation," Fornwalt said. There are other programs that provide home health aides and other help so people with disabilities can live on their own. The programs are all designed to keep people such as Ginter out of long-term care, which is costly to taxpayers, Fornwalt said.
Those programs sometimes have long waiting lists, Fornwalt and Culp said.
"But because he was admitted to a nursing home, he likely will automatically qualify for these programs," Fornwalt said.
B.R. Masters, the deputy chief of staff for the state Senate Democrats, has been working with Warren and Ginter to try to find a way to get Ginter out of the nursing home. Masters has been making phone calls to try to find another placement for Ginter. Masters was asked to help after Warren contacted state Sen. Robin Webb, D-Grayson, about Ginter's plight.
"We are going to look at every possible solution to see if we can get Mr. Ginter back in his home," Masters said.
Back on his feet
Meanwhile, Ginter must stay in the nursing home in Carroll County, 90 minutes from his family, his house and his dogs.
On Tuesday, staff at the nursing home — Green Valley Health Care and Rehabilitation Center — helped him stand up twice.
On Wednesday, he stood and put weight on his legs four times.
"I stood for 30 seconds, which was better than the day before," Ginter said. "I'm not making progress as fast as I would like to, but I'm making progress. I'm trying to take it one day at a time."
Evensen, his third-grade teacher, said she wasn't surprised.
"He can do this," Evensen said. "If he says he's going to walk again, he will walk again."