When a cab took Rufus Bush from Medical College of Georgia Hospital this week and dropped him off outside The Salvation Army of Augusta, he was left with no coat and no shoes on his feet.
"He was confused and disoriented when they brought him, when he showed up at 6 o'clock at The Salvation Army," said Sister Fran Voivedich, the outreach nurse at St. Vincent dePaul Health Center at the shelter on Greene Street. "They wanted to send him back, he looked so bad."
The incident is the latest in a series of ongoing disputes between homeless advocates and the hospital over how it discharges homeless and uninsured patients.
Advocates say the hospitals are trying to avoid being charged for using the Good Samaritan Respite Center on Broad Street, even though it was built with their agreement that they would use it for homeless uninsured who were too sick to be back on the street. That's where 50-year-old Mr. Bush is recuperating now - in a bed that he has difficulty getting out of.
A series of staples encircle Mr. Bush's head, and his right eye is swollen shut and bulging out of his face, the result of a hammer attack Dec. 1 at his home on Broad Street.
According to a report at the Richmond County Sheriff's Office, Mr. Bush had a dispute with Gerald McNutt, who admitted hitting Mr. Bush in the head with a hammer. Mr. Bush suffered a broken eye socket and broken sinus bones and said he underwent two surgeries at MCG.
He was there until Monday, when he was summarily discharged.
"I had no say-so in the matter at that time," said Mr. Bush, who often lapsed into an unintelligible mumble. When he got to the cab, "they already had the address where they were going to take me and everything," he said.
It is a problem The Salvation Army sees on a "weekly" basis, said Maj. James Hall, the commanding officer of the Augusta facility. It prompted him to write a letter about a month ago to MCG and University Hospital asking them to stop discharging patients to his facility and instead to use the respite center, which opened a couple of months ago.
"Now that it's built, it's in operation, the hospitals are still sending people directly to us," Mr. Hall said. "In fact, they will drive them down to our emergency shelter and put them on the sidewalk and allow The Salvation Army to take care of them when some of these people are debilitated."
In a statement attributed to Sandra McVicker, the senior vice president of patient care services, MCG Health Inc. said it did not discharge patients without them being certified as "medically stable" by a doctor.
"When patients arrive at the hospital without adequate clothing, our hospital staff is diligent about attempting to locate garments, either by contacting members of the patient's family or by accessing the limited number of items we have available for just such a contingency," the statement said. "In this case the family was notified and visited the patient."
The hospital is aware of the respite center and to date has discharged one patient there, the statement said.
"Staff did not assess the Respite Center to be a viable option in this case," the statement said.
University, which said it has fewer than 10 homeless patients admitted each year, will discharge people to a personal care home if they are homeless and still need to recuperate, spokeswoman Rebecca Sylvester said. The difference is the person can stay in the home for $500 for a month, giving them more time, versus $150 a day at the respite center. University would use the center if the patients needed a higher level of care, she said, but "we have very few patients who meet the qualifications" for the center.
MCG Health said it is reviewing the criteria for admission to the respite center and was aware of the Salvation Army letter.
"Rather than discharge the patients to the streets, we hope that by sending them to The Salvation Army that it will serve as a temporary solution until the Respite Center's criteria can be adjusted," the statement said.
And Mr. Hall said he would like to think it is just a misunderstanding.
"I'm going to take the high road, and the high road says it's just a communication issue. The hospitals really may not understand that resource that's available," he said.
But to others, the motive appears to be financial.
"They, in essence, don't want to spend $150," Sister Voivedich said.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.