By Dorsey Griffith Bee Staff Writer (Published April 2, 1998)
At Sutter Memorial Hospital, Room 476 has been transformed in the past
three months. A stuffed lion, bear and pig hang from an IV stand. Giant
metallic balloons hover near the ceiling. Snapshots adorn the cabinets. A
Pearl Jam tune plays on a boom box on the window sill.
But hard as Sara Granda tries to feel comfortable in this intensive care
unit room, it's a far cry from home for the 18-year-old.
The most agonizing thing is that doctors and hospital officials agree she
is ready to return to the Davis home she shares with her mother and sister.
The problem for Sara, who was paralyzed from the neck down in a car
accident last July and breathes with the help of a ventilator, is that her
insurance will not pay for the round-the-clock nursing care she will need
once she gets home and there is no guarantee that public assistance can
fill the gap.
So, while everyone argues over who is responsible for the costs of her
care, the girl who was supposed to be studying international business on a
scholarship at Cal Poly waits alone in a hospital room typically reserved
for the critically ill.
"Everybody here is old," she says, her soft-spoken words separated by gasps
of breath, tears streaming from her clear brown eyes. "They can't talk. My
neighbors are dying. It's depressing because I think I may die, too. I want
to go home."
Sara's ordeal began July 24 while running errands in Woodland with her
older brother. The two had been shopping for clothes and then went to fix
the tires on her 1989 Ford Escort.
"The car ran off the road. I wasn't speeding. Then I tried to brake, and
the car flipped over three times and spun around."
Her brother walked away from the accident, but when Sara woke up at the UC
Davis Medical Center, she found she wasn't so lucky. "I couldn't move. I
couldn't talk."
Sara had broken her neck and suffered the same spinal cord injury as actor
Christopher Reeve. Like Reeve, Sara has no feeling below her shoulders and
breathes through a tube in her throat.
After five weeks at UC Davis Medical Center, Sara was transferred to
Children's Hospital in Seattle, where she spent three months in a
rehabilitation program. She then went to University of Washington Hospital,
where she remained for a month.
On Dec. 29, she was flown to Sutter Memorial. What was meant to be a
weeklong stay, however, has turned into a three-month hospitalization where
she is cheered only by family visits, television sitcoms and time with her
nurse, who applies makeup and paints the nails on Sara's unmoving fingers.
Her doctor, pulmonary specialist Bradley Chipps, said there is a very slim
chance that she will recover any movement or that she will ever breathe on
her own again. He has recommended she get 24-hour licensed nursing care.
He said that as long as she's cared for appropriately she should be able to
live a long and productive life. For Sara, that begins with a trip home.
The chief obstacle is the health insurance policy her father has as a
professor at California State University, Sacramento.
Jos Granda pays about $375 per month for the coverage he bought through the
California Public Employees Retirement System. He also pays for the PERS
long-term care plan.
"Professor Granda was responsible enough to take out what was represented
to him to be the very best insurance available for his family," said Roger
Dreyer, the family's attorney.
In fact, the policy covers only 100 home nursing visits per year at four
hours per visit, or 161/2 days of 24-hour care. The long-term care plan
does not cover dependent children.
"No one offers 24-hour nursing care for a person's lifetime," said Pat
Macht, Cal-PERS' public affairs chief. "Our job is to make sure everyone
gets the benefits they are entitled to. It's also our job to make sure . .
. we're not providing things that aren't under the policy that would
ultimately cause rates and premiums to go up and out of control."
Macht added that the plan will pay for only 180 days of skilled nursing
care at $500 per day. Sara has used up 90 days already.
Sara's mother, Beverly Granda, has applied for Medi-Cal, which would most
likely cover up to 16 hours per day of home care. But even if that were
enough to meet the need, few home health-care operators accept Medi-Cal
patients because the reimbursement rate for 24-hour care -- at $532 per day
-- is too low.
"You just can't make any money at it," said Richard Helms, administrator at
Customcare of Sacramento, which specializes in ventilator-dependent patients.
Hospital officials have tried to urge Sara to consent to moving to a
skilled nursing facility, but they acknowledge that none exists in the
Sacramento area that are appropriate for her. And they know she fears being
put in an institution more than anything else.
So, she remains in the intensive care unit at Sutter Memorial because it's
the only place in the hospital where nurses trained to take care of
patients on ventilators and respiratory therapists are available around the
clock.
"I have told the family I can't turn Sutter into a rehab facility," said
assistant administrator Mark Rieger. "But I do think we have gone out of
our way to accommodate many of the things they need."
The hospital has paid many of the bills Beverly Granda has been unable to
pay since quitting her nursing job to care for her daughter. Craftsmen for
Christ, a charitable group, has begun readying the Granda home for Sara's
return. And members of St. James Catholic Church in Davis have sent meals
to the Granda home and have made a quilt that will be raffled off for her
care. They have also set up a trust fund to help cover the cost of moving
her home.
Sara still clings to her dream of going to college with the help of a nurse
and looks forward to attending weddings and baby showers for her friends.
In the meantime, she has asked her nurse to take the clock off the wall in
her room. "Otherwise all I'd do is watch the clock," she said.
-- Maksim (Max) Bily
mail to: imax(AT)odyssee.net