Imagine a hurt and bloodied child being turned away from medical care because his mother brought him across the border.
Now imagine we’re talking not about international boundaries, but about the state line that separates suburban Ballantyne from suburban Fort Mill.
That’s the situation that faced Brooke Adams when she rushed her 3-year-old son, William, to the nearest urgent care center after a recent tumble down brick steps. Because the child, who has autism, is covered by South Carolina Medicaid, Carolinas HealthCare System’s urgent care center in Ballantyne, north of the state line, turned the family away.
It wasn’t even a matter of losing money. The family also has UnitedHealthcare coverage, and Adams says she offered to pay cash. Medicaid provides coverage for some severely disabled children even when the parents’ income and resources exceed the normal limits for the program, which generally serves low-income patients.
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But after a doctor looked at William from across the room and declared him stable, Adams said, she was told to go back to South Carolina.
William was treated at the CHS urgent care center in Fort Mill, about 10 miles away, and is fine. But, says Adams, “This could have turned out a lot worse. What if something would have happened to him from point A to point B? What if he had internal injuries that a glance once over couldn’t see? All because he has Medicaid? It’s unreal!”
CHS has apologized to Adams. It’s up to each location to decide whether to accept S.C. Medicaid, said spokesman Kevin McCarthy, and the system is exploring a change for centers like Ballantyne, which doesn’t participate even though it’s less than 3 miles from the state line. All CHS hospitals take S.C. Medicaid, he said, but not all medical practices do.
“For the benefit of our S.C. patients who live near the N.C. border, we are exploring having our urgent care locations near S.C. enroll in S.C. Medicaid,” he said.
Here’s how it played out: On May 20, Adams heard William scream and found him bleeding from his mouth and nose at the bottom of the garage steps. William doesn’t speak, so he wasn’t able to tell his mom what had happened or where he was hurt. Adams worried about internal injuries. With the boy’s face swelling, Adams got William and his 6-year-old sister into the car and headed to Ballantyne, which is where her husband works and William’s doctor practices.
It was almost 6 p.m., so the doctor’s office was closed. They went to the urgent care center, where Adams says the front-desk staff took their insurance information. After they raised questions about S.C. Medicaid, Adams offered the private insurance and cash options.
“They told us that was fraud and we would have to leave,” Adams said. “The lady at the front desk sent us back to a room to have a doctor determine if he was stable to make the trip to South Carolina. The doctor could not have been more rude. She stood across the room from him and would not examine our son. She said he seemed OK and sent us out.”
While McCarthy said he couldn’t comment on specifics of the situation, the Ballantyne center “is able to accept alternative payment sources should a patient have them. We are working to ensure staff at this and all applicable practices are informed of this fact and that they act accordingly.”
Adams says William was treated “wonderfully” once they reached the Fort Mill urgent care center. The doctor there checked him carefully, she said, and told her how to monitor him afterward.
After Adams filed a complaint with CHS and the Observer inquired about her case, Adams says she got a call from hospital officials.
“They said the staff was not trained properly on the procedure and that care came first regardless, so we shouldn’t have been turned away,” she said.