Aetna Member Story

Hopeless To Hopeful

Tucker, a 33-year-old member of Aetna Better Health of Illinois, had been in the hospital since attempting suicide. After he swallowed drain cleaner, he had to have his stomach and esophagus removed leaving him with a trach and J-tube and the inability to eat food or drink by mouth.

Tucker was homeless and had difficulty getting a permanent discharge plan due to his previous aggressive and suicidal behavior, refusals of care, and his medical condition. He was discharged to a shelter for a short time but returned to the hospital when he didn’t follow NPO instructions or perform proper trach care. He didn’t need acute hospital care but wasn’t safe caring for himself in the community. 

Lisa, an RN care manager with Aetna Better Health of Illinois was assigned to Tucker’s case. She immediately scheduled a care team meeting to address Tucker’s depression before referring him to a long-term care facility. The hospital discharge planner and care managers from the health plan contacted a list with more than 100 facilities over a period of five months until identifying a long-term care provider who agreed to work with Tucker. He was then successfully discharged from his lengthy hospital stay to a long-term care nursing facility where he is now receiving nursing care and mental health assistance.

The persistence of our care management team ensured Tucker was not inappropriately discharged to a shelter. Their efforts focused on Tucker’s safety and wellbeing, to ensure his behavioral health needs are met and that he is not at risk for frequent hospital stays or death related to improper trach care, suicide attempts or malnutrition.

*Member and care manager names changed to protect privacy