Having a major operation is arduous. Having a major operation when you're homeless is another story altogether.

Having a major operation is arduous. Having a major operation when you're homeless is another story altogether.

Robert Logsdon, known to friends as Robin, found that out the hard way when he broke his hip more than a month ago. He lives on the streets of Ashland and has no insurance.

Logsdon was admitted to Ashland Community Hospital on Sept. 30 after he fractured his left hip while recycling cans behind the Minute Market. He underwent surgery and had three pins put in his hip as part of a community care program that assists anyone unable to pay.

During his hospital stay, Logsdon was due to appear in municipal court for a prior offense. In a letter to the court explaining why he would miss his court date, a doctor explained that she anticipated a four- to six-week hospital stay. Instead, Logsdon found himself discharged from the hospital on Oct. 15, just two weeks after his surgery, with instructions to walk only with crutches and take ibuprofen for the pain.

He was referred to the Medford Gospel Mission but chose not to go because it was in Medford, too far from his friends for his liking, he said. Instead, he ended up on the porch of an empty home and declined quickly. He was confined to a sleeping bag, could no longer walk and was losing feeling in his hands, he said.

His friend Montana Glinzman, who experienced a stint of homelessness herself in the past, found him there last Friday and determined to get him the help he needed. She got him back into the hospital, where doctors discovered his hip had collapsed, she said.

Glinzman said she believes Logsdon is a victim of a system that lets homeless patients slip through the cracks, while hospital officials said they do all they can with the services available in the community. And those services are sometimes unable to help if those seeking assistance are unable or unwilling to help themselves.

"I do think there is a problem with people like Robin after surgery," Glinzman said. "If they were sending someone home like you or me, no problem, but someone like Robin, there is no facility. There's a gap ... I think this hospital does a lot of good, but it's also got its issues and people like Robin fall into the cracks. I don't think the hospital has an awareness of the needs to be addressed for someone like Robin."

Hospital policy

Logsdon signed an authorization form to disclose his medical records, but the hospital declined to comment on his case. As a policy, the hospital offers care to anyone who is unable to pay, whether homeless or just uninsured, through its community care program and makes arrangements for rehabilitation after they leave, said Kathi Wilcox, the vice president of organizational transformation at the hospital.

"We have a discharge planner who assists with all patients' discharge needs that begins at the point of admission," she said. "We don't wait until someone is ready to walk out the door before we assess their needs."

The hospital considers patients' financial situation, living situation and support network in planning for their recovery outside the hospital, she said. They also assist with payment for medication or other equipment such as crutches if they are prescribed by a doctor.

"We have resources in the community that of course are limited, but we access those resources as needed and offer options to our patients that are appropriate," she said. "Patients often will have the choice and do have the choice whether to accept those options or not, and as we know with the homeless population, there are those who will choose not to have the option of a shelter or a foster home or somewhere that has limitations on them because they don't want those limitations."

Limited resources, options

Logsdon said he declined a trip to the Medford Gospel Mission because it was too far away.

"I love Ashland, I love the people of Ashland, and I didn't want to end up in Medford," he said. "That was just like being displaced and losing all my friends here."

Another barrier to some prospective users of the mission is alcohol, according to Jason Bull, the assistant program director at the mission.

There are agencies in the Rogue Valley to help people with alcohol problems, but often they end up at the mission and can't stay, he said.

"We all try to work pretty well together so nobody really slips through the cracks," he said. "The problem we have is we're kind of the emergency shelter. We're kind of the catchall. If the hospital helps somebody in an emergency room a lot of times they end up here."

Still, Logsdon said he was led to believe he would have more time in the hospital before being given the choice between the mission and the street and he blames it on the health care system and the pressure it places on doctors to get people out quickly.

Wilcox said patients stay only as long as medically necessary because the hospital is obligated to be responsible and use its resources wisely.

Once he was released, Logsdon's only other choice besides the mission was to carry his possessions and attempt to walk on his healing hip because the hospital does not have a transportation program.

"I saw him with the crutches and trying to carry a bag, and he looked like he was about to collapse," Glinzman said of her first glimpse of Logsdon.

The lack of transportation is also to blame for Logsdon's missed follow-up appointment with his doctor on Oct. 20, he said.

"The problem is that for someone like Robin who doesn't have a home to go to, he needs rehabilitation to get strong enough so that he can get around," Glinzman said. "They sent him packing after two weeks and he just couldn't make it on the street."

Before Glinzman brought him back to the hospital, Logsdon seemed to have given up hope.

"I don't know what to do; I have no desire to live," he said. "I don't like to be seen or be heard, but this is ridiculous. If I met someone in this situation, I would grab them and take them right out of here if they wanted to."

Staff writer Julie French can be reached at 482-3456 ext. 227 or jfrench@dailytidings.com.