When case managers at Floyd Medi-cal Center in Rome, Ga., are stuck in an especially tough situation, they seek out their boss, Ricky Knight, R.N., the director of coordinated care. Knight is a roll-up-your-sleeves kind of guy who has been known to go to great lengths to find care for the homeless, friendless and undocumented.
A supervisor of case managers, mental health assessors, behavioral health workers and documentation specialists, Knight parses the complicated cases with his employees at a one-hour meeting every week and pitches in if the situation calls for it. "He turns over every rock," says Alison Land, a vice president at Floyd. "And the way he does it is so sensitive to the patients' and families' needs, and even the needs of the staff. Everybody pulls together when he's on the team."
When Land and her colleagues nominated Knight for the Georgia Hospital Association's Hospital Heroes awards earlier this year, they had no problem coming up with anecdotes describing his doggedness. There was the story of a man with severe dementia and cancer who arrived at the hospital with a fake driver's license and the Social Security number of a deceased person.
"He was a John Doe for months and months," says Knight, who was unable to track down any family, but eventually found the man a home in a Catholic hospital for indigent patients. "He lived out the rest of his life with the sisters there," says Knight. "They took him on and cared for him just by donation."
There was also the time Knight, who was named a Hospital Hero, worked with the Guatemalan consulate in San Francisco to locate the family of an undocumented man seriously injured in a car accident. With the help of an interpreter and the authorities in the man's hometown, Knight got the immigrant's wife on the phone and learned about her situation. With five children and no work except washing other people's laundry in the creek, she couldn't afford to care for her husband.
After many calls to the Guatemalan embassy and help from a company called MexCare, Knight found a facility to care for the man near his home in his native country. Floyd Medical Center agreed to foot the bill until the Guatemalan government took over payments.
"So many of the folks who come from Guatemala and Mexico are working hard to send money back to their families, but they have no resources," observes Land. "When they get into trouble, nobody wants them. Ricky really steps up and finds a way to help them."
Another case involved a patient who had suffered a massive stroke and required round-the-clock care. "We didn't even know at first where he was from," Knight says. He sought the help of [then] Rep. Newt Gingrich's office to track down the man's country of origin.
Investigators soon learned the man was a Vietnamese refugee who was seeking asylum in the United States but was undocumented. Because of his refugee status, the hospital could not send the patient back to Vietnam. Tracking down his relatives took more than a year, during which he remained at Floyd. Relatives wouldn't take him in, so Knight arranged with a local nursing home to provide long-term care.
Knight worked as a nurse for many years, first as a pediatric LPN and later as an RN. He spent seven years in the Air Force as an operating room scrub tech, but he really found his calling in case management at Western Arizona Regional Medical Center in Bull Head City, which had a large homeless population and a substantial number of immigrants.
"I loved the challenge," says Knight, who also pastored a church for the eight years he was there. "I loved the part where I could go in and talk with the patients, make them feel comfortable about their disease process. A lot of times their fear was fear of the unknown. They didn't know they had a serious medical condition and didn't know what they were going to do. I could go in and develop a plan with them — look at what they had in their home, what their limitations and resources were — and then really look at what resources we have in the community to help them."