With nowhere else to go, he slept in the emergency room

Howard Holten slept in the Integris Southwest Medical Center emergency department the night he left an Oklahoma City rehabilitation hospital frustrated with his discharge plan.

In July, Holten was riding his bike when a car struck him from behind in a hit-and-run accident, fracturing his left hip. Scratches from the accident still dotted his arms weeks later. Holten, 56, has spent much of his life in and out of homelessness. He spent an anxious two weeks at Jim Thorpe Rehabilitation Center, part of the Integris Health system, recovering from major hip surgery and trying to figure out where he’d go after he left the hospital.

“It was so painful,” Holten said. “I had to have someone help me even to stand up.”

The Integris social worker involved in Holten’s case called five shelters, but they were all full or didn’t call back. Plans to stay with a friend fell through. On his scheduled discharge day, Integris sent Holten to a shelter that immediately sent him back to the hospital because he was too unsteady on his feet for the shelter to safely care for him, according to Holten’s medical records.

Oklahoma City has limited resources for people experiencing homelessness after they’ve been medically cleared for discharge from a hospital. Hospital social workers often have few options but to discharge people to the street, typically armed with a bus pass, or to send them to local shelters. Oklahoma City’s four largest hospital systems told The Frontier that they do not have specific procedures for how to discharge homeless patients, apart from general discharge policies that apply to all patients, which are modeled after federal guidelines.

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