Tim GilmerOne year ago my nephew, Nick, sustained a traumatic brain injury from a freak accident. He began emerging from a coma two months later. Three months following his accident, Nick’s trach tube was removed, and he began standing with help and receiving initial speech and physical therapy. He looked like he was on his way to recovery. But his insurance, a very limited HMO, had no TBI treatment centers in their network. So they sent him to a general rehab facility where people go after they have had knee or hip surgery and other common conditions that require physical therapy.

The first week there, Nick’s brain became infected with meningitis and cerebritis, probably due to a fall from bed a few weeks earlier in the long term acute care facility the HMO had sent him to after being discharged from the acute care hospital. He was the youngest resident among older respiratory residents at the LTAC, many of whom would die there.

The brain infection was devastating, and after three surgeries, he remains bedridden in a nursing home, paralyzed, back on a trach and feeding tube, intermittently conscious. His wife, 22-year-old son, two teenage daught