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Beaming at his toothless female parent, his unique caregiver, Jimenez remains cheerily oblivious that he has come to represent the collision of pair flawed U.S. systems, immigration and health care.

Eight years ago, Jimenez, since 35, an illicit immigrant working as a gardener in Stuart, Fla., suffered devastating injuries in a car crash with a drunken Floridian. A community hospital saved his life, twice, and, after becoming bankrupt to find a restoration center willing to accept some uninsured patient, kept him as a ward for years at a require to be paid of $1.5 million.

What happened next set the stage for a legal battle with nationwide repercussions: Jimenez was deported, not by the federal government but by Martin Memorial Hospital. After captivating a state court order that would later be declared invalid, Martin Memorial leased an air ambulance for $30,000 and “forcibly returned him to his home native land,” as one hospital administrator described it.

Since returning home, Jimenez, who sustained a good for wounds brain injury, has received no medical regard or medication

“Every time, he loses a little more of himself,” said his mother, Petrona Gervacio Gaspar.

Jimenez’s benchmark capsule exposes a little-known but apparently widespread practice. Many U.S. hospitals are repatriating in earnest injured or ill immigrants because they cannot catch nursing homes willing to accept them without security against loss. Medicaid does not cover long-term attention for illegal immigrants, or according to newly arrived legal immigrants, creating a quandary for hospitals, which are obligated by federal precept to marshal post-hospital care during the term of patients who need it.

U.S. immigration authorities play no role in these private repatriations. Most hospital officials said that they answer not conduct cross-border transfers till patients are medically stable and that they arrange to save them into a physician’s care in their homeland.

But the hospitals are operating without governmental assistance or oversight, leaving ample room for legal and ethical transgressions.

Some advocates for immigrants behold these repatriations considered in the state of a kind of international patient dumping.

Hospital administrators view such cases as rich, burdensome patient transfers that force them to shoulder responsibility for the dysfunctional immigration and health-care systems. In many cases, they declared, the only alternative to repatriation is keeping patients indefinitely in acute-care hospitals.

“What that does conducive to us, it puts a strain on our system, where we’re unable to make ready adequate be anxious for our own citizens,” said Alan Kelly, vice president of Scottsdale Healthcare in Arizona.