Ralph Rust’s decade-long struggle to stay out of the hospital involves some of the factors that cause patients to be readmitted frequently — poor diet, poor literacy and inability to pay for medications. Rust, a Southeast Washington man who is covered by Medicaid, said that for years he was hospitalized as often as three times a month at Howard University Hospital. When Rust was transferred to Washington Hospital Center in 2008 to get his pacemaker replaced with a defibrillator, however, he had a change of heart about changing his habits to stay out of the hospital.

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