Los Angeles hospitals enact new discharge rules
Hospitals agree to 5-year discharge monitoring
A California hospital that settled a lawsuit claiming that it dumped an indigent, paraplegic patient in downtown Los Angeles' Skid Row in 2006 will be monitored by a former U.S. attorney for up to five years to ensure the hospital won't engage in patient dumping again.
Hollywood (CA) Presbyterian Medical Center earlier this year settled allegations that it left the man, Gabino Olvera, crawling on the ground in a hospital gown and with a colostomy bag, according to a report in the Los Angeles Times. Besides agreeing to be monitored, the hospital settled on paying $1 million that will go to nonprofit groups that assist the homeless in Los Angeles.
Olvera had been brought to the hospital following an automobile accident; he was sent by ambulance to a mission in the Skid Row area. The mission did not have a wheelchair for Olvera nor the facilities to care for him, so they refused to accept him and he was brought back to the hospital, where he sat unattended for 8 hours before once again being driven to skid row and told to get out of the van.
The hospital acknowledged early on that the man was not properly discharged and promised to improve how homeless patients are treated. The case caused some risk managers to reassess their own procedures for discharging the homeless, and the lawsuit ignited fears that what others may perceive as insensitive treatment could result in litigation.
After the lawsuit was filed, Hollywood Presbyterian issued a statement saying that it remained optimistic that a settlement could be reached and that the hospital had taken steps to ensure that such incidents did not happen again. Under the new rules, physicians, nurses, and social workers are required to assess and document homeless patients' mental status and refer them for cognitive and neurological exams when needed.
The resolution of the lawsuit is the biggest settlement so far in the Los Angeles city attorney's campaign to put a stop to patient-dumping on Skid Row.
Los Angeles health care providers are especially sensitive to the issue because providers there have been the subject of several media reports about how the homeless are discharged. These reports include one in April 2006 that showed footage of a homeless woman who had been treated at a Kaiser Permanente facility and then dropped off by taxi at a shelter on Skid Row; from there, she wandered on the sidewalk in a hospital gown and socks. Kaiser Permanente confirmed at that time that staff put a 63-year-old woman into a taxi and had her dropped off.
After the local city attorney filed charges of misdemeanor imprisonment and threatened to pursue the case further, Kaiser Permanente, based in Oakland, CA, agreed to create new protocols for discharging homeless patients. As part of the settlement, Kaiser paid $5,000 in civil penalties, $50,000 in investigative costs to the city attorney's office, and contributed $500,000 to a charitable foundation benefitting local homeless programs.
In July, a law went into effect in Los Angeles making it a misdemeanor to take a patient to a location other than his or her residence without written consent, punishable by a $1,000 fine and up to three years' corporate probation.
A former U.S. attorney for Los Angeles and retired U.S. District Court judge will oversee the hospital chain's compliance for up to five years; the same retired jurist is already overseeing the Kaiser chain under a similar agreement reached with that group last year.
A California hospital that settled a lawsuit claiming that it dumped an indigent, paraplegic patient in downtown Los Angeles' Skid Row in 2006 will be monitored by a former U.S. attorney for up to five years to ensure the hospital won't engage in patient dumping again.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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