A Las Vegas news crew captured footage of a for-profit hospital, Valley Hospital Medical Center, refusing to treat an elderly patient who couldn’t afford payment—a process Las Vegas elected officials dubbed as “patient dumping.” Rather than assist this woman inside, security officers took her across the street, as she struggled to use her walker, and left her on the sidewalk like a UPS delivery at University Medical Center (UMC).
On the same day that the aforementioned elderly woman was left on the UMC sidewalk, she was taken in there for evaluation and care. During an interview with a local news affiliate, William McCurdy II, UMC Board of Trustees chairman, noted that he had heard rumors of patient dumping within his community. Outraged by this kind of unlawful mistreatment, McCurdy vowed to report the alleged violation to the Nevada State Department of Health and Human Services, as well as to the Joint Commission.
Sadly, this infraction is not an isolated incident within the United States. According to Kentucky Health News, patient-dumping lawsuits resulted in a loss of $2.4 million each for two Kentucky hospitals. Additional incidents have occurred in other states throughout the country.
Legislative Barriers Are in Place to Curb Patient Dumping
Thankfully, there are legislative barriers aimed to curb patient dumping. In 1986, the US enacted the Emergency Medical Treatment and Labor Act (EMTALA)—a law designed to protect access to emergency care for all patients, regardless of whether they could afford it. According to the Centers for Medicaid and Medicare Services (CMS), hospitals have a legal obligation to stabilize any patient who shows signs of an emergency medical condition. Should the hospital be ill-equipped to do so, they are required to transfer the patient to another facility.
Physicians can play a significant role in preventing patient dumping. For starters, they should gain an understanding of section 482.42 from the Code of Federal Regulations, which codifies specific mandates for hospital discharges. For example, hospitals must identify patients who are at risk for health problems following discharge without adequate discharge planning, and as such, must have a discharge plan in place for these patients. Other mandates include documenting discharge planning, reviewing plans with either patients or their proxies, and aiding patients or their proxies in selecting post-acute care clinicians.
Jennifer Mensik Kennedy PhD, RN, NEA-BC, FAAN, president of the American Nurses Association, offers additional guidance for physicians looking to understand the legalities surrounding patient discharge. Some of her suggestions include speaking out if discharge plans feel “off,” requesting social worker consults for patients, carefully documenting physician guidance on each individual patient’s discharge plan, holding patient care conferences to firm up discharge plans, and having working knowledge of any charitable care options offered by the hospital. If physicians take the above measures, they can play a huge role in the effort to curb patient dumping.
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