More patient dumping alleged in Los Angeles area

Modern Healthcare

A new accusation of patient dumping by a Kaiser Permanente hospital in the Los Angeles area could put the integrated provider at risk of new penalties for violating a landmark settlement reached over a highly publicized incident, according to the city attorney’s office.

The accusation is one of 10 alleged incidents of patient dumping by Los Angeles hospitals being pursued by the city attorney’s office. In the past year and a half, the office has received about 70 reports of homeless patient dumping. On June 26, the city filed civil action against two other area hospitals-410-bed Hollywood Presbyterian Medical Center in Los Angeles and 334-bed Methodist Hospital of Southern California in Arcadia-in four other patient dumping incidents.

Patient advocates said it’s unclear whether the issue is isolated to the Los Angeles area or is part of a nationwide problem because there’s no central authority tracking anecdotal incidents. “Given the pressures we’re dealing with in the health care system, this is the kind of practice you’d expect to see everywhere,” said Jerry Flanagan, a patient advocate with the Foundation for Taxpayer and Consumer Rights in Santa Monica, Calif. “But its hard to monitor.”

Kaiser officials say they followed court-ordered protocols put in place in May as part of a settlement with the city over a former patient who was videotaped wandering a street in a hospital gown after being dropped off by a taxi near a homeless shelter.

The new allegation involves Jose Gonzalez, a 26-year-old day laborer who sustained a back injury in May. He was treated at 172-bed Kaiser Permanente Baldwin Park (Calif.) Medical Center for several days and then released.

Because of the injury, Gonzalez could no longer work and so soon became homeless, said Celeste Durant, spokeswoman for the American Civil Liberties Union of Southern California, which is representing Gonzalez. He then attempted to go back to work and reinjured his back, Durant said.

He was rushed to Kaiser‘s Baldwin Park hospital and received treatment there for two weeks in June. Baldwin Park released him on June 30 and, because he was now homeless, delivered him by taxi to New Image Shelter near downtown Los Angeles. Gonzalez required a walker so he was denied a bed at the shelter, which only takes able-bodied clients. The taxi driver called hospital officials, who instructed the driver to take Gonzalez to Union Rescue Mission, a shelter bordering Los Angeles’ Skid Row, Durant said.
Union Rescue Mission officials called the city attorney’s office on July 2 to report the incident, according to Cindy Shin, spokeswoman for Los Angeles City Attorney Rocky Delgadillo. “We were troubled by the fact that they cut off his treatment,” Shin said.

Jim Anderson, a Kaiser spokes-man, said the hospital had arranged for Gonzalez to go to Project Achieve, a homeless shelter that transitions people to permanent housing. But his physicians released him on a Saturday so he was taken to a shelter for several days until Project Achieve opened on Monday, Anderson said. “We made an interim arrangement,” he said. “He signed the discharge forms and forms on the homeless shelters. He was alert and with it when he signed them.”

Gonzalez, who had never been to either shelter or to Skid Row, contends the hospital told him he would be going to a rehabilitation facility for further treatment, not a homeless shelter, Durant said. Gonzalez is now being treated at another hospital and will require ongoing physical therapy for sciatica and an injured disc, she added.

Anderson said Kaiser did everything right under new protocols on releasing homeless patients. The court-ordered protocols require all Los Angeles County Kaiser hospitals to assess and document homeless patients’ mental status. If the patient’s understanding of the discharge is in question, the discharge will be delayed. The settlement also requires medical staff training and special record-keeping on the homeless. Retired U.S. Senior District Judge Lourdes Baird was appointed to monitor Kaiser‘s compliance with the court order.

Kaiser paid $50,000 in investigative costs to the city attorney’s office and a $5,000 fine for patient dumping. It contributed $500,000 to a charitable foundation as part of the settlement.

Kaiser is cooperating with the new probe and could face undetermined fines and other penalties if found to be out of compliance with the court-ordered settlement, Shin said. “We’ll be working with the city attorney’s office to address any questions they have,” Anderson said.