Hospitals dumping patients who can't pay on the street

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kitkat22

Golden Member
Feb 10, 2005
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Oh, I can also add we have JHACO visits about twice a year. They review buildings, protocols, charts and patient care. These guys are incredibly thorough. They can also stop you mid-hallway and ask protocol questions on the spot which is graded for or against the hospital.

I have to do peer to peer discussions with insurance companies regularly. Usually once or twice a week. I fight for my patients.

We give up profits for "charity" care all the time. Me
 

kitkat22

Golden Member
Feb 10, 2005
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There is the world the way it should be.


and then there is reality:
Nationwide:

San Diego:

Las Vegas:

Kansas:

Baltimore:
Again, discharging a patient to the street, if they were homeless is not a crime. Not everyone has a home and it is not our job to house a stable patient. We already have to fight for the beds we have in hospital. When you have 30-40 patients in the ER waiting on an inpatient bed, stable patients get discharged once the medical need is complete.

People who were homeless before and are capacitated are discharged to their prior living arrangements. Again, we are not hotels or homeless shelters.
 

kitkat22

Golden Member
Feb 10, 2005
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So let me state this, if these patients are being dumped without appropriate care, isn't that a malpractice suit waiting to happen? Just one bad outcome as a consequence of "dumping" and the hospital is on the hook for millions.
 
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Jaskalas

Lifer
Jun 23, 2004
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The US is not a shithole. The problem is that a great many people in the US are shitheads who hate their fellow Americans and do everything they can to fuck over their fellow Americans.
We call these shitheads conservatives.
Half the time they are holding power.
The other half they are blocking nearly all improvements and or policy implementations.
If one cannot separate US governance from the shitheads, then..... what follows is as I lamented.
 
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Jaskalas

Lifer
Jun 23, 2004
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So move to another one. Canada and Mexico are close by, and at least one of them has nationalized health care.
Roots are here. Got no connections nor any means to move to another country.
If anything, those who spit in the face of us lamenting such treatment of our vulnerable, our poor, and our unhealthy.... those folks will feel the consequences of extreme mismanagement. Trump spoke of 2nd amendment solutions to these issues. You wouldn't favor that.... you wouldn't vote for... and act to cause that, would you?
 

SteveGrabowski

Diamond Member
Oct 20, 2014
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Oh, I can also add we have JHACO visits about twice a year. They review buildings, protocols, charts and patient care. These guys are incredibly thorough. They can also stop you mid-hallway and ask protocol questions on the spot which is graded for or against the hospital.

I have to do peer to peer discussions with insurance companies regularly. Usually once or twice a week. I fight for my patients.

We give up profits for "charity" care all the time. Me
So you're in hospital administration? Do you also put a page about not committing suicide over medical debt at the end when you send a person a ruinous bill?
 

SteveGrabowski

Diamond Member
Oct 20, 2014
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So let me state this, if these patients are being dumped without appropriate care, isn't that a malpractice suit waiting to happen? Just one bad outcome as a consequence of "dumping" and the hospital is on the hook for millions.
I'm sure that lady breathing hard on the ground in the soiled hospital gown with the blanket over her head can bankroll a multiyear lawsuit against the hospital.
 
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Leeea

Diamond Member
Apr 3, 2020
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Again, discharging a patient to the street, if they were homeless is not a crime. Not everyone has a home and it is not our job to house a stable patient. We already have to fight for the beds we have in hospital. When you have 30-40 patients in the ER waiting on an inpatient bed, stable patients get discharged once the medical need is complete.

People who were homeless before and are capacitated are discharged to their prior living arrangements. Again, we are not hotels or homeless shelters.
San Diego was dumping homeless as you say.

Las Vegas was rejecting patients who couldn't pay.

Kansas was dumping people out of nursing homes.

Baltimore appears to be a case of homeless dumping again, this time with a just a hospital gown on a cold night.



you are correct, it is simply not possible for hospitals to deal with this social problem.


but lets be honest with ourselves. When a person hits rock bottom in the US, they getting dumped out in the street in a hospital gown, out of their mind, and left to freeze to death. And the Jane Doe isn't going to sue, because nobody cares.
 

kitkat22

Golden Member
Feb 10, 2005
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I'm not in hospital admin but work with them regularly including our chief medical officer, case managers, etc. Our hospital admin is literally down the hallway from our office. I work with them regularly. Maybe I'm naive. I worked in non-profit hospital systems and from my practice, I get paid regardless of anyone's ability to pay. As a consequence, I am privileged to provide the best care I know regardless of insurance or not. Sure, I have to justify my care, I have to do that anyway. Our system has spent millions in charity care a year. Can I speak to all hospital systems? No, I cannot. To be honest, I've worked for contracting group which was for-profit for a few years and vowed never to do that again.

My personal care is expensive. My medication, Benefix, literally costs $1000000 a year. I have to give myself an IV injection every 3 days. Add in the frequent hospitalizations for joint bleeding and pain control and I am considered a high utilizer. It would not take long for a hospital to boot me out if I couldn't pay. I already know I will never qualify to going to a rehab center. My meds are too expensive. I have to go to specialized centers because most hospitals don't carry my drug or its equivalent. Its too expensive. It sucks when I go out of town because an out of network bill could easily be >$15000. I blow through my $6000 deductible every year within the first 2 weeks of the year. I can't have long-term care insurance or most disability insurances because I don't qualify. I'm also a transgender intersex woman. I've literally had to relearn to walk about once every 2-3 years of my life. My life is literally fragile, but I keep going.

I don't like our healthcare insurance setup in this country. I think everyone should have access to healthcare regardless of their ability to pay and I practice that way. Believe me, there are some patients in the past I would love to discharge, but I still make sure they're well taken care of. These are the patients who have physically assaulted my staff and those who have sexually harassed me.

When a patient comes in without insurance, we try to set them up. If they can't, it's a simple application for charity care. We've taken care of people for months in the hospital knowing we wouldn't be reimbursed.

In answer to the other question, if there was a bad outcome as a consequence of being booted out of a hospital then the answer is "yes" they are very much liable for that outcome. I have to sign a discharge summary stating what happened and why in the hospital. I also have to state a clear directive of a safe and appropriate disposition. I sign my name dozens of times a day. I'm not sure what happens in all hospitals, but I will not work for one that doesn't care for patients appropriately.

BTW, that Baltimore case:
https://oig.hhs.gov/fraud/enforceme...es-case-involving-patient-dumping-allegation/ was an EMTALA violation. The HHS fine was small, but it would not surprise me if there was another settlement with the patient/patient's family
 
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FelixDeCat

Lifer
Aug 4, 2000
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Some homeless people go to the hospital and refuse to leave. My brother was in one not too long ago and there were people everywhere being dumped there by police to get them off the street. They would be given treatment for as long as medically necessary and asked to leave like any other patient.

However homeless people have nowhere to go, like the free room, free food and being waited on by nursing staff. Many have mental problems and just take prozac all day or act up. But eventually the police escort them off the premises.

Its a hospital, not a hotel.
 

kitkat22

Golden Member
Feb 10, 2005
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Also, that small fine isn't even the biggest threat HHS can make. Not allowing to see Medicare patients is a deathblow to any hospital.

Nursing homes and rehab centers are run by different rules.
 

MrSquished

Lifer
Jan 14, 2013
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I think we should start treating Republicans like homeless people in hospitals. Just fucking kick them out and dump them somewhere.
 

Muse

Lifer
Jul 11, 2001
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Often hospitals will have guidelines where they'll reduce the billing based on income, sometimes based on percentage of the federal poverty line. Requires contacting patient financial services or whatever the equivalent is to get the paperwork going.

But yes, our current healthcare system is kind of a ghastly nightmare for people who aren't well-off (and can grind people who are well-off down to being poor)
Saw video of a woman who was a successful a lawyer, fell on hard times and reduced to homelessness by virtue of suffering a physical condition she could not have anticipated. Really heartbreaking what can happen to the great majority of Americans if they are unlucky. And yes, that includes the great majority of us here.
 
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cytg111

Lifer
Mar 17, 2008
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I looked. Its not simple.

Stepping stone: Denmark or Sweden. :). I mean if it's absolutely have to be Norway. Much like the rest of the developed world we're looking at some level of population collapse and any import of knowledgeable workforce is wanted, put western culture on top of that, and I imagine you have a free ticket.