The University of Maryland Medical Center in Baltimore made the national spotlight in 2018 when a terrible video made the rounds on social media. The video showed hospital personnel dropping a homeless female patient at a bus stop in 30-degree weather, wearing nothing but a thin hospital gown and socks. The hospital was under federal investigation over the event, made a formal apology, and ultimately reached a financial settlement with U.S. Department of Health and Human Services Office of Inspector General.
The University of Maryland Medical Center was found guilty of a vile practice called “patient dumping.”
What Is Patient Dumping?
Patient dumping refers to the unethical or unsafe discharge or transfer of patients, particularly the poor and disadvantaged, who are under the care of medical facilities or personnel. It is also called involuntary discharge, and it happens at hospitals and nursing homes. The term has been around since the mid-to-late 1800s, when sickly patients were dumped by horse-drawn ambulances at the doors of any public hospital who could help them. The sad practice continues today in various forms.
Since 1986, hospitals have had a legal duty to care for the emergency needs of anyone who enters the facility, regardless of their ability to pay. American healthcare is the most expensive in the world, and our for-profit hospitals have significant financial reasons to clear hospital beds as soon as possible, once the patient’s health is stabilized. The dilemma for these hospitals is what to do with the poor or homeless when they are stable but not healthy enough to exit on their own or do not have anywhere to go to finish their recovery. All too frequently the less fortunate are dumped to public health centers, homeless shelters, or on the streets.
Sending these patients out of the hospital before they are ready is a form of medical malpractice it can result in injury or death.
In a study of 215,028 emergency department visits at 160 hospitals, patients who were uninsured or poor (qualifying for Medicaid) were “more likely to be transferred to another hospital than privately insured patients. Uninsured patients also were “markedly” more likely to be discharged from the emergency department.”
Patient Dumping at Nursing Homes Is Even Worse
Unlike hospitals, nursing homes are designed and intended for long-term care, and they’re funded by the government to cover the cost of those who cannot afford it. That would seem to remove the need for patient dumping. Unfortunately, nursing homes regularly engage in the practice due to pure corporate greed.
In the United States, the majority of nursing homes are funded by the Centers for Medicare and Medicaid Services (CMS). For people who qualify, the CMS pays for the long-term care for the elderly who do not have the means to pay for it out-of-pocket. Medicaid is the entity that pays for those long-term care needs. It is perhaps lesser known that nursing homes also care for people who are recovering or rehabbing from serious injuries. Unlike the typical nursing home resident, they are often younger and are transferred from hospitals to the nursing home on a temporary basis, so they can get the care they need until they are ready to go home.
Whereas Medicaid funds the long-term residents of nursing homes, Medicare covers the cost of these shorter-term rehabilitation and recovery patients. In many situations, the short-term Medicare patient brings in more money than the nursing home gets for the long-term residents from Medicaid. In California, the CAHF reports “that the average Medicaid (known in the state as Medi-Cal) reimbursement rate for a nursing home is about $220 per day, whereas the Medicare reimbursement rate may be as high as $1,000 or more per day.”
This has created a financial incentive for nursing homes to dump less profitable long-term residents for more lucrative rehab patients on Medicare. In some cases, the nursing home facility will take advantage of elderly residents, including those with dementia symptoms, to trick them into signing themselves out of the facility when they do not understand what they are agreeing to. In the Yale study, researchers concluded that their findings “confirm the belief that financial incentives, or a patient’s ability to pay, may be associated with hospitalization decisions.”
Patient Dumping Is Against the Law
Medical facilities must follow specific legal guidelines when discharging or transferring a patient in their care. If you believe that your loved one experienced a serious injury or even death to the practice of patient dumping or some other form of medical malpractice or nursing home negligence, you should seek the advice of legal counsel. For a no-cost, no-obligation consultation, please call Brown & Barron at (410) 698-1717 or contact us online by clicking here.