Most Hospitals Not Punished for Ousting Patients Who Can’t Pay

The federal government has taken punitive action against just four of 33 California hospitals it cited for illegally transferring or refusing to care for medically unstable poor patients since 1986, a consumer group reported Wednesday.

Nationwide, punishment was meted out to 24 of 268 hospitals cited for the practice, known as patient dumping, in which patients who are uninsured or unable to pay are denied treatment, the group reported. The study was prepared by the Public Citizen Health Research Group, using statistics from the Health and Human Services Department.

The group used the report to call for tougher federal reporting regulations and enforcement, saying that many violations each year go unreported.

“There is the horrible specter of the dumping of thousands of patients per year in medically unstable condition from hospital emergency rooms,” said Dr. Sidney Wolfe, director and co-founder of the group. “For many of these patients, dumping means death.”

In response to an increasing number of incidents, a 1986 law made it illegal for hospitals to turn away or transfer people in medically unstable conditions. Hospitals violating the law can be fined or prohibited from treating Medicare-insured patients, for which the government provides reimbursement.

But only 9% of hospitals cited by the Health Care Financing Administration of HHS were punished.

“The government is basically telling the hospitals that over 90% of the time, if we catch you, you’re not going to be fined,” Wolfe said.

But Anthony Tirone, director of surveys and certification for the health finance agency, defended the government’s practices, explaining that hospitals are punished only in instances of extreme or uncorrected violations.

“The act requires us to make sure the dumping doesn’t happen again,” Tirone said. “We treat almost all incidents as immediate, serious threats and give hospitals 23 days to correct the problem or be terminated from the Medicare program.

“In almost all cases, hospitals do correct the problem, which is the real goal of our enforcement,” Tirone said.

According to the group, 13 hospitals cited in the Los Angeles area for violations include Alhambra County, Burbank Community, East L.A. Doctors, Fountain Valley, Glendale Memorial, Hawthorne, Palmdale General, Presbyterian Intercommunity in Whittier, Sherman Oaks, St. John’s in Santa Monica, Terrace Plaza in Baldwin Park, Valley Presbyterian in Van Nuys, and Whittier.

None of the hospitals suffered punitive action.