Document text
Hospitals penalized for �dumping� patients By JOHN DARLING Medford�s two hospitals � cited by the federal government for their handling of indigent patients in the late 1990s � say their violations were clerical and not the "dumping" made public in a report released Thursday. The federal Health Care Finance Administration cited Providence Medford Medical Center for "screening, transfer and no central log" but levied no fine, according to a report by Public Citizen Health Research Group. HCFA cited Rogue Valley Medical Center for "transfer" and fined it $25,000. Most of the 527 hospitals named in the research project conducted by Public Citizen were cited for breaking a law that guarantees patients the right to be treated at the nearest available hospital. The hospitals were cited for illegally sending patients with emergency conditions to other hospitals in the late 1990s, according to a report from a public interest group. The practice, called "patient dumping," is a way for hospital emergency rooms to get rid of poor patients who have no health insurance. "Screening" and "transfer" refer to the intake process, where staff determines if patients have an emergency condition and whether the hospital can treat that condition or must transfer them to another medical facility, said Linda Hildreth, Providence�s risk management officer. Hospitals ask patients how they intend to pay, but it�s illegal for them to refuse emergency treatment based on a patient�s ability to make good on a bill, she said. Of the 30 Oregon hospitals cited by HCFA, 20 were for "documentation errors," said RVMC community relations director Andrea Jablonski, while 10 were fined for more serious violations. "Public Citizen and the media make it sound like every hospital was dumping. It�s very misleading and it�s absolutely untrue that we were cited for dumping." RVMC was fined for one 1995 case, in which a patient was screened and transferred to Providence in a stable condition, but the documentation was not fully done, said Scott Kelly, RVMC vice president for planning and marketing. "This was absolutely not a dumping case by any stretch of the imagination. We treat about 50,000 emergency cases a year and this was by far the exception, not the rule. We give a full medical screening of every emergency patient regardless of ability to pay and last year did about $2.7 million in charity care." The Providence citation was also for incomplete documentation, said Hildreth. "The rules for internal tracking records are voluminous and either you�re doing it 100 percent or you�re not doing it. To us, it was not dotting every �i� and crossing every �t� � not doing anything to hurt a patient." Both hospitals said they immediately tightened up record-keeping procedures and believe they�re now fully in compliance. In Southern Oregon, Douglas Community Hospital was fined $60,000 for screening and transfer and Roseburg Mercy Medical Center was fined $75,000 for screening. Cited and not fined were Southern Coos General in Bandon for screening and Curry General in Gold Beach for transfer and no central log. All six of the Southern Oregon hospitals are not-for-profit institutions. About 72 percent of the violating hospitals were not-for-profit hospitals, according to the report. About 19 percent were for-profit. The status of 8 percent of the hospitals was not known. Rick Wade, a spokesman for the American Hospital Association, said the report doesn�t indicate a serious problem. "We have a million visits to the (emergency room) every year," Wade said. "We have 5,000 hospitals in this country. The numbers (Public Citizen) is reporting are not significant and do not reveal any sort of trend." In the worst instances, the report concludes that a patient�s insurance status likely influences hospitals� compliance with the law. Wade said that many of the violations do not reflect malice by hospital staffs. "There are all sorts of reasons that a hospital could be cited for breaking the law that do not mean the hospital intentionally turned away a patient," Wade said. "In some cases, the emergency room may misread the seriousness of the illness. This is a human process and there is human error. Hospitals work everyday to reduce the possibility for error." Public Citizen, however, concluded that the federal fines are not big enough to force hospitals that commit the most serious violations to change their ways. The fine amounts generally do not exceed $50,000 per violation. "The sad truth is that it�s cheaper for a hospital to break the law and pay a fine than to treat an uninsured patient," said Dr. Sidney Wolfe, medical director of Public Citizen, which was founded 30 years ago by consumer activist Ralph Nader. "Hospitals know that the risk of getting caught is low, and even if they are caught, the risk of being fined is even lower and the fines are minuscule compared to hospitals� operating budgets." On the Net: www.citizen.org The Associated Press contributed to this report. John Darling is a free-lance writer living in Ashland. E-mail him at [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.