Perhaps I missed it in the OP, but is this being handled as a prehospital call or an interfacility transfer? Has the urgent care office filled out a COBRA form, and do they have a recieving physician?
If it is considered a prehospital call, and your company does not want you to give a patient a choice of hospitals, then absolutely report your company. But if the sending facility is not giving a patient a choice of hospitals and is treating it as an interfacility transfer, then your company should be off the hook, and the urgent care facility is the one that should get in trouble.
In either case, there is absolutely no reason fro your company to give you grief. But we all know that the people in the office will do that whatever you do.
My company and the urgent cares choose to view these calls as interfacility transfers. However, I don’t believe this to be the correct legal stance.
This is where it gets kinda grey. According to Cobra, urgent cares are not considered an extension of a medical facility. This means that they do not specifically have to contact a MD at the emergency room they are sending to. As we all know this is different than transferring from one hospital to another where both an accepting MD and an actual bed must be accounted for.
The urgent care does fill out transfer paperwork, but they only contact the charge nurse at the emergency room they prefer to send to. The way it seems to work (second hand information, patient telling me) is that a patient walks into the urgent care, is seen by a MD for their complaint, and is then told that the MD believes that they need to go to the ED for further treatment/testing and arrangements have been made. The patient is frequently not given the choice on what hospital they would like to go to.
So, then I enter stage left, walk in, say hello, and say “so I understand you’d like to go to hospital A” and the patient frequently says “not really, do I have to?”
Now, before I would tell the patient that they, in fact, do not have to go to hospital A, and are allowed to go to any hospital they’d like. I’d then talk to the staff at the urgent care about this. This procedure kicked up a whole bunch of waves and resulted in a few not so pleasant sit downs with my management.
So, now all I can do is tell a patient that they need to discuss their destination with the staff at the urgent care. At which point, the nurse or MD walks into the patient’s room, tells the patient that transport is arranged, and the receiving hospital is expecting them. While the staff does not overtly say, “You must go to our hospital”, they do their best to give that impression.
That is the part that really fucking pisses me off. Well, that, the fact that my company lacks the balls to stand up and do something about it, and the idea that they are willing to fire me over this when otherwise I’m a damn good employee. Great to know you’re not only expendable (which we all are), but they have no fear of pulling the trigger if you get in the way of their money.
Yeah, but it’s going to cost them a lot more if Medicare finds out and cuts them off. I don’t know if it is COBRA they are violating, but I’m pretty sure something about this is illegal.