This story (and (this one and this blog entry ) about a homeless woman that a Kaiser Permanente hospital “dumped” at a homeless shelter on Skid Row in LA by a taxi paid for by Kaiser.
Why is this illegal? Emergency rooms are highly specialized to provide acute services to people who are dying right now. It is a huge waste of resources to force hospitals (especially ERs) to provide room and board to the homeless?
Do we feel so guilty about these poor homeless people that we are going to bring criminal charges against hospitals that discharge them when they have no acute need?
I remember working in Detroit hospitals it was a real problem getting some patients out. If they had no relatives willing to take them, you had to get them into “the system”; medicaid nursing home beds, rehab, or something. It can be really hard to find an entity willing to take on an ill, addicted or mentally affected patient, especially a homeless one that wants to go back to their regular routine.
It’s one thing to “discharge” a patient. But, all of the linked stories, involve removing the patient to a different location, and leaving them abandoned. Why can’t they “dump” them at another facility?
Hospitals shouldn’t be required to care for everybody that wanders in without a medical need. But, they also should not be allowed to endanger the lives of those they consider unworthy of their care.
Trouble is, there’s a conflict in there, forcing someone (a doctor, hopefully) to make a determination at some point of who should be at the hospital and who should not. Do you want every decision subject to review? By whom and with what possible penalty?
What’s more, if I’m not mistaken, in several of these cases patients were dumped there even when they didn’t want to be taken there.
In which case the hospital should have, for instance, let them walk out on their own or arranged transportation by relatives rather than dumping them in a strange unfamiliar and possibly dangerous place without their consent.
I think the “dumping” is perfectly acceptable, as long as they transport the patient to another facility or shelter. Not by leaving them in a parking lot, or Skid Row.
Of course, lots of patients come from the street, have no relatives or friends in the area, have been banned from the shelters, don’t want to go to a shelter, and are better off being treated to a cab ride down to where homeless services are available rather than walking out the front door. When you are holding icu pt on ventilators in the ER, you have to move people along. If you establish a minimum level of care to send everyone to, you’ll have lots of homeless heading to the hosp, and refusing to leave without a “home” to go to. Of course I have no knowledge of the specific case cited.