Cedars-Sinai Medical Center in Los Angeles, the fabled "hospital to the stars," has agreed to pay $40,000 to settle federal charges of patient "dumping."
Cedars-Sinai was just one of four big-name California hospitals to recently settle similar charges with HHS' inspector general's office.
In the latest round of dumping cases, Cedars-Sinai was joined by Santa Monica-UCLA Medical Center and two Kaiser Foundation hospitals in paying settlements.
None of the hospitals admitted to violating federal law. MODERN HEALTHCARE obtained a copy of the settlements last week under the federal Freedom of Information Act. They were signed in December 1998 and January.
Through the third quarter of federal fiscal 1998-the most recent available figures-HHS' inspector general's office settled 42 cases of alleged patient dumping by hospitals. Total settlements topped $1.2 million.
The 1986 dumping law bars hospitals from transferring or refusing to treat medically unstable emergency patients or women in labor for economic reasons. It requires hospitals to perform a basic medical screening of all emergency patients.
According to HHS records, here is what transpired in the Cedars-Sinai case: On Oct. 8, 1997, an 82-year-old man arrived by ambulance at another, unnamed Los Angeles hospital with swelling in the brain. He required the attention of a neurosurgeon. That hospital didn't have a neurosurgeon, so it called Cedars-Sinai, which had one on call. But Cedars-Sinai's emergency room physician didn't call the neurosurgeon, and when the patient showed up, he was refused treatment.
HHS cited Cedars-Sinai for refusing an appropriate transfer when it had the capacity for treating the patient.
The $40,000 fine is a drop in the bucket for 762-bed Cedars-Sinai, which turned a $32.6 million profit on total revenues of $831.8 million in the fiscal year ended June 30, 1998.
Perhaps a greater public relations penalty for the prestigious hospital is the requirement that it run two ads in the Los Angeles Times saying the hospital accepts all Medicare and Medicaid patients and treats all emergency patients regardless of ability to pay. That's a typical condition of such settlements.
Grace Chang, Cedars-Sinai vice president of marketing and public relations, said the hospital weighs a variety of factors when it agrees to settle a case. Citing a purported confidentiality agreement in the settlement, Chang said she could not comment on the dumping charges. The settlement agreement, however, does not appear to include a confidentiality clause.
Santa Monica-UCLA was cited when it failed to provide medical screenings to five patients who arrived at the hospital's emergency room in August and October 1996. The 271-bed hospital paid a $55,000 fine.
Meanwhile, Kaiser Foundation Hospital and Rehabilitation Center in Vallejo, Calif., paid $22,000 to resolve its patient dumping incident, which HHS said occurred in 1997. The case involved a 26-year-old pregnant woman who came to the 219-bed hospital's emergency department and was sent to another hospital.
Kaiser Foundation Hospital in Santa Clara, Calif., paid $25,000 for an alleged dumping incident, also in 1997. That case involved a 33-year-old woman who arrived by ambulance and was transported to another hospital for care.