Hospitals in Southern California are considering taking legal action to block a Los Angeles ordinance on discharging patients on grounds that it could jeopardize millions in CMS funding.
Signed by Los Angeles Mayor Antonio Villaraigosa late last month, the city ordinance prohibits hospitals from transporting discharged patients or arranging their transport to a location other than the patients residence without written consent. Violating the ordinance is a misdemeanor offense subject to fines up to $1,000 and probation of up to three years.
The aim is to stop the practice of patient dumpingdropping off discharged homeless patients on Los Angeles Skid Row without ensuring follow-up care.
While the ordinances penalties are minimal, CMS inspector generals office must suspend funding for no less than five years to hospitals convicted of misdemeanor crimes, according to the Hospital Association of Southern California. If a hospital is in violation of the ordinance, it could possibly lose half or more of its total revenue. Our attorneys are pursuing the matter to get clarification, said the associations Executive Vice President James Lott.
A spokesman for the CMS said the agency had no comment.
Frank Mateljan, spokesman for Los Angeles City Attorney Rocky Delgadillo, called the hospitals argument specious and said that the CMS mandatory exclusions dont apply to local ordinances. He added that the decree doesnt conflict with state licensing authority, another argument made by the hospital association.
The association may seek a court injunction against the ordinance, which will take effect in mid-July, or wait to contest it until a hospital is found to be in violation, Lott said.
Delgadillo has pursued patient dumping aggressively. On June 2, 321-bed Hollywood Presbyterian Medical Center, Los Angeles, settled with the city over two incidents, agreeing to pay a total of $1 million to two Skid Row agencies to fund services for the indigent.
It also will pay the city $10,000 in civil penalties and $50,000 in investigative fees. The hospital has implemented new protocols on homeless patient care, and former U.S. Attorney and retired U.S. District Judge Lourdes Baird will oversee compliance. Delgadillo reached a similar agreement last year with Kaiser Foundation Hospitals, a 28-facility system in Oakland, and other patient-dumping investigations are ongoing.
While Hollywood Presbyterian expects to be in full compliance with the ordinance, officials worry about the CMS funding issue, with 60% of the facilitys patients on Medicaid. We serve an area of Los Angeles county, said Ron Lahner, general counsel for Hollywood Presbyterian, where we have a lot of through-put of homeless in our ER.