January 12, 2018
The practice of so-called “patient dumping” is a national problem that’s hardly new.
Originally it involved private hospitals sending poor patients to public hospitals, but it’s come to mean any hospital that releases someone, usually a homeless and/or mentally ill person, to the streets rather than connecting them with social services.
The University of Maryland Medical Center Midtown is the latest hospital across the country accused of patient dumping. The hospital was thrust into the national spotlight and social media erupted with outrage after a viral video showed security guards leaving a disoriented woman on the street, barely dressed, when the temperature was in the 30s.
The New York Times first began writing about patient dumping in the 1870s when private hospitals were sending patients who couldn’t afford their services to Bellevue Hospital, the city’s public hospital, according to a 2011 report in the American Journal of Public Health.
Traditionally, poor patients in the United States were largely treated by public or charitable hospitals. Private hospitals were under no obligation to admit patients and could refuse service to anyone.
That changed in 1986 when Congress passed the Emergency Medical Treatment & Labor Act, which was signed by President Ronald Reagan. The law prohibited emergency rooms from denying hospital services to anyone even if they can’t pay.
The Joint Commission, which accredits hospitals, also requires that hospitals have a discharge plan. But discharge policies can differ widely by hospital.
The issue drew widespread national attention about a decade ago when the city of Los Angeles began a crackdown on patient dumping after several incidents there, particularly along Skid Row, where many of the city’s homeless people live. The city has imposed millions of dollars in fines on hospitals for the practice.
In one particularly egregious incident, a paraplegic man was found crawling around Skid Row in 2007. Hollywood Presbyterian Medical Center, which was accused of taking him there without a wheelchair, paid $1 million to settle that case.
Good Samaritan Hospital in Los Angeles had to pay $450,000 to settle allegations that it dumped a homeless patient on the street in 2014 after he was treated for a foot injury.
In May 2017, two Howard University police officers and their supervisor were fired after being recorded dumping a patient from a wheelchair outside the university’s hospital in Washington, according to reports in The Washington Post. A video of the incident showed a male officer pushing the barefoot woman to a bus stop. Two other officers watched as she fell onto the sidewalk.
The U.S. Commission on Civil Rights issued a report on the persistent problem in 2014 that found insufficient regulatory oversight as well as a lack of funding to adequately treat the population contributed to patient dumping.
The commission called for reforms to the Emergency Medical Treatment & Labor Act, increased oversight and training, better linking community mental health services to hospitals, and consistent discharge planning.