Jesse Bravo, a schizophrenic patient, had been in treatment for two weeks at White Memorial Medical Center when hospital workers dumped the 49-year-old husband and father at a homeless shelter on Feb. 11, 2011, according to reports.
No one knew of his whereabouts - his wife Laura searched for her husband for days before identifying him on Valentine's Day in 2011. He wandered the area for two nights until police picked him up climbing into a van that resembled his wife's.
Hospital workers had tied Jesse Bravo's hands together with plastic restraints, put him in a van, and left him in front of a homeless shelter with no warm clothing, money, identification or medication, according to her complaint about the incident.
Mr. Bravo was drugged and then dumped by a hospital that did not want to care for him, Patrick Dunlevy, director of Public Counsel's consumer law project, which is representing Bravo, told NBC. In their rush to push Mr. Bravo out the door, the hospital staff missed all the stop signs that should have protected him.
Jesse Bravo filed suit against White Memorial Medical Center on Feb. 3.
Patient dumping - hospitals' refusal to treat emergency patients - cost hospitals over half a million dollars in fines in 2011, despite being outlawed 25 years ago.
In 2002, the earliest year data is available for, U.S. hospitals spent $625,500 settling patient dumping cases, according to the U.S. Department of Health & Human Services, which administers the penalties. Since then, the number of cases has decreased steadily until 2011. The money spent settling the cases has fluctuated, however, from $515,000 in 2004, to $625,000 in 2006 to $535,000 in 2011.
Patient dumping became illegal after Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986. Despite that, hospitals in the United States spend hundreds of thousands of dollars settling patient dumping cases every year.
EMTALA requires any hospital that accepts payment from the Department of Health and Human Services, which is virtually all hospitals in the country, to provide emergency healthcare to anyone who requires it, regardless of their citizenship, legal status or ability to pay. Neglecting to do so may subject the hospital to fines.
Under EMTALA, hospitals must provide screening to determine if a prospective patient has an emergency medical condition, and cannot delay this to inquire about an ability to pay or citizenship status. They must treat an emergency medical condition until the patient is stable and able to care for themselves, or until they can be transferred to a long-term care facility. If hospitals fail to adhere to these standards, they can be penalized by the U.S. Department of Health & Human Services.
In 2002, the earliest year data is available for, U.S. hospitals spent $625,500 settling patient dumping cases, according to the U.S. Department of Health & Human Services. Since then, the number of cases has decreased steadily until 2011. The money spent settling the cases has fluctuated, however, from $515,000 in 2004, to $625,000 in 2006 to $535,000 in 2011.
The Office of the Inspector General has a civil monetary penalty under EMTALA that allows us to fine these hospitals when necessary, Don White, spokesman for the Department of Homeland Security Office of the Inspector General said. They are also required to file corrective actions. The idea is to change the behavior of the hospitals without putting an undue burden on them.
White went on to say that hospitals take EMTALA violations very seriously, and said that once confronted, very rarely are hospitals cited again for the same violations. It's very unusual to see an EMTALA violation for the same problem, White said. However there have been hospitals that have been closed down due to EMTALA violations.
One of those hospitals is the Martin Luther King, Jr. Multi-Service Ambulatory Care Center in Los Angeles. In June 2007, the U.S. Centers for Medicare and Medicaid Services found the hospital to be in violation of EMTALA after a man with a brain tumor waited four days in the hospital's emergency room instead of being transferred to another hospital, according to The Los Angeles Times. This was the fourth time in three years the hospital was cited for EMTALA violations. The hospital closed in August of that year.
While EMTALA has been applauded for providing emergency healthcare to those who otherwise could not afford it, others have chastised it for pushing the cost onto others.
They say we have the greatest health care in the world, Sen. Barbara Boxer (D-Calif.), told Rachel Maddow in 2009. Well, the fact is, we pay twice as much and our outcomes aren't as good. We have 48 million people with no health care. As a result, they walk into emergency rooms. It's costing every American who is insured $1,100 to pick up the cost of uncompensated care that goes on at the emergency room.
Fifty-five percent of emergency healthcare goes uncompensated, according to the Centers for Medicare and Medicaid Services, and that forces hospitals to push the cost onto those who can pay. In California, it has been estimated that cost shifting costs every family $1,186 per year, according to PolitiFact.
White Memorial Medical Center denies Jesse Bravo's allegation. We investigated this matter and determined that we followed all policies and procedures appropriately, spokeswoman Alicia Gonzalez told The Los Angeles Times. We don't believe this was patient-dumping. It was a patient drop-off.
Jesse Bravo's lawyers, however, do not believe that. White Memorial has set a new low for hospital dumping, Hernan D. Vera, president and chief executive of Public Counsel told The Los Angeles Times. They took someone who was not homeless and made him a homeless man.