A Catholic hospital system is suing a number of California sufferers and their advocates as a result of the sufferers allegedly refused to be discharged. The fits invoke a novel authorized strategy: accusing them of trespassing beneath a California legislation supposed to cease anti-abortion protesters from blocking entry to well being services.
Dignity Health has filed three lawsuits in Sacramento County accusing sufferers of “commercial blockade” for refusing to vacate hospital beds despite the fact that the well being care supplier had deemed them medically and legally eligible to both go house or go to a different facility. Dignity alleges the sufferers “unreasonably and unlawfully” refused discharge, disrupting its capability to serve others at a time when well being services have been overwhelmed by COVID-19.
Relatives and advocates say the sufferers have been exercising their proper to be discharged to a facility that provided applicable care and that they may afford, not merely despatched house with out the power to handle themselves.
The lawsuits might set vital precedents for each using the California business blockade statute to go after sufferers and their advocates and, extra broadly, the dealing with of circumstances through which the hospital and affected person can’t agree on a plan for discharge.
The state’s hospital foyer not too long ago highlighted discharge delays as a rising downside costing the business $2.9 billion a yr. The California Hospital Association estimates a minimum of 5,000 sufferers daily expertise such delays, usually in making an attempt to determine expert nursing services.
Patient advocates, who usually cost sufferers a charge to assist them navigate the well being care system, warn {that a} resolution in favor of Dignity might chill their complete career and provides hospitals a brand new avenue to hunt cash from sufferers.
“It could be a watershed case if it goes in either direction,” mentioned Tony Chicotel, senior employees legal professional with the Berkeley-based California Advocates for Nursing Home Reform, who has labored on hospital discharge circumstances. “If it’s a defense verdict, we’ll know our laws are somewhat protective of patients. And if it’s a plaintiff’s verdict, patients around the state could be dumped and us advocates will have to figure out what we can talk about without getting sued.”
San Francisco-based Dignity Health, a tax-exempt group with $9.5 billion in income, was based by nuns to serve the sick and the poor. Spokesperson William Hodges mentioned the well being system doesn’t touch upon pending litigation.
A 68-year-old affected person, Daphne Muehlendorf, who’s blind, started struggling a collection of seizures in 2021 and was out and in of the hospital. Each time she went house, her daughters say, her well being declined, with slurred speech and the shortcoming to hold a cup, regardless of receiving in-home bodily remedy. By the time she entered the acute rehabilitation unit at Dignity’s Mercy General Hospital in Sacramento, she had already utilized for Medi-Cal, the state’s Medicaid program, which covers the price of nursing houses if the affected person demonstrates each monetary and medical want.
Dignity, which has not specified an quantity it seeks in damages, contends in its lawsuit that medical doctors decided Muehlendorf was eligible to go house however the household refused for weeks whereas ready for her Medi-Cal assisted residing waiver to be accredited. Once that got here by, Muehlendorf was transferred to Bruceville Terrace, considered one of Dignity’s expert nursing services in Sacramento.
“I don’t see what the case is and that’s what’s scary for me,” mentioned considered one of Muehlendorf’s two daughters, Terra Khan, about Dignity’s authorized argument. She can also be being sued by Dignity. “I have no idea what’s going to happen. I’m terrified.”
Dennis McPherson, the legal professional representing Dignity, mentioned the hospital made the choice to sue after critical deliberation. Muehlendorf “did cause a significant disruption,” McPherson mentioned. “It took a lot more manpower and our unit was full. There were patients wait-listed who couldn’t get into this unit.”
The household and their affected person advocate, Carol Costa-Smith, who runs the corporate The Light for Seniors in San Diego, mentioned it wasn’t secure for Muehlendorf to return house and accused the hospital of delaying submitting paperwork for Muehlendorf’s Medi-Cal software. State and federal legal guidelines require hospitals to rearrange take care of sufferers who’re prone to undergo hostile well being penalties upon discharge, and sufferers have a proper to enchantment discharge selections.
Likening themselves to tax advisers, impartial advocates with authorized, finance, and insurance coverage backgrounds fill a cottage business serving to sufferers and their households navigate the well being system and long-term care services, which regularly consists of making use of for Medi-Cal.
Costa-Smith, who costs every shopper $2,000 to $3,000 a yr, mentioned Dignity is making an attempt to place affected person advocates out of enterprise so there may be much less pushback towards hospital discharges and different selections. “I’m the pit bull and I’m not going to let them do a home discharge if it’s not safe,” she mentioned.
Dignity’s use of the business blockade legislation seems to be new. California lawmakers handed a invoice in 1994 permitting civil claims towards trespassers at well being services, authored by then-Assembly member Jackie Speier, who not too long ago retired from Congress and is now working for the San Mateo County Board of Supervisors. The legislature’s evaluation of the proposed invoice from that point confirmed it was supposed to dissuade anti-abortion protesters from blocking individuals getting into or exiting well being care services by threatening a lawsuit.
The evaluation mentioned it might additionally cease different disruptive actions comparable to extreme cellphone calls to tie up cellphone strains, using stink bombs to evacuate well being services, and faux fireplace calls that immediate emergency evacuation. It was backed by the American College of Obstetricians and Gynecologists, California NOW, and Planned Parenthood Affiliates of California.
Anti-abortion teams opposed the invoice, arguing “those who impede access in order to save babies should not be treated differently than those who might do so to save animals, or to block access to government buildings or bridges.” Opponents prompt that pro-choice teams might search to take advantage of the invoice for revenue.
Patient advocates are alarmed by the Dignity lawsuits and say they’ve by no means heard of hospitals submitting such claims. Dignity can also be suing Craig Smedley, who operates Estate Advisory Group in Murrieta. According to a June 30, 2021, grievance, Smedley suggested a affected person at Mercy Hospital of Folsom “refusal to accept safe and lawful placement and be discharged” despite the fact that the affected person had been medically eligible for discharge since May 9, 2021.
Dignity contends it misplaced cash as a result of the affected person’s insurance coverage denied cost, and it accuses Smedley of directing the hospital to ship her to a talented nursing facility when medical doctors mentioned she had no want for that stage of care. Dignity has not specified an quantity it seeks in damages. Smedley, who’s defending himself, mentioned disagreeing with a hospital’s discharge plan was hardly a business blockade.
“I’m not chaining myself to the front door to prevent people from passing through to the hospital like an anti-abortion protester,” Smedley mentioned. “I’ve never visited the hospital. I give advice by phone. My clients were the ones communicating with the hospital.”
Chicotel, the legal professional with the nursing house reform group, mentioned he didn’t consider Dignity’s claims have been supported by the legislation. Hospitals, he mentioned, have an obligation to discharge sufferers to a secure facility they’ll afford.
“In my experience, the Catholic hospitals are focused on the bottom line,” Chicotel mentioned. “We see finances become much more important than the spiritual mission. I see that over and over again.”
McPherson argued that the business blockade legislation was written broadly to incorporate any disruption to the traditional features of a well being care facility that renders it quickly or completely unavailable.
“The outcome of the trial will dictate to the client what we’re going to do with respect to the others,” he mentioned. Dignity has filed a third lawsuit, towards Costa-Smith and one other shopper.
As a registered nurse who has labored for numerous hospitals, Khan believes she was doing what any particular person would do in advocating for a beloved one. She mentioned her mom, who as soon as lived independently regardless of her incapacity, wouldn’t have requested for assist if she didn’t really want it. “I know we moved through this honorably,” she mentioned.
Khan is each troubled and comforted realizing that Dignity goes after different sufferers and affected person advocates.
“It makes me feel like, OK, it wasn’t that we did something wrong — there’s something else at play that we’re not privy to.”
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This article was produced by KFF Health News , which publishes California Healthline , an editorially impartial service of the California Health Care Foundation .
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