From: drarwingnuttephd@gmail.com   
      
   Civil Rights Panel Probes "Patient Dumping" by Hospitals   
      
      
   HOSPITAL FORCES MENTALLY ILL MAN ON A GREYHOUND BUS IN "PATIENT DUMPING"   
   SCANDAL   
      
   Matthew Keys | March 17, 2014 | Health | No Comments   
   James Flavy Coy Brown has become the national face of a shady yet little-known   
   practice at many hospitals in the United States. But Brown never wanted to   
   become the symbol of a cause -- he just wanted someone to help him.   
      
   The former South Carolina resident has suffered from depression, anxiety,   
   schizophrenia and other mental disabilities since 2006 when he was badly   
   injured in a car accident. For years, he received treatment in his home state   
   until cuts to mental health    
   funding prompted his doctors to suggest he look elsewhere.   
      
   Go west, they told him. That was his best prospect for getting help.   
      
   Acting on their advice, Brown chose Nevada, where he received treatment at a   
   group home called Annie's Place in Las Vegas. When the facility shut down, he   
   and four other patients were sent to Rawson-Neal Psychiatric Hospital, an   
   inpatient medical    
   facility run by the Southern Nevada Adult Mental Health Services.   
      
   Brown says he received treatment at Rawson-Neal for three days before a doctor   
   decided he was well enough to be discharged. The doctor asked Brown a question   
   he wasn't expecting: where do you want to go?   
      
   Brown told the doctor he didn't want to leave Nevada, but the doctor was   
   insistent. "California sounds like a really nice state," the doctor said,   
   according to Brown. "I think you'll be happy there."   
      
   The hospital gave Brown three days worth of medication, four bottles of   
   Ensure, a handful of crackers and a Greyhound bus ticket. Staff members   
   instructed Brown to call 911 for help once he reached his final destination   
   and wished him well.   
      
   Fifteen hours and 600 miles later, he and five other patients arrived in   
   Sacramento. For Brown, Northern California was like an alien planet -- he   
   didn't know where he was, and he had no connections in the city. Worse, he had   
   no money and no    
   identification -- just hospital paperwork that listed his discharge address as   
   "Greyhound Bus Station to California." He was left to aimlessly wander the   
   streets.   
      
   --   
      
   Hospitals call it "bus therapy," but the federal government has another term   
   for it: patient dumping, a practice where medical centers turn away or   
   discharge patients who cannot afford services.   
      
   Patient dumping was made illegal in the late 1980s under the Emergency Medical   
   Treatment and Active Labor Act (EMTALA), which states that any hospital that   
   receives Medicare funding cannot turn away an individual who seeks medical   
   care, regardless of    
   their ability to pay. Under the act, hospitals also cannot discharge a patient   
   without their consent, but they are allowed to transfer a patient to another   
   facility that can better accommodate them.   
      
   Almost all hospitals in the United States receive some form of Medicare   
   funding, including Rawson-Neal, the hospital that discharged Brown. But for   
   years, hospitals have routinely made "patient dumping" a part of their   
   practice with very little    
   consequence.   
      
   According to data reviewed by TheBlot, 12 hospitals -- mostly in the south and   
   midwest -- settled with federal medical regulators last year over "patient   
   dumping." The settlements ranged anywhere from $20,000 to $50,000 -- a drop in   
   the bucket for an    
   industry that charges up to $300 for four boxes of gauze (retail price: $3).   
   As part of the settlement, none of the hospitals had to admit any kind of   
   wrongdoing.   
      
   "Patient dumping" settlements reached in 2013 between the U.S. Department of   
   Health and Human Services and medical centers in the United States.   
   "Patient dumping" settlements reached in 2013 between the U.S. Department of   
   Health and Human Services and medical centers in the United States.   
   Those settlements involved one or two cases of patient dumping. Rawson-Neal,   
   on the other hand, has been accused of dumping nearly 1,500 patients over the   
   course of five years based on case reviews cited by The Sacramento Bee. In   
   many of those cases,    
   Rawson-Neal patients were sent via bus to metropolitan cities in California,   
   including Los Angeles and San Francisco. Some of those patients wound up   
   homeless; others became violent criminals.   
      
   Brown could have ended up either way. When he stepped off the Greyhound bus   
   last February, he wandered aimlessly through the streets of Sacramento until   
   he stumbled upon a homeless shelter called Loaves and Fishes. By then, his   
   medication had run out and    
   the voices in his head had returned. His depression was back, and he was   
   having thoughts of suicide.   
      
   Loaves and Fishes took him in and, with their help, Brown eventually found his   
   way to U.C. Davis Medical Center. He wound up in at least two boarding homes   
   in Sacramento before his daughter -- who became aware of Brown's plight after   
   being contacted by a    
   Sacramento Bee reporter -- brought him home to North Carolina.   
      
   --   
      
   After the Bee published its report on Brown, the federal government opened an   
   investigation into Rawson-Neal. Of the cases it reviewed, the government found   
   the hospital violated "patient dumping" laws 40 percent of the time by failing   
   to make sufficient    
   arrangements for discharged patients. It is unclear how many of the 1,500   
   cases cited by the Bee were reviewed by the government.   
      
      
   The review cost Rawson-Neal its accreditation. It also prompted Brown, armed   
   with the American Civil Liberties Union and civil rights attorney Mark Merin,   
   to file a class action civil lawsuit against the State of Nevada alleging the   
   state-run hospital    
   violated both Nevada law and the U.S. Constitution.  A federal judge dismissed   
   the lawsuit in February, saying doctors didn't force Brown onto the Greyhound   
   bus and that Brown wasn't harmed by the hospital's decision to send him to   
   Sacramento because he    
   eventually received treatment at the U.C. Davis Medical Center.   
   But the U.S. Commission on Civil Rights isn't convinced that Brown, and others   
   like him, aren't harmed when a hospital transports them out of state without   
   adequate arrangement. Last Friday, the federal oversight board held a hearing   
   to determine if    
   patient dumping had become a systemic problem.   
      
      
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