Patient Dumping: Overview and FAQ for Facilities
While healthcare providers are trained to treat patients to the best of their abilities, financial motives can sometimes get in the way of moral standards. When healthcare systems prioritize patients who can pay for their care and neglect those who can’t, this can lead to a practice known as patient dumping.
As this practice can leave vulnerable patients without adequate shelter or care, it’s considered highly unethical and may even violate federal law. To help facilities avoid this issue, we’ll answer some of the most frequently asked questions about this phenomenon and outline measures that should be taken to prevent it.
What Is Patient Dumping? Meaning and Overview
Patient dumping occurs when facilities transfer or discharge patients primarily for financial reasons. This term was coined in the 1960s, based on several historical instances in which private hospitals in New York were caught shifting indigent patients to public mental health facilities. Since patients didn’t receive the type of care they needed, many of them suffered severe medical consequences.
While this term was originally used to reference financially motivated transfers, it now also references unsafe discharge practices that leave patients with nowhere to go. Homeless individuals and nursing home residents are most commonly affected, since they may not have family or shelter to go to after being released from a facility.
Why Do Patients Get Dumped?
While this practice is mainly driven by financial motives, it can also be exacerbated by other constraints on the healthcare system. These motives and constraints include the following.
- Inadequate insurance: Patients who can’t pay for their care are sometimes transferred and discharged simply because facilities can’t make money from them.
- Short staffing: Hospitals that are overcrowded and understaffed may prioritize patients with higher-paying insurance plans and deny care to others. This may be a direct attempt at alleviating workflow strain and maximizing revenue.
- Avoidance of complex treatments: When patients require complex procedures or treatments, facilities may transfer or discharge them to avoid expenses. This is considered dumping if the facility is fully capable of providing these services.
- A lack of staff awareness: Staff may not always be trained to discharge or transfer patients in the safest manner. For example, staff may not know how to transfer homeless patients to shelters and instead discharge them without proper onward arrangements.
Is Patient Dumping Illegal?
Federally, the Emergency Medical Treatment and Labor Act (EMTALA) prohibits hospitals from denying treatment or transferring patients purely for financial reasons. In general, if a hospital is able to medically stabilize a patient, they must do so regardless of the patient’s ability to pay.
Additionally, many court rulings have declared instances of dumping across various types of care facilities illegal. These rulings cover a wider range of unsafe transfer or discharge practices that may not be directly tied to finances.
Can a Nursing Home Evict a Patient?
Nursing homes have the right to evict residents as long as they have a valid reason and follow appropriate procedures. If nursing homes fail to secure alternative care arrangements, this can potentially lead to a patient dumping lawsuit. Common lawsuits involve nursing homes that send residents to hospitals for temporary care, only to deny them entry once they’re ready to return.
What Are the Consequences of Dumping?
Facilities caught unlawfully transferring or discharging patients can face legal consequences and cause harm to everyone involved. These consequences include the following.
- Financial Penalties: Violating the EMTALA may lead to hefty fines for facilities and healthcare providers.
- Loss of Funding: Facilities may lose funding from federal organizations, such as Medicare and Medicaid.
- Patient Harm: Patients who don’t receive timely or appropriate care can face further injury, illness, and even death.
- Poor Public Perception: Dumping is widely looked down upon by the healthcare community and general public. Thus, participating in this act can severely damage a facility’s reputation.
- Healthcare System Strains: Frontloading patients to public facilities can cause overcrowding and strain resources across other areas of the healthcare system.
What Can Facilities Do to Prevent Improper Patient Releases?
While dumping is more specifically linked to financial motives, there may be instances in which facilities inappropriately transfer or discharge patients because of administrative errors. Follow these steps to optimize your facility’s transfer and discharge practices and minimize the risk of these errors:
- Learn about laws and regulations dictating hospital discharges and transfers.
- Thoroughly train staff on facility-level protocols and how appropriate discharges and transfers are defined.
- Ensure that all transfers and discharges are planned out in advance and reviewed by the healthcare team.
- Work collaboratively with patients or their guardians to secure alternative care arrangements when transfers or discharges are necessary.
- Implement measures to evaluate transfers from other facilities and report potential dumping that may be impacting your facility.
Stay Up to Date on Other Relevant Healthcare Regulations
Patient dumping is one of many unethical practices that can pose risks to both patients and facilities. Need help maintaining regulatory compliance? Our expert-written articles provide timely and accessible updates on various healthcare policies that may impact your facility.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.