HOSPITAL FINED BY COUNTY PATIENT DUMPING LAW CITED.

Byline: Karen Maeshiro Staff Writer

LANCASTER - Lancaster Community Hospital paid a $9,000 fine and provided additional training for emergency room staff after being cited for violating a federal law that prohibits ``patient dumping.''

The hospital was among 77 hospitals in California and 527 nationwide that were found in violation of a law that prohibits hospitals from denying medical screening or stabilizing treatment or from inappropriately transferring a patient whose condition is not stable.

The federal law also requires hospitals to provide emergency care to patients, regardless of their ability to pay.

County officials say the facility on 10th Street West between Avenues J and K has taken corrective action.

``They provided us with a plan of correction. We went back ... for a re-survey and they were in compliance at the time,'' said Eric Stone, a supervisor with the Los Angeles County Department of Health Services.

Michael McAndrew, chief executive officer at Lancaster Community, denied that the hospital ever dumped patients or did anything wrong.

``There was some documentation issues. We provided them with more information,'' McAndrew said. ``We hired an attorney, who reviewed the case and said nothing was done wrong.''

Health inspectors said Lancaster Community failed to provide medical screening exams to two patients, records show.

The hospital responded in its correction plan that a medical screening was performed but ``was not always documented within the medical record,'' records show.

``The emergency room staff and physicians have been educated regarding the need for medical record documentation of medical screening examination of the patient to determine the condition/stability of the patient,'' records show.

The hospital also pledged that emergency room staff will monitor the completeness of the documentation prior to transferring patients.

``We will only transfer patients following medical screening examination, having an accepting hospital, transferring all appropriate documentation with the patient, and transferring via the appropriate accommodation,'' the hospital said in its plan of correction.

McAndrew characterized the fine as paying a ``nuisance claim.''

``Everybody who comes to our center does get a medical screening. If we had done what they accused of us doing, they would have yanked our Medicare,'' said McAndrew, who took over as top administrator after the hospital was cited. ``We follow the letter of the law. We'd be foolish to do anything else because we could be closed.''

According to a report prepared by state health inspectors, a 17-year-old girl was brought to Lancaster Community's emergency room about 7 p.m. on Jan. 20, 1999, complaining of swollen, watery eyes.

A nurse practitioner concluded that the patient had a ``nonurgent condition.'' There was no documentation to indicate that the patient received a medical screening exam, the report said.

The patient's managed care plan was contacted for authorization to examine and treat the patient, but the girl was told to come to the plan's clinic the next morning, the report said.

The medical record indicates that the patient's mother was told that authorization had been denied and that the mother would have to pay for an examination. The mother and patient then left.

The emergency room nurse documented that the patient left without being seen, the report said.

In the second incident, an 18-year-old woman came to the emergency room at 10 a.m. on Oct. 3, 1998, with a severely injured ankle, the county report said.

There was no documentation or other evidence to indicate that the emergency room doctor performed a medical screening, the report said. The only documentation by the physician on the record was the words, ``stable for transfer.''

The patient's insurance carrier was contacted and requested that the patient be transferred to another hospital for evaluation and treatment. Discharge instructions told the patient to go to the other hospital ``now,'' the report said.

The patient was taken by private car to the other hospital, where she was treated for a broken ankle, the report said.