Study finds county hospitals rank high in patient dumping violations.

Los Angeles County has the dubious distinction of being the county with the largest number of hospitals that recently violated federal patient dumping laws, according to a study by a consumer advocacy group.

While California was third among the states with 14 violations between April 1994 and March 1995 (Texas had 31 and Florida, 22), no region surpassed L.A. County's eight citations, according to the study, released last month by Washington-based Public Citizen.

Hospitals can be cited for violating federal law when they screen out and deny treatment to patients or transfer them to other facilities because they lack proper insurance. Violators can be fined as much as $50,000 per incident and be barred from participating in the Medicare program.

Local hospitals cited included Valley Presbyterian in Van Nuys; the Kaiser Permanente Hospital in Panorama City; Greater El Monte Community Hospital in South El Monte; Alhambra Community in Alhambra; Antelope Valley Hospital Medical Center in Lancaster; and Desert Palms Community Hospital in Palmdale.

Desert Palms, closed last month by its owner, Pasadena-based Paracelsus Health Corp., was cited on three separate occasions. Officials at Paracelsus did not return phone calls seeking comment.

Lauren Dame, the Public Citizen staff attorney who co-authored the study, said nothing should be inferred by one area having more patients dumped than another.

"Texas leads the nation, but I really don't think we can compare states to states, and I really don't think more dumping is going on in Texas than elsewhere," she said. "It may be the regional offices (of the Healthcare Financing Administration, which monitors patient dumping and enforces the law) are more active, or it may be more people are aware of the law. Normally, a violation isn't discovered until someone calls it in."

Jim Lott, senior vice president at the Healthcare Association of Southern California, a trade group that represents hospitals, said he wasn't particularly surprised there was such a concentration of violations in L.A. County.

"One out of three residents in the county has no health insurance, and that creates a stress on hospitals with emergency rooms that you don't see anywhere else," he said. However, Lott added that because of the numbers of uninsured, "hospitals are real careful about accepting transfers from other hospitals."

Under federal law, such transfers are legal only if it is of a medical benefit to the patient.

According to the study, all six hospitals cited in L.A. County avoided fines or Medicare-related penalties by taking corrective measures. Only 10 of the 153 hospitals cited nationwide were fined.

Hospitals contacted by the Business Journal said the citations they received were mostly for minor violations of a technical nature.

Kaiser-Panorama City was cited for an incident that occurred on Nov. 18, 1994. Hospital spokeswoman Megan Kern said a walk-in to an outpatient clinic affiliated with the hospital was treated for minor injuries, but referred by the physician to a non-Kaiser hospital for X-rays. The facility was not contacted before the referral was made, a violation of the law. Kern confirmed the patient was not a Kaiser enrollee.

Antelope Valley Hospital was cited for a Dec. 7, 1994, incident. A psychiatric patient and resident of nearby Kern County was transferred to facility in that jurisdiction, according to hospital spokesman Gary Cothran. The transfer was made because the hospital receives state funding for indigent patients based on the county in which they reside, Cothran said.

Both Kaiser-Panorama City and Antelope Valley agreed to take corrective action, mostly in the form of briefing staff about proper procedures.

Ironically, the HCFA has been slow to respond to Antelope Valley's plan. "We submitted it, but haven't heard back from them," Cothran said.