Los Angeles issues new rule limiting discharges

After a long battle over the alleged dumping of homeless patients in the street, the city of Los Angeles has enacted a new ordinance making it a misdemeanor for hospitals to transport a patient to a place other than their residence without written consent. Over the last year or so, several city hospitals have been accused of dumping homeless patients in the street in hospital gowns, including patients who were disoriented or mentally ill. In fact, city attorney Rockard Delgadillo is investigating 50 suspected cases from before June 30, when the new city rule took effect. Now the ordinance, believed to be the first of its kind in the U.S., would allow city officials to take direct action rather than suing the hospitals and working things out via court system.

Hospital administrators in the city, for their part, say they're afraid a conviction under the new law could trigger an automatic exclusion by CMS. They're also worried about the cost of keeping patients beyond when they're healthy enough to be discharged. Meanwhile, the Hospital Association of Southern California is investigating whether the measure violates state law, and has also asked CMS what it would do if a hospital was convinced of violating the ordinance.

In the mean time, county agencies and private hospitals have launched a pilot project providing "recuperative beds"--transitional housing for discharged patients who need more care--adding 30 more beds to system. Hospitals are also rethinking their discharge planning process and are providing specialized training to their staffs.

To learn more about the ordinance:
- read this Wall Street Journal piece (sub. req.)

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