Parkland May Lose CMS Funding Because It Discharged Injured, Suicidal Homeless Man

Parkland could lose $400 million in federal funding because staffers discharged a wounded homeless man who attempted suicide to a shelter that was not equipped to provide care for his severe injuries.

The findings are detailed in a report filed by the Centers for Medicare and Medicaid Services that declares Parkland Memorial Hospital to be in “immediate jeopardy” of losing its federal funding. Investigators place blame on the hospital system’s board of managers, who failed to assure the man’s safety after receiving care.

According to the findings, the man, known only as Patient No. 5, fractured his spine and broke his wrist and feet while attempting to kill himself. Parkland officials never performed a psychiatric evaluation before discharging him, “even though (the) injuries were sustained due to a suicide” attempt, the report reads.

He also protested the discharge. Parkland staffers responded by calling hospital police, CMS found.

“The patient stated he did not feel safe going to the shelter with three casts on,” the report reads. The employee “reiterated that placement was found and transportation was made,” then consulted with a supervisor.

“Supervisor stated if patient does not accept the safe placement made..he will have to be escorted off the floor by police,” according to the report.

He also acted erratically in the hospital, at one point jumping up from his bed onto his broken feet and screaming, “See what you made me do? Are you happy now?”

CMS officials will tour the entire hospital some time in the next two weeks to make sure the facility is in compliance. For its part, Parkland says it is “reassessing” its emergency department protocols and assuring that they are in line with the National Patient Safety Goals for psychiatric consultation.

In order to better understand where it is discharging the homeless, social workers and managers will visit eight shelters throughout the county to assess 24 elements, such as wheelchair accessibility, locked storage for medications, and “other criterion for admission.” It has reached out to regional and hospital peer groups for recommendations on discharge plans and initiated unannounced monitoring processes.

If CMS finds the system is still not compliant, the feds could yank $400 million in funding on September 6. The full report is below:

Parkland Hospital CMS 2567 POC 8.2014

9 comments on “Parkland May Lose CMS Funding Because It Discharged Injured, Suicidal Homeless Man

  1. I came to the US from another country. I know that America is the greatest country in healthcare. Doctors and nurses are abused here.

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  2. This is happening NOW , ALL OVER !! Shame on our heatlh care system.!!!!We are addressing the same type of issues with a local hospital in Richardson , TX who has been trying to Discharge our family member to home following a severe head injury . His Health car team told us he needed to DC home and his Dr. told us he was competent in make decisions, and needed MINIMAL supervision . we, his family, disagreed with this assessment , and had to ask for a head injury specialist to do an evaluation to determine if he was safe to return home . We saw many examples of ‘unsafe forgetful behaviors’ not to mention his inability to get himself on and off a commode or walk more than 50 feet .
    After requesting a head injury specialist to determine this, we were told that such type of doctor was not on staff at that hospital visit him and do an evaluation . We had to ( on our own) find a head injury specialist doctor evaluate him who stated he was needed 24/ 7 supervision and could not return home unless this was provided at home ( which it was not. )They finally got a doctor to come in ( physical medicine and Rehabilitation specialist , who stated the same thing!! Our family member TO THIS DAY has not had a psych eval to assess his cognitive deficits, despite his stroke and sever frontal brain injury!!! They just today had a meeting with us stating he needed to be discharged to home and was safe. ( this was largely due to a nursing home not being able to accept a Medicaid pending patient.!!!
    Our family member has no job, no insurance and is Medicaid pending. They are under pressure to ‘get rid of these ‘ non funded patients at whatever cost even the patients SAFETY!!!
    We had to attend countless meeting and make suggestions on how to get our family member properly. taken care of . ( from physicians to provide evaluations to suggesting medications …. The doctor even told him he could ‘sign himself out’ because he was competent! I am a nurse , THIS IS UNEXCUSABLE. Funding or not, he needs to be kept in a safe environment until they could find a nursing home or rehab to put him in. when his funding comes through. THey would rather compromise patient safety rather than keep a patient who has no funding .

    This is a HORRIBLE way to treat Humans,!!!! It is so sad and unfortunate that something so serious ,such as loss of a life ,had to happen at Parkland. It is happening everywhere I am sure. We are experiencing this same scenario now with our family member. I call it PATIENT DUMPING . SHAME ON THEM!!. Losing their 400 million in funding is just a slap on the hand…a HUMAN LIFE was lost. !! We are trying to keep this from happing to our loved one. It has been a constant struggle. Management by incompetent people!!!!!!

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  3. Unfunded patients do not have the right to unlimited healthcare. No unfunded American has that right since socialized medicine is not practiced here. Even if we do not like the idea, hospitals are businesses and no business can operate without revenue. Additionally, hospitals are not housing facilities for the indigent. It is a poor utilization of a scarce resource.

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  4. A patient jumping onto a bed to avoid being kicked out of a hospital is not acting erratically. It’s called a cry for help. Something that is not unexpected from someone who just tried and almost succeeded in killing himself.

    If the hospital staff knew what it was doing, maybe they could have figured out that discharging a suicidal man, without treatment for his suicidal tendencies, was just a reckless action. Maybe it would have been wise to hold him for his own protection. He definitely didn’t think he was ready to be discharged.

    Parkland deserves all the bad press they have been getting.

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  5. Anne,

    I’d yout are concerned about your family member file a complaint with the Department of Safety and Human Services. They’ll research your concerns.

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  6. Matt – can you provide a link to the underlying report? I’d like to read what additional nuance there is, if any. Thanks.

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  7. What are the obligations of the family in the care of a loved one ?? Why are they not watching this individual 24 /7? It is unfair and impractical and downright selfish to expect any county hospital to totally take over the care and habitation of a patient. I am truly astonished that no family member offered him a place to stay or get involved in his care while he was in the hospital and when he was discharged . I think this act of care and compassion from his family members would have eliminated a lot of stress, injury and mental confusion this patient suffered. County hospitals have limited funding and worse , limited applicant pools for jobs because of precisely the above cases! ‘ dumping’ of family members who are financially distressed or mentally distressed or mentally incapacitated and expecting physicians and nurses and healthcare workers to substitute for a patient ‘s family. As a person of eastern origin may I offer a piece of eastern wisdom ; let us all participate in the care of our elderly and sick . Families take care of their homeless relatives and participate in the care of their sick members. Use hospitals when truly needed and help their family members through homelessness and sickness. This will keep our hospitals performing well and help retain healthcare personnel of high quality . Threats of litigation and eliminating funding simply makes our healthcare system less accessible and less efficient. ‘ You can’t expect others to do for you what you can’t do for your own’ .

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