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California Superior Court Issues Ruling on "Patient Dumping"

April 26, 2022

The Superior Court of California issued a declaratory judgment that under federal law, a nursing facility cannot refuse to readmit a resident who has been cleared by the hospital to return to their facility.  According to the court, such a refusal on the part of the facility constitutes an involuntary transfer under state and federal law, and triggers the facility's obligation to comply with the transfer and discharge requirements in 42 CFR 483.15.  

In this case, brought by resident Gloria Single and the California Long-Term Care Ombudsman Association, Ms. Single was refused reentry to Pioneer House, a long-term care facility in which she had been residing with her husband, after she had been cleared to return from a hospital stay.  The complaint alleges that by failing to allow Ms. Single to return, Pioneer House circumvented the legal process for evicting nursing home residents. 

Key Takeaways:

  • The Superior Court of the State of California ruled in a declaratory judgement that under federal law (42 C.F.R. § 483.15), a facility cannot refuse to readmit a patient who has been cleared by the hospital to return to their facility.
    • Such a refusal on the part of the facility would constitute an involuntary transfer and trigger the obligation for the facility to comply with the “transfer and discharge” requirements in in 42 C.F.R. § 483.15.

Summary:

Gloria Single was sent to a medical center by the nursing facility in which she resided (known as Pioneer House). Even after she received hospital clearance, Pioneer House refused to readmit her. After a hearing on March 24, 2017, the Department of Health Care Services issued an order that Ms. Single must be immediately readmitted by Pioneer House to the first available bed. She eventually agreed to placement at a different nursing facility but sought to return to Pioneer House to be reunited with her husband. Tragically, she died before she was able to return and did not get to see her husband again before her passing.

The California Long Term Care Ombudsman Association and Ms. Single had filed an amended complaint against Pioneer House, which came before the Superior Court of the State of California on February 24, 2022. The complaint alleges that Pioneer House “dumped” Ms. Single into Sutter Medical Center and refused to readmit her to Pioneer House once the hospital cleared her to return home, circumventing the legal process for evicting nursing home residents.  On April 19, 2022, the Superior Court of the State of California filed an order granted the CLTOA and Ms. Single’s motion for summary adjudication of declaratory relief. The Court ordered as follows:

1) A facility's refusal to accept a resident back from the hospital after the hospital clears the resident for return to the facility constitutes an involuntary transfer under state and federal law.

2) A facility's refusal to readmit a resident under these circumstances triggers the facility's obligation to comply with the "transfer and discharge" requirements listed in 42 C.F.R. § 483.15.

3) The involvement of a third party in a resident's admission to the hospital does not exempt the facility from complying with the transfer and discharge requirements of 42 C.F.R. § 483.15.

4) Once a hospital clears a resident to return to the facility, the facility may not refuse to accept the resident on the grounds that the facility cannot properly care for the resident, or that the facility is still gathering information to assess the resident's current condition.

This order may be helpful to use as reference and precedent for other LTCO offices working with residents who have been refused readmittance to nursing facilities after receiving hospital clearance.

Reference:

Gloria Single, and California Long Term Care Ombudsman Association vs. Cathedral Pioneer Church Homes, Case no. 34-2017-00220058-CU-NP-GDS. Order granting in part and denying in part plaintiff CLTCOA’s motion for summary adjudication (Filed April 19, 2022).

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