Facts

On Oct. 17, 2006, Sergio Verugo, a homeless person, was admitted at Hollywood Presbyterian Medical Center in Los Angeles, due to abdominal pain, hypertension and symptoms of alcohol withdrawal. Verugo was later discharged and taken to Union Rescue Mission on Skid Row. Union Rescue Mission could not accept Verugo and he was readmitted at the hospital.

On Feb. 8, 2007, Gabino Olvera, a homeless paraplegic, was taken to Hollywood Presbyterian Medical Center's emergency room after a car accident. He was later discharged and taken to Midnight Mission on Skid Row. Midnight Mission could not accept Olvera because it lacked proper facilities and sent Olvera back to the hospital. Hospital staff placed Olvera in a van and instructed the driver take him back to Midnight Mission. Instead of taking Olvera back to Midnight Mission, the driver left Olvera outside a small park on Skid Row without a wheelchair or other means to get around.

PLAINTIFF'S CONTENTIONS:
The state of California contended the hospital failed to engage in adequate discharge planning of patients Verdugo and Olvera in violation of section 1262.5 of the California Health and Safety Code and 42 CFR section 482.83. Plaintiff also contended that federal and state regulation also apply to emergency patients, such as Olvera.

DEFENDANTS'S CONTENTIONS:
With regards to Olvera, the hospital contended Olvera did not appear to be homeless as he provided the hospital with a residential address, which he described as a home and stated someone was waiting for him there. As a courtesy, the hospital provided transportation to the address given. It was at that time they realized the address was for the Midnight Mission shelter rather than a residential address. The hospital contended that the hospital staff did not, at any time, direct Olvera be taken to a shelter. The hospital further contended that Olvera returned to the hospital to meet with a social worker for placement first thing in the morning. The hospital claimed that Olvera asked for a ride home in the morning and the driver, who was employed by an outside company, left Olvera at the address he provided.

The hospital also contended that state and federal statutes do not apply to Olvera because he was an emergency patient and not an inpatient.

With regards to Verdugo, the hospital contended that Verdugo was admitted and treated and once he was cleared by a physician for discharge, he asked to be transported to a shelter. The hospital further contended he was transferred back to the hospital because he suffered a relapse in transit. The defendant also claimed it did have appropriate planning processes in place and these incidents were merely an aberrational failure to follow -up on a change in the patient's condition after discharge.

Injuries

The state sought civil penalties and injunctive relief (hospital adopting homeless patient discharge protocols).

Result

The case settled for $1,060,000, including $600,000 to support the provision of post-discharge recuperative care for the indigent; $400,000 to support the provision of physician outpatient services for indigents; $50,000 to reimburse investigative expenses and $10,000 in civil penalties. The hospital also agreed to adopt protocols that require better discharge planning for homeless patients. Olvera brought a separate lawsuit and reached a confidential settlement. Verdugo's whereabouts are unknown.