SAN DIEGO (KGTV) — Scripps Health is responding to accusations by San Diego's City Attorney that staff illegally discharged a patient who could not care for himself.
San Diego City Attorney Mara Elliott filed a civil enforcement action Monday against the hospital system, claiming a court had determined the patient released from the hospital was "so gravely disabled that he could not care for his own basic personal needs."
"Our Office is putting San Diego hospitals on notice that ‘patient dumping’ is inhumane, illegal, and will not be tolerated," Elliott said in a release. "Scripps Health knew this vulnerable patient could not care for himself, and instead of putting his well-being first, left him to fend for himself. This conduct is inexcusable and horrific."
Elliot added that the complaint alleges the hospital failed to have an effective discharge planning process to determine if a patient is "likely to suffer adverse consequences upon discharge."
Elliott's office claims:
"The 68-year-old victim, who had been diagnosed with schizophrenia and suffered from hallucinations, cannot care for daily needs like obtaining food and shelter. He was hospitalized after being found naked, disheveled, unresponsive, and barely coherent during a welfare check by the City Attorney’s Office in April, 2019, on residents of a substandard and unsafe College Area independent living facility (ILF). ILFs are businesses that do not need to be licensed and can only accommodate independent individuals.
During two subsequent interventions by the Psychiatric Emergency Response Team (PERT) of the San Diego Police Department, clinicians determined the victim was gravely disabled and unable to care for himself.
While hospitalized at Scripps Mercy Hospital, employees described him as disheveled, delusional, refusing to attend to basic needs, irritable, agitated, not showering, and frequently cursing and repeating the same question. A treating physician noted he 'cannot maintain himself independently in the community' because of his severe schizophrenia, and a court ordered that he be placed in a locked, skilled nursing facility when he was discharged. Contrary to the court’s order and observations by its own treating physician, Scripps Health discharged the victim to a group home in December 2019, where he was left to manage his own prescriptions and keep medical and psychiatric appointments without transportation. City Attorney personnel intervened to arrange transportation, and found during a subsequent welfare check that he had not showered for days, had not taken his medicine, and that his bedsheets were soiled with feces. PERT removed him from the home."
Scripps Health responded to the allegations on Monday, saying in part, "taking care of the region’s most vulnerable patients is not a business for us, it is our mission. We would never engage in patient dumping. We believe no hospital in San Diego is more dedicated to serving the needs of patients with behavioral health issues or those experiencing homelessness than is Scripps Mercy. We strive to provide all of them with exceptional care.
"We find it unbelievable that the City Attorney’s office would portray our role in this case the way they are and that they would use it to disparage the great work the staff at Mercy does day in and day out to help the most vulnerable among us," the statement added.
(Scripps' full statement can be found below.)
The City Attorney’s Office is seeking an injunction banning Scripps from unfair competition and civil penalties of at least $1 million. The victim's case manager has also filed a complaint against Scripps.
The 68-year-old victim is currently staying in a skilled nursing facility in Yucaipa, Calif.
Elliott's office said it is investigating whether there are any other possible cases of illegally discharging patients, or what the office called "patient dumping."
SCRIPPS HEALTH'S STATEMENT:
"Scripps is bound by law to protect patient privacy, so we cannot speak to specifics of any patient case. However, we can say that we totally disagree with the action filed today by the San Diego city attorney regarding Scripps Mercy Hospital. We believe their claims have no merit, are completely outrageous and are unwarranted. Importantly, this case was referred to the California Department of Public Health, which found no deficiencies in the actions of Scripps Mercy. It is unconscionable for the City Attorney to try to use this case to misrepresent the great work Scripps Mercy does in serving thousands of homeless and mentally ill patients each year. We look forward to defending ourselves in court.
Taking care of the region’s most vulnerable patients is not a business for us, it is our mission. We would never engage in patient dumping. We believe no hospital in San Diego is more dedicated to serving the needs of patients with behavioral health issues or those experiencing homelessness than is Scripps Mercy. We strive to provide all of them with exceptional care.
To provide some more perspective, from January 2020 to March 2021, we had 11,487 homeless patient visits. We saw 57,211 patients with psychiatric issues in our emergency department in fiscal year 2019. And, in fiscal year 2020, Scripps Mercy covered more than $10 million in the direct cost of care for patients who had no other means to pay. That’s just a snapshot. The thousands of patient visits and the caring for them continues.
We find it unbelievable that the City Attorney’s office would portray our role in this case the way they are and that they would use it to disparage the great work the staff at Mercy does day in and day out to help the most vulnerable among us.
With every behavioral health patient, we work to resolve issues and alleviate symptoms that led to their hospitalization, reduce the risk of dangerous behavior, and increase their coping skills to help them live more effectively in the community. When these goals are met, our dedicated staff develops a discharge plan closely integrated with community services to encourage ongoing care and to help patients return to their families and communities. When the patient is ready to return to the community, we offer social worker-assisted placements in long-term residential or short-term crisis housing, board and care, and skilled nursing facilities when needed; services and referral facilitation for chemical dependency, psychiatric and medical home health nursing; and referral facilitation to licensed professionals, continuing care and community support groups.
But San Diego is facing a behavioral health crisis. Everyone knows someone affected. And we need more of everything to help those affected -- more psychiatric hospital beds and long-term care options, better care coordination, more outpatient and supportive services.
And San Diego is facing a homelessness crisis – one that we see at Scripps Mercy every day. It’s part of our mission to serve the underserved, and before patients who have no home leave our care, we connect them with community resources so they can get needed treatment and shelter, we clothe them, and support them in many other ways. Still, more is needed to help those experiencing homelessness.
Solutions to the behavioral health and homelessness crises are not easy, and they are not single-faceted. This requires a comprehensive approach from agencies and organizations throughout the region. We are dedicated to being part of those solutions. We have been here helping thousands of behavioral health and homeless patients every year, for generations. And we will be here for generations to come.
Our doctors, nurses and support staffs at Scripps Mercy and across the Scripps Health system have worked tirelessly over the past 18 months caring for patients during the COVID-19 pandemic. They remain strong today, even as new cases and hospitalizations continue to rise. Their dedication, compassion and professionalism further underscore Scripps’ deep commitment to the communities we serve."