Discharge Planning Case Study

     Illegal immigrants usually hold jobs that have bad conditions and worse pay.  Oftentimes, these jobs are found in sectors such as agriculture, construction, food-handling and manufacturing (Dwyer).  Unfortunately for the illegal individuals who acquire these jobs, they have no access to comprehensive health care, though their line of work tends to demand it.  Although illegal immigrants are consequently strapped for cash, many of them will not visit primary care physicians for fear of being deported.  This sets up a vicious cycle: individuals get sick yet ignore the signs.  When illnesses get remarkably worse and are too severe to treat at doctors' offices, the individuals then go to emergency rooms, where the cost is considerably greater.  More often than not, the immigrants cannot afford to pay their hospital bills.  The cost is then covered by the medical institutions and tax-payer dollars (Wolf).  While some argue that illegal migrants do not

Without this law many individuals were denied services, and resulted in death or more serious injury to individuals. Hospitals must have a plan in place during an emergency to triage individuals. Medical care to individuals, who lack the monetary resources, have improved because of this law. As the law states, “transfers” of clients cannot be arbitrary and based on financial loss to the hospital.

The filing of the complaint must be completed within 72 hours of the transfer (Sally Austin, 2011). As a result of this, it has been difficult to see whether or not EMTALA has truly been successfully implemented and effective (Sara Rosenbaum, 2012). Another disadvantage is that EMTALA only requires hospitals to treat “true emergencies”, which are subjective in nature. The last revisions in 2003 for EMTALA by policymakers and CMS limited EMTALA to only patients that arrived to the emergency department, not to other areas of the hospital, such as a doctor’s office appointment or outpatient surgery (Sara Rosenbaum, 2012). Another negative consequence of EMTALA that is not addressed by the law is that emergency department physicians can still be held liable and face malpractice issues by uninsured patients (Singer, 2014). There have been legislative proposals by members of Congress that are working to change this to include physicians as members of the Public Health Services, which would address these concerns (Singer, 2014). These hesitations by physicians has forced some hospitals to close their emergency departments in California to avoid these financial consequences of lawsuits (Friedman, 2011).

Everyday people are sent to the hospital. Not only are they in fear of losing their life but also in fear of being in debt due to the prices of health care treatment they need. But what if this patient happens to be an illegal alien? What if the patient has a foreign illness that needs to be cured so it does not spread? Should healthcare providers continue to provide (s) he with treatment even if they cannot pay? Or should illegal aliens be treated just like any other patients by having a right to health care?

Situations like Maria’s have become fairly common here in the United States. In 2014, Pew research estimated that there are 11.3 million unauthorized immigrants in the United States (Krogstad & Passel). In 1986, the Emergency Medical Treatment and Active Labor Act (EMTALA) made it possible for unauthorized citizens to qualify for Emergency Medicaid. Moreover, any hospital which is eligible to receive Medicaid reimbursements is required to treat ANY patient with emergency medical treatment (Sultan). Prior to the Affordable Care Act (ACA), hospitals could also receive reimbursements for patients who those who needed non-emergent

The dilemma is that Mrs. Margie Whitson a patient at Golden Oaks Rehabilitation Center is going through some very hard times after just loosing her son William about a week ago. She has also had to deal with loosing her husband in the past 5 years leading up to this. She is also reflecting back to when she lost her first son to a motor vehicle accident. Margie is having a very difficult time taking this all in and now feels all alone and wants the one and only thing keeping her alive removed. Margie suffered a heart attack 2 years ago that almost took her life and she

[2] The law requires care providers to deliver medical services despite patients’ ability to pay. The act outlines specific guidelines for providers that deliver emergency services. If a patient has a medical emergency, such as an injury or active birth, the law obligates caregivers to stabilize the patient and provide treatment up to the point where the patient remains stabilized. If the care provider cannot deliver this service, the law mandates that the provider transfer the patient to a capable facility.

Barquero was diagnosis with dilated cardiomyopathy, a potentially fatal condition that’s only known cure is a heart transplant. However, as Dr. Ofri writes “’she’s undocumented,’ the intern said sotto voce, and not another word needed to pass between us. Julia’s fate was sealed. Undocumented patients-illegal aliens- couldn’t get on the transplant list” (Ofri, 30). Therefore, even though Ms. Barquero could go to hospitals, become diagnosed with a fatal condition and purchase medication to minimize symptoms because she was unable to speak English and gain citizenship she was going to die from her illness. This is a major issue. An individual may have the ability to access care in the United States and there may be treatment available however, their citizenship, their legal government status can prohibit lifesaving medical care. Immigration status also affects a patient when it comes to ow the hospital is reimbursed for services. For example, Mr. Amadou Sow, a middle-aged Senegalese man and one of Dr. Ofri’s patient suffered from a severe form of bone cancer that caused him to develop mets in his bones throughout his body. Radiation treatment is available to fight Mr. Sow’s cancer however it is mostly completed on an outpatient basis. MR Sow could however have gotten a room in the hospital use throughout his month-long treatment however because he was undocumented and unable to afford the room out of pocket the hospital would not be reimbursed for their services and

Unfortunately, the homeless has little access to health care related to many factors. The homeless face health risks and are more likely to suffer from mental health issues and chronic health problems. They are exposed to the elements and have poor nutrition and limited access to health care (Potter, Perry, Stockert, and Hall, 2015, p. 620). As a result of limited access, they have less of an opportunity to receive help to prevent or treat illness and injuries. By not receiving help from care providers, their risk for injuries, infection, and terminal illnesses are highly increased. They are susceptible to many diseases more than someone who does receive health care.

Medical repatriation, a practice commonly termed as the transfer of uninsured immigrants with particular long-term care needs to facilities abroad. This has been considered as an economic requirement by the hospital administrators and as an unethical behavior of dumping patients by the lawyers. It is hard to analyze the number of medical repatriations as no state or federal agencies of the government track these deportations. In spite of such numbers, current government and state laws don 't specifically address repatriations. Rather, movement and Medicaid changes over the previous decade have made a true administrative system in

Raised since 1985 and even more to generate the Emergency Medical Treatment and Active Labor Act (EMTALA) by Congress in remedy to its torts, patient dumping still appear to be an issue in our society today. In fact, patient dumping occurs when hospitals deny treatment to emergency patients -- often because those patients can't pay. As Patient dumping is the practice of refusing to treat patients who cannot pay for healthcare services. Federal anti-dumping law, initiated by Congress as part of the Consolidated Omnibus Budget Reconciliation Act of 1985, was designed to reverse a disturbing trend among hospital emergency rooms that either

EMTALA was passed as an act of congress and requires the following legal duties of hospitals. Per the statute, only facilities that participate in Medicare are included. Hospitals were to perform a medical screening examination (MSE) on patients who presented to the emergency department for the determination of an emergency medical condition (EMC). In the event of an EMC exist, the staff stabilized, treated and admitted such patients regardless

The Emergency Medical Treatment and Active Labor Act (EMTALA) ensures public access to emergency services, meaning stabilization and treatment, regardless of a person’s insurance status and ability to pay. Overall, the purpose of this federal law is to prevent hospitals from discriminating against patients who are uninsured or unable to pay by either refusing to treat the patient, rejecting the patient entirely, or transferring them to a lower quality hospital. Thus, it keeps medical emergency practitioners in check by looking at how they may help the patient rather looking at how much they can get out of the patient. EMTALA does apply in this situation. Further, this situation demonstrates how this act was directly violated. It is the hospital’s

The ethical right for individuals to have access to health care already has a form of legal binding within the United States as seen in the Emergency Medical Treatment and Active Labor Act. “In 1986, Congress passed the Emergency Medical Treatment and Active Labor Act (EMTALA), which forbids Medicare-participating hospitals from “dumping” patients out of emergency departments” (Pozgar, 2010, p. 221). The act provides that:

I agree with what Diego has said, to add on I would like to say that the family cannot force the homeless to receive treatment because the homeless has the right to refuse treatment if he is competent and if he is incompetent it would still arise an ethical issue. In the book self-determinism is defined as "the right to choose one's own health-recommended by health professionals" (Boyd, pg.17). The homeless has the right to refuse and sort of treatment offered to him. His rights are under ethical issues. If the homeless is competent he will be able to make a decision because the homeless understands the information that the family gives to him. If the homeless is not competent then forcing the treatment is still questionable because it would