Home Health & Hospice Week
HHA Wins Settlement In Patient Steering Suit
Health system agrees to training, audits on patient choice. Home health agencies having trouble with local hospitals steering patients to their own HHAs may take heart from a new lawsuit settlement.
Providence Health System in Washington state and Woodinville, WA-based Assured Home Health & Hospice have settled a lawsuit Assured filed in April 2003 (see Eli's HCW, Vol. XII, No. 17, p. 130).
Under the settlement, Providence says its hospitals in three Washington counties will undergo:
"We honor patient choice in the selection of a home health care agency and will work hard to ensure that patients continue to have a choice," Scott Bond, CEO of Providence in Southwest Washington, says in a release.
Assured obtained all the Providence changes it wanted in the settlement, CEO Richard Block tells Eli. "We're satisfied with the outcome," Block says.
The five-year agreement also covers patient choice of hospice and nursing home services, Block adds.
Providence will pay no money to Assured, the health system points out. The agency never asked for money as part of the settlement, Block says.
Long, hard road: The favorable settlement didn't happen overnight. Assured has spent years documenting patient choice improprieties, and spent a considerable sum of money on legal expenses related to the suit, Block says.
Assured's legal counsel had nearly finished discovery and were preparing for a trial scheduled for April 2005 when the settlement came through, he relates.
The employee-owned agency had to finance the lawsuit out of its retirement fund, which was painful, Block says. But the alternative in the certificate-of-need state could have been for Assured to close its doors under the dwindling referrals from Providence, which controls 80 percent of the hospital beds in Assured's service area. And when calculating damages for the pending trial, Assured realized the alleged patient steering had cost it millions over the years.
Many agencies fear bringing their referral concerns to local hospitals will cut off any referrals they still are getting from the facilities. But Block believes Assured's relationship with Providence has improved under the process, and he expects the agency's business to grow quickly in coming months and years.
"Never give up if you think you have something that needs to be righted," Block urges. But agencies also must have cold, hard facts to back up their patient steering charges - referral statistics, first-hand examples, etc., he warns.
Providence denies the suit's charges of patient steering against its St. Peter Hospital and Centralia Hospital, and says it settled the suit to head off further litigation costs.
"The bottom line is Providence has to make all the changes to assure patient choice and Providence has to pay for the services that will assure compliance," Block responds. "The victory belongs to patients."
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