Saint Rose Dominican Hospital Las Vegas

ImageRegistered nurse Nicole Evans straightens up a room in the trauma center at St. Rose Dominican Hospital — Siena Campus in 2008.

University Medical Center, which is Clark County's only publicly funded hospital.

Brian Brannman

State investigators have found a pattern of improper patient transfers by St. Rose Dominican Hospitals — Siena Campus to the region’s only public hospital, University Medical Center, according to documents obtained by the Las Vegas Sun.

UMC CEO Brian Brannman said the practice could be contributing to financial shortfalls at UMC and is worsening the overcrowding of its emergency room.

“We want to be the community’s hospital, but we need to be a lot more protective of taxpayer dollars and not get run over, ” Brannman said after reviewing the documents, obtained by the Sun through a public records request.

Clark County Commissioner Chris Giunchigliani said the investigation confirms long-held suspicions: “The fact that it was systemic and substantiated that they were inappropriate is consistent with what many of us have thought.”

Depending on how common the practice is at St. Rose and other private hospitals, the transfers of patients could be costing UMC — and, thus, county taxpayers — millions of dollars to treat uninsured or underinsured patients. Conversely, hospitals that are sending patients to UMC are saving a like amount of cost on their books.

According to data supplied by UMC, St. Rose Siena transferred 78 patients to UMC between August 2011 and May 2012, more than any other valley hospital.

UMC’s current deficit is about $30 million.

Rod Davis, senior vice president of operations of St. Rose parent company Dignity Health Nevada, released a statement to the Sun saying that St. Rose is a faith-based, nonprofit institution with a mission to serve the indigent. The transfers, he said, were medically necessary — a claim disputed by UMC. Because the patients transferred from St. Rose Siena to UMC in 2012 were more likely to be insured than the typical UMC patient, St. Rose is actually helping UMC, Davis said.

Regardless of the financial outcome, “The findings of this investigation indicate the hospital’s actions and use of internal policies were not in compliance” with state law, according to the documents.

Investigators with the state Department of Health and Human Services reviewed just a sample of patient transfers and found 13 that were “inappropriate.” Investigators give a score based on severity and scope. The St. Rose severity score indicates patients were not put at risk due to the transfers.

The scope score, however, indicates the problem is systemic, meaning it has been a routine practice to move patients from St. Rose to UMC in violation of state and possibly federal law.

The Centers for Medicare and Medicaid Services, the powerful federal health regulator, will likely now determine if St. Rose is operating in compliance with the Emergency Medical Treatment and Active Labor Act, known in the health care industry as EMTALA.

The law requires hospital emergency rooms to provide care or arrange for services with another hospital if it is unable to do so. If its own specialists are not available, the hospital is required to transfer the patient to another hospital that can provide the care. St. Rose has a transfer agreement for these circumstances with UMC.

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