Efforts to force the Atlanta hospital to continue providing free dialysis treatment to a group of immigrants, most of them illegal, suffered a setback on Tuesday when a judge dismissed a lawsuit challenging the recent closing of the hospital’s outpatient renal clinic.
A lawyer for the roughly 50 patients said he would appeal. But the ruling for Grady Memorial Hospital brings the patients closer to a Jan. 3 deadline for finding new sources of the life-sustaining dialysis treatment.
When the struggling hospital closed the clinic for fiscal reasons in early October, it agreed to pay for three months of dialysis for the patients at private clinics, either in the United States or in their home countries. That reprieve has nearly expired, and most of the patients have not taken steps to seek treatment elsewhere.
Luis is a 53-year-old, Mexican-born laborer who after building houses around the Mid-South for a decade needs costly medical care to stay alive.
But Luis is an undocumented immigrant with no insurance — he doesn’t qualify under the Affordable Care Act and can’t legally buy private insurance — so he has only one option in Memphis’ massive health care network: the emergency room.
Increasingly in Memphis, and around the U.S., emergency rooms are becoming the source of specialized medical care for undocumented workers. Not only is it not the best option, medically, it’s adding an expensive burden to hospitals forced to cover the cost because they can’t legally turn away uninsured.
Consider the financial impact of just his case: Luis, who declined to provide his full name for fear of being deported, goes to the ER as often as three times a week for dialysis. Specific cost figures were not available, but experts estimate emergency room dialysis costs are at least triple that of private treatment centers. As a result, he’s piling up unpaid charges that the hospital has very little if any chance of collecting.
It costs about $200 for each dialysis treatment at Methodist Hospital’s ER, according to officials. Most patients need three dialysis treatments per week — that’s a total of $600 per week plus other cost associated with the procedure.
Luis, who immigrated to the U.S. in 2003 with his family, was first rushed to the hospital with shortness of breath in October. Doctors found fluid in his lungs and told him he was suffering from acute kidney failure, the result of two decades of inadequately treated diabetes. The father of two was hospitalized for almost two weeks as he was stabilized and as the hospital — he won’t say which hospital for fear of losing his care — tried to locate a private treatment facility that would accept him. But when that search failed, doctors instructed Luis to return to the ER each time he required dialysis. After complications from diabetes, Luis stopped working. Luis lives with his married daughter and his wife cleans houses to support him.
With each trip, the bills pile up.
Without those trips to the ER, he’ll die within a week, doctors told him.
“This is inhumane,” Luis said in Spanish. “Our right to live is being denied.”
The practice of receiving dialysis in the ER is called “emergent dialysis” and it happens regularly across the country. In Memphis, Methodist Hospital reports having only five such patients in 2010, but the number climbed to 18 by 2014.
The newspaper was unable to obtain similar data from other area hospitals.
Dr. Scott Morris, CEO of Church Health Center, said hospitals are doing what they can to treat the population, but the issue remains a serious frustration because most of the dialysis in Memphis is performed at private treatment centers where the uninsured are typically not served. Morris said he treated a 40-year-old man needing dialysis who said an ER doctor told him to return to the ER each time he needed treatment.
Morris said he didn’t believe it and called the director of the hospital.
“I told him what the patient told me. I said surely there’s a better plan for this. This cannot be how you deal with people like this. I’m not making this up, what he said to me is: ‘Is it working?,’ ” Morris said. ” ‘I guess for the short run it is working.’ He said ‘When it stops working, call me back.’ ”