Texas Hospital Challenges Ban on Releasing Patients During Crisis

A Houston-area rehabilitation facility claims county officials have put it in the unique position of operating as a hospital but with the quarantine restrictions of a nursing home.

(AP Photo/Ted S. Warren, File)

HOUSTON (CN) — As hospitals across the country fill up with patients from the Covid-19 pandemic, a Texas rehabilitation facility was ready to release one man who was finished with treatment for an unrelated ailment. But instead of heading home, county officials ordered the hospital to retain him and all other patients.

Encompass Health Rehabilitation Hospital of Humble, a facility just northeast of Houston, filed a lawsuit Wednesday seeking injunctive relief against the Harris County Public Health Authority so that it can release patients not at risk of spreading the coronavirus, but those who would be exposed to it as the hospital prepares to accept an influx of patients in recovery from both Covid-19 and non-virus conditions.

According to the complaint filed in Harris County District Court, county officials first came to inspect the hospital and provide guidelines for the pandemic on March 30, but only gave “minor recommendations” such as providing hand sanitizer, social distancing and shutting off water fountains inside the building.

“The county left without expressing any alarm or concern and without mentioning any need to return for additional meetings or walkthroughs,” the complaint states.

However, county officials contacted Encompass just three days later to serve it with a “quarantine of property” notice. The officials did not convey the order’s severity at the time it was served, according to the complaint. One of them allegedly said during an April 2 phone call that the order was a “non-event meant to tell the public that the hospital was in compliance with public health guidance.”

Encompass says it developed a compliance plan the next day and updated county officials with its progress, but received no response. After eight days without correspondence, county officials sent Encompass a second quarantine notice on April 10.

Despite county officials’ claims to the contrary, the notice was not hand-delivered but instead came in the form of a single email that was redirected to a spam folder, according to the lawsuit.  

The second order added significant new restrictions on patient movement at the rehabilitation facility, including a ban on admitting or discharging patients, allowing patients outside or sharing employees who work at other facilities with positive Covid-19 cases — which is most of the hospitals in the area, the complaint states.

The order from the county classified Encompass as a long-term care or nursing facility, which the hospital disputes.

 “Rehabilitation hospitals, like Encompass Hospital, play a critical role in patient care particularly with regard to a potential Covid-19 surge scenario,” the lawsuit states.

When patients no longer need critical care, they are often transferred to secondary hospitals such as Encompass’ facility, which “provides an important ‘release valve’ for acute care hospitals by freeing up acute care beds” for all kinds of patients, the complaint states, regardless of whether they have been infected with Covid-19.

Encompass claims the quarantine notices have not been applied to any other hospital in the area. According to the lawsuit, Harris County has labeled the facility as a non-hospital entity, which puts Encompass in the unique position of operating as a hospital but with the quarantine restrictions of a nursing home.

Encompass’ attorney, Kenneth Broughton with Reed Smith in Houston, declined to comment on the complaint prior to a hearing on the case Wednesday afternoon.

Encompass has not admitted any Covid-19 patients into its facility, or any other patients in compliance with the quarantine orders as of April 12, but it seeks injunctive relief from the restrictions and a temporary restraining order on their enforcement so that it can operate appropriately in its role as a secondary care facility for acute care hospitals.

Elizabeth Perez, spokeswoman for the Harris County Public Health Authority, offered insight into the orders and said the agency was being cautious. Perez explained that moving patients — even asymptomatic ones — could put future patients at risk.

“If you’re moving someone, and just because they may have a pending result, that’s a problem,” she said.

Perez could not get into further detail regarding case specifics, such as why the facility might have been classified as a nursing home, due to ongoing litigation, but said the goal is to make sure there is communication and coordination before the county would authorize patient movements.

“We just want to make sure that people are safe,” she said.

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