How does a jury or media feel about NP firing patient over a bill?

[Lorie Brown RN, MN, JD]

Hi Lorie

Is firing patients for non-payment seen differently than firing patients for other reasons such as violence at the office? Especially where the patient may not be able to get another provider in the 3 other providers and "You have 30 days." that most articles state is the standard to D/C a patient.

The exact issue is I work in a Community Mental Health Clinic as an NP in a very poor neighborhood. Our manager who is not a prescriber wants to tell the patients if they don't pay any of their past balances like old co-pays etc. that she will fire them and issue the 30 day letter.

My concern is it may take them more than 30 days to get a new provider. Even then the other CMHP may not take them as they limit their patients to geographic area, or it may take 2 or 3 months for them to be seen by another prescriptive provider.

I said we still liable for their medications until they are seen by a prescriptive provider for refills or worse the lapse in medications result in a severe return of symptoms maybe causing a suicide or legal consequences.

One article I read was concerned about how a jury or the media would feel about the NP firing the patient over a bill.

What do you think?

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Dear Firing Patients for Non-Payment

As an employee of a community mental health clinic, you are in a difficult position. If the health clinic has a policy to fire a patient for nonpayment and the patient agreed to that when they became the patient, the facility has every right to take that action. How would it affect you in a medical malpractice case? If you are giving them the 30-day letter and providing referrals, you should be safe.

I agree that the media would have some concerns about it because these facilities are putting profits over patients' wellbeing.

Wishing you the best,

Lorie

[rn_patrick, NP]

What about providing medication past the 30 day window if they cannot get services? In my area Psych Prescriber appointments can be 2-3 months from initial intake with social work.