Wednesday, September 19, 2012

A fine is not fine

Regular readers know of the patient quality and safety troubles faced by Parkland Memorial Hospital, as made broadly public last summer.  A new chapter has now unfolded. As reported by Patient Safety and Quality Healthcare:

Parkland Health & Hospital System has reached a settlement agreement with the Department of State Health Services (DSHS) that resolves and discharges all potential litigation and enforcement actions for compliance issues prior to May 31, 2012.  Under the agreement with DSHS, Parkland will be assessed $1 million for violations that occurred prior to June 1, 2012. $750,000 will be payable within 30 days of the execution of the agreement. $250,000 will be held in abeyance subject to Parkland’s compliance with the terms of the agreement.

I understand the need for a closely supervised quality and safety improvement program, but I cannot understand the purpose of a fine, especially when the institution being fined is a non-profit hospital.Why would you take resources away from a hospital when what is needed is for it to invest in an extensive and intensive quality and safety program?

I could even see requiring Parkland to spend this amount on quality and safety programs, but I don't see the point of hurting them financially.

Your thoughts?


Unknown said...

Paul, you don't know how evil Parkland is, so naturally, you have come to the wrong conclusion. Parkland was fined this record amount because they willfully and deliberately harmed their patients and, at the same time, they ripped them off.

If any non-profit, charity hospital deserves a fine, that hospital would be Parkland and UTSW. It's one that's well deserved.

Anonymous said...

Parkland is actually a tax-supported governmental entity, the Dallas County Hospital District.

Paul Levy said...

PHH, see the next comment after yours. So, the taxpayers will end up paying the fine.

Anonymous said...

It could be seen as reimbursement to State Health Services for their costs.

Unknown said...


We do greatly respect your expertise on matters concerning public non-profit hospitals in general, but I would advise you and your readers to check out my blog on the problems at Parkland and UTSW before deciding what is appropriate for a fine, especially the News section. (See

There is more than meets the eye in widespread problems and scandals going on at Parkland and UTSW, and they are not as innocent as you would be led to believe.

With charges of Medicare fraud--there are now four federal lawsuits filed against Parkland and UTSW with serious charges of patient billing fraud linked to serious patient harm--the $1 million fine against Parkland is actually just a slap on the hand by the DSHS.

No hospital in the history of the state of Texas has ever more deservingly gotten a $1 million fine than Parkland, with the possible exception of their partner-in-crime UTSW. They are both a embarrassment and complete disgrace to the profession of medicine.

We are glad to know you are still thinking of us, however, so best wishes to you, Paul.

Shelly said...

I agree that a fine for purposes of fining is not fine. Where does this money go? Who benefits? I would however be fine with a fine if that amount of money was put back into the hospital to help improve quality and safety. It might be a way to jump start investing in this area.

Heather said...

Non profit does not necessarily = no money. I work for a non-profit hospital and there are seemingly unlimited funds available for technology, new construction and expansion~despite repeated denials for Certificates of Need. (It seems they build it and permission eventually comes). No, hospitals are corporations, first and foremost, and it seems the Dollar
is the only language they speak.

Kerry said...

The fine might be quite effective if it comes out of the C-Suite's compensation packages. If it is rolled into overhead it is virtually meaningless.