Appellate Updates

Kern County Hospital Authority v. Department of Corrections and Rehabilitation (May 26, 2023, F083743) __ Cal.App.5th __ [2023 WL 3675914]

The California Department of Corrections and Rehabilitation (CDCR) unsuccessfully attempted to locate skilled nursing facilities to accept four medically compromised inmates approaching their parole dates. CDCR then “paroled” and transported them to the emergency department at Kern Medical Center, a general acute care hospital. Kern County Hospital Authority, which operates the center, sought and obtained a writ of mandate and a permanent injunction barring CDCR from transferring parolees to the authority’s facilities absent advance permission or a medical emergency. CDCR appealed.

Friedenberg v. Lane County, __ F.4th __, No. 21–35078, 2023 WL 3558224 (9th Cir. May 19, 2023)

A municipal court referred Michael Bryant to a jail diversion program (as a condition of probation) and ordered him to report to Lane County Mental Health (LCMH) for treatment. But Bryant stopped taking his medications, leading to a psychotic break during which he killed two people and maimed another.

Futterman v. Kaiser Foundation Health Plan, Inc. (Apr. 25, 2023, A162323) __ Cal.App.5th __ [2023 WL 3070944], ordered published May 17, 2023

Three plaintiffs sued Kaiser Foundation Health Plan under the Unfair Competition Law alleging the Plan violated the California Mental Health Parity Act by failing to provide coverage for medically necessary mental health treatments for themselves or their dependents. They presented evidence that the Plan denied, or deterred members from obtaining, one-on-one therapy sessions without determining medical necessity.

Naranjo v. Doctors Medical Center of Modesto, Inc. (2023) 90 Cal.App.5th 1193

After receiving a bill for emergency medical treatment at Doctors Medical Center of Modesto (Hospital), Joshua Naranjo filed a class action lawsuit seeking declaratory and injunctive relief. Naranjo alleged the Hospital’s failure to disclose the emergency room evaluation and management service (EMS) fee included in his bill violated the Consumer Legal Remedies Act (CLRA) and the unfair competition law (UCL). The trial court sustained the Hospital’s demurrer and entered a judgment of dismissal. Naranjo appealed. 

Crestwood Behavioral Health, Inc. v. Baass (May 1, 2023, C094882) __ Cal.App.5th __ [2023 WL 3166593]

Some skilled nursing facilities serving Medi-Cal beneficiaries may provide special treatment program (STP) services to patients with chronic psychiatric impairments, for which they receive reimbursement from the Department of Health Care Services based on days of care and type of services provided. Under the Quality and Accountability Supplemental Payment System (QASP), the Department may authorize supplemental payments to facilities meeting certain performance standards, using audited bed days to calculate payment amounts.

Kirchmeyer v. Helios Psychiatry Inc. (Feb. 14, 2023, A165128) ___ Cal.App.5th ___ [2023 WL 2518258]

When a patient complained to the Medical Board of California (Board) that Dr. Jennifer Dore—a certified psychiatrist and surgeon—inappropriately prescribed controlled substances, the Board opened an investigation into Dore and her practice. After finding an irregular prescription of Adderall and Klonopin (both controlled substances) to a family member employed by her medical practice, the Board served Dore with an investigative subpoena for the family member’s medical records. Dore refused to produce the records.

Carrillo v. County of Santa Clara (Mar. 13, 2023, B322810) ___ Cal.App.5th ___ [2023 WL 2469717]

A nurse for Santa Clara County’s Department of Corrections popped a blister on Emilio Carrillo’s foot over his objection while he was forcibly detained. Within three days, the wound became infected. Carrillo developed gangrene, became febrile, and went into septic shock. Doctors amputated his foot later that month.  Four months later, Carrillo was advised to pursue legal action while visiting the Mexican Consulate for immigration advice.

Lopez v. American Medical Response West (Mar. 15, 2023, A161951) __ Cal.App.5th __ [2023 WL 2518511]

Ubaldo and Leobardo Lopez were allegedly injured when the American Medical Response West (AMR) ambulance in which Leobardo was being transported collided with another vehicle. Eleven months later, the Lopezes’ counsel sent a settlement demand letter to the AMR’s claims administrator. 

Algo-Heyres v. Oxnard Manor LP (Feb. 28, 2023, B319601) ___ Cal.App.5th ___ [2023 WL 2257761]

Cornelio Algo-Heyres entered Oxnard Manor, a skilled nursing facility, after suffering a stroke. Although Algo-Heyres struggled to communicate and comprehend things, Oxnard Manor had him sign an arbitration agreement waiving his rights to sue for medical malpractice, elder abuse, and other torts. Algo-Heyres lived at Oxnard Manor for nine years. After he died, his successors sued Oxnard Manor for wrongful death, elder abuse, and other causes of action. Oxnard Manor moved to arbitrate the claims. The trial court denied the motion, ruling that Algo-Heyres likely lacked capacity to understand the arbitration agreement that he executed. Oxnard Manor appealed.

State ex rel. Rapier v. Encino Hospital Medical Center (Dec. 21, 2022, B302426, B303196) __ Cal.App.5th __ [2022 WL 18396584], modified and ordered published Jan. 20, 2023

For about three years, Encino Hospital Medical Center, a licensed acute care hospital, operated at its facility the Serenity Recovery Center to provide acute drug and alcohol detoxification services.  Serenity provided no long-term or outpatient services; rather, its patients received round-the-clock care for three to seven days at the hospital. Most patients arrived with a planned transfer to long-term treatment facilities in place.