Why bureaucracy and a baroness' stay are costing a New York hospital more than $600K

What happens when legal and healthcare bureaucracy collide? In one New York City case, the result is hospital bills of more than $600,000 and mounting.

Such is the case at Mount Sinai West hospital. According to The New York Times, an initially unidentified woman with no government documents or health insurance has been in a hospital bed for six months after apparently suffering a stroke.

The woman, since identified as a European baroness from a historically wealthy family, cannot be discharged by the hospital to a nursing home or rehab facility because there is no obvious money or insurance to pay for it. The patient, Baroness Birgit Thyssen-Bornemisza, is what hospitals call a "longtime boarder" — a patient who cannot pay and does not need acute care but also cannot be transferred to a nursing home or rehab facility.

The $600,000 hospital bill may be a false number, said John Rowe, MD, a professor of health policy and management at New York City-based Columbia University and former chief executive of Mount Sinai Medical Center. Patients with insurance would pay a fraction of that total and, for those who cannot pay, New York has a Bad Debt Pool that partially reimburses hospitals, according to the Times.

However, the situation does highlight what can go wrong when patients with no insurance and no obvious paper trail enter the healthcare system, said Elisabeth Benjamin, vice president for health initiatives at the Community Service Society of New York.

"Healthcare bureaucracy hits legal bureaucracy," she said. "And the victim of that is this woman."

Read the full story here.

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