Question: When a patient is no longer capable of decision making, has no family and is impoverished, the hospital must hire an attorney to petition the court for appointment of a guardian or conservator. This can be necessary to execute care decisions, such as discharge to a long term care facility. Legal and conservator fees may continue for the life of the patient, unless the patient’s circumstances change. In some jurisdictions, there are limited public (i.e., County) resources for guardianship and conservatorship. When borne by the hospital, should these costs be reported as community benefit?
Recommendation: We recommend reporting the cost of applying for guardianship and the cost of a conservator as community benefit for impoverished patients as Community Health Improvement / Health Care Support Services (A3). This service addresses the needs of a vulnerable population, enables access to needed health care, and relieves the burden on government.
(Updated July 7, 2020)