Broward Health hospice contractor VITAS denies admission to dying, indigent inmate

By Dan Christensen, FloridaBulldog.org 

Publicity photo for VITAS Healthcare’s inpatient hospice unit at Broward Health North

A dying homeless man ordered released from jail Friday so he could be sent for hospice care at Broward Health was instead denied admission to hospice after he refused to sign a form, according to email obtained by FloridaBulldog.org.

Pablo Hernandez, a 65-year-old indigent suffering from terminal liver cancer, was back at the Broward County Jail today, his lawyer said.

Refusing to sign the form wasn’t the only apparent reason Havana-born Hernandez was denied access to hospice. In an email copied to Hernandez’s lawyer, Assistant Public Defender Lorena Mastrarrigo, Broward Sheriff’s transportation Sgt. Carl Richardt said a nurse had informed him “the onsite hospice provider VITAS (Healthcare) refused him due to him being undocumented.”

Mastrarrigo said BSO Inmate Health Manager Yusimir Arencibia told her Monday that profit was also a motive to deny hospice care to the terminally-ill Hernandez.

“She said VITAS is a for-profit company and they don’t like uninsured, undocumented people,” Mastrarrigo said.

Mastrarrigo’s boss is outspoken Broward Public Defender Howard Finkelstein.

“I am troubled with an indigent hospital contracting out some of their responsibilities and letting the private corporation decide whether to provide services, if that is what is occurring, which it seems to be,” said Finkelstein. “Is it financially or politically motivated, or both? Did (Broward Health’s) board intentionally contract it this way?”

Pablo Hernandez

The hospice form that Hernandez didn’t want to sign is called a DNR, or “Do Not Resuscitate,” which instructs health-care providers to do no rescue efforts if a patient stops breathing or his heart stops. VITAS, which operates the Hospice Unit at Broward Health North, requires hospice patients to sign a DNR form before they are admitted.

Mastrarrigo said Hernandez speaks little English and may not have understood the form, which he refused to sign a second time on Monday. VITAS manager Elizabeth Jerome said, however, that consent forms are in both English and Spanish.

Jerome referred a reporter to other VITAS officials, but they did not respond before deadline.

Court records show that Hernandez was arrested three weeks ago for violating the terms of his three-year probation for a felony conviction of driving after his license was permanently revoked. He was also jailed for a year.

Hernandez got into trouble last year when he walked away from Miami’s Salvation Army facility, where he’d been living with the court’s permission on March 23, 2015. He was charged with absconding and failing to report or pay various court and probation costs, but police didn’t catch up to him until last month.

Mastrarrigo saw Hernandez at Broward Health North in Pompano Beach on March 9. She described him as being in “good spirits and not in pain.” Two days later, BSO’s Arencibia wrote to say she’s received an update on Hernandez’s condition.

“He continues to decline. He was referred to hospice and hospice has accepted him,” Arencibia wrote. She also inquired as to whether there’d been any discussion regarding getting a judge to release Hernandez from jail. “Historically, hospice will not take him while he remains in custody status.”

Two hours later, Mastrarrigo wrote back. “I was just able to have Judge (Edward) Merrigan sign an order to ROR (release on own recognizance) Mr. Hernandez and to have BSO transport him to hospice based on your representation that he was referred to hospice and they have accepted him.”

But the deal fell apart Saturday with Sgt. Richardt’s email stating that VITAS had refused to admit Hernandez because he was undocumented. On Sunday, Arencibia wrote that when Hernandez “was interviewed by hospice he stated he did not want to sign the DNR form. That is a requirement for hospice!”