Hospital Reports Crime, Gets Rapped

John Commins, for HealthLeaders Media, September 3, 2008

This story has been bugging me.

According to the Associated Press, Trinity Medical Center in the Dallas suburb of Carrollton, TX, is taking heat because the hospital called authorities when a woman applied for a cafeteria job using a counterfeit Social Security card. The woman was arrested, jailed, and deported.

Now, advocates for illegal immigrants are claiming the hospital went too far. Apparently there is nothing in the law that says an employer is obligated to notify authorities when they suspect or know that an employee or job applicant is in the United States illegally.

The AP reports that immigration attorneys and advocates believe employers like Trinity have become overly cautious about hiring illegal immigrants, to the point that the prospective employers might be bending or breaking the law.

"When people are being prescreened before a decision to hire is being made, then you could have exposure to discrimination charges," Kathleen Walker, a lawyer and former president of the American Immigration Lawyers Association, told AP.

Interesting interpretation. An applicant's crimes should be ignored in the prescreening process—whatever that is—because there is a potential for discrimination.

Trinity spokeswoman Susan Watson offered a different, albeit far more mundane, interpretation. The hospital suspected that at least one crime—identity theft—was being committed. Watson says the hospital felt an obligation to report its suspicions to police.

"Regardless of whether they were an illegal alien, legal immigrant or an American citizen, it still wouldn't have mattered. They still would have been reported," she told AP.

Imagine that. A hospital is taking heat for reporting a crime. The nerve!

This criticism comes at a time when the nation's healthcare system is getting blasted—and rightly so—by consumer advocates and the media for its failure to secure patients' records against illicit snooping and identity theft. In Carrollton, we have a job applicant caught using a bogus Social Security card and Trinity is rapped for reporting her. Let's imagine what would have happened if Trinity had hired an illegal immigrant, who then poached patients' records and perpetrated identity theft. How would that play in the media? How many lawsuits would that lapse have created?

The charge of discrimination lodged against a hospital for reporting a crime committed by an illegal immigrant is particularly galling when you consider that illegal immigrants have no better friend in this nation. Our hospitals are the often-uncompensated healthcare provider of first and last resort for many of the estimated 10 to 13 million illegal immigrants living in the United States. In Texas alone, the state's comptroller estimates illegal immigrants cost hospitals $1.3 billion in 2006, with most of those costs eaten by hospitals.

This is not a rap on illegal immigrants; the vast majority are hardworking and decent people who are just trying to provide for their families.

But it does illustrate the unique and vulnerable position that hospitals find themselves in when dealing with illegal immigrants. We have the millions of illegal immigrants using and stressing healthcare services in the country. We have a federal government that is doing little if anything to address this free for all. We have advocacy groups and the media on all sides of the argument waiting to pounce on any perceived error.

Report a crime: Busted! Don't report a crime: Busted! Take your pick.

It's a problem that hospitals didn't create, didn't ask for, and have little or no influence over. But it's still their problem.

John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at

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