The two men, desperate and hungry, ordered a meal and then ran before the bill arrived. They did not make it. His friend was arrested, but Mr. Theisen went to a pay phone and called the authorities. “I told them I had a knife and was going to kill myself,” he said. “After the dine-and-dash, I just gave up.”

He begged not to be sent back onto the streets of Las Vegas, he said, and did not care where they shipped him. “They asked me what kind of work I had done, and I said I was a cook,” he said. “So some young woman said, ‘Well, there are a lot of restaurants in San Francisco.’ ”

Mr. Theisen said he eventually wound up at the Rawson-Neal facility, where he spent the night. The next morning, he said, his doctors sent him to a Greyhound station with seven sack lunches and a day’s medication for the 14-hour ride. He arrived with three lunches left and $30 on a food stamps card, and bounced from shelter to shelter until he managed to get a room in a downtown transients’ hotel.

Rumors of such journeys had become part of California homeless lore.

“In San Francisco, it’s been urban myth for decades that this sort of practice was going on,” Mr. Herrera said. “But this is the first instance that I am aware of where we have been able to document a state-supported and state-sanctioned effort.”

Ms. Woods, the spokeswoman for Nevada’s health agency, said that from July 1, 2008, to March 31, the state bought out-of-state bus tickets for 4.7 percent of the patients it discharged, an estimated 1,473 people. “The findings show there were 10 instances in the course of five years where there was not enough documentation to know for certain if staff confirmed there was housing/shelter and supportive services at the destination,” she said.

The federal Centers for Medicare and Medicaid Services, however, said last month that its inquiry showed a more widespread problem. About 40 percent of the mental patients discharged by the hospital went into local homeless shelters or were shipped elsewhere, the federal investigators said, and most of those were sent directly to a Greyhound bus station with a ticket but without proper documentation or instructions on what they should do when they arrive.

Some medical staff members at Rawson-Neal were fired after the furor following the Bee report, Ms. Woods said, and the hospital strengthened its discharge protocols. Gov. Brian Sandoval of Nevada pushed the Legislature to approve, which it did, $30.4 million in additional mental health spending, including $2.1 million for Rawson-Neal.