Haven for Hope had just opened its men's dorm in April when the first discharged patient showed up.

It was evening at the homeless center and Haven CEO George Block was walking along the sidewalk when he spied a woman getting out of a taxi. She was in a hospital gown and pushing an IV pole, with the intravenous line still attached to her.

“I asked the taxi driver what he was doing,” Block recalled. “He said he had a note saying to drop the woman off at this address. The women's dorms weren't even open yet, so we had no place to put her. We sent her back to the hospital.”

Since then, the practice of “medical dumping” — in which hospitals try to transfer their still-sick homeless patients to homeless shelters or other hospitals — has increased at Haven, officials allege.

Since last month, when Haven opened Prospects Courtyard, its outdoor sleeping area, about 15 homeless people discharged from area hospitals have shown up at the gate, all too ill to be cared for at the center.

“One guy still had his EKG pad on,” said Susan Jenkins, who oversees the courtyard.

Intake Director Vilma Pinto said a woman was found three weeks ago lying face-down on the lawn in front of the campus, in a hospital gown and unable to speak or walk.

“We saw the cab driving off,” she said. “We got her a wheelchair, but Centro Med (the on-campus clinic) said if she couldn't walk, she needed to go back to the hospital. On Prospects Courtyard, we can't have people who can't do for themselves.”

Medical dumping is a major problem at homeless shelters across the country, said Ann Hutchinson Meyers, vice president of transformational services at Haven.

It was an issue at the SAMMinistries emergency shelter on Commerce Street, where on average a patient would get dropped off once every two weeks, said Navarra Williams, CEO of SAMMinistries.

A federal statute seeks to prevent hospitals from dumping homeless or low-income patients at other hospitals. Dumping sick patients at homeless shelters that can't provide proper medical care also violates federal regulations, said Dodjie Guioa, a spokesman for the Centers for Medicare & Medicaid Services

But the problem remains prevalent at homeless shelters. Meyers said Haven's goal is to stop the trend before it develops into a “long-term cycle.”

“What's so frustrating is they're not releasing them to Haven, they're directing them here when they're still sick,” she said. “We have a protocol for the homeless outpatient population that has been distributed to all the hospitals.”

Meyers said Centro Med oversees 35 medical beds at Haven that are designated for the homeless who require some medical care, but that level of care is only primary. Those requiring more complex care should either be in the hospital or receiving home health care.

She said hospital officials argue that hospitals are only appropriate for acute care, and they're at a loss in dealing with homeless who no longer require such care but can't be discharged to home health care.

“It's all about bed days,” she said. “There's a specific length of stay for each diagnosis, and if (patients) stay past that, the revenue streams are decreased. So they end up at Haven.”

The irony, she said, is that it costs taxpayers and hospitals much more to send the homeless through the hospital-shelter-hospital revolving door than it does to simply keep them in a hospital room.

But she said there's a “gray line”: Who decides eligibility for discharge? The doctors do, and that's where things get ambiguous.

Residents at Haven must at least be able to perform “activities of daily living” — using the bathroom, eating and so on.

Meyers said she and her staff have begun compiling information on the medical dumping so they can confront the offending hospitals. Pinto said the woman who was found prostrate on the lawn had release papers from Brooke Army Medical Center.

Dewey Mitchell, chief of public affairs at BAMC, said the hospital does discharge patients to homeless shelters “if we know that patient has no place else to go or if the patient says they live there and it's medically appropriate to send them there. The ER will contact the shelter and get approval.”

He added that the BAMC chief of emergency medicine said he'd tried to send medical patients to Haven before but had been turned away because the center was “too full.”

“That's simply not true,” Meyers responded. “We've always had medical beds open, so that's simply not true.”

Meyers also said they found at least one patient dumped from Christus Santa Rosa Hospital.

But the hospital disputed that claim.

“Our policy is to never release a patient unless they're ready to be discharged,” said Melissa Krause, director of marketing and communication for Santa Rosa. “We take care of patients if there's an acute medical need requiring hospitalization.”