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Regional seeks OK for long-term care license
Published Wednesday, March 5, 2008
Natchez — Natchez Regional Medical Center administrators will defend plans to create a long-term acute care hospital today at a hearing in Jackson.
NRMC representatives are expected to appear today at a certificate of need hearing at the Mississippi State Department of Health.
State law mandates the issuance of a CON before certain types of medical facilities are created.
The county-owned Natchez Regional has applied for a CON to transform the hospital’s largely unused fifth floor into a long-term acute care hospital.
“We’re going to create, essentially, a hospital within a hospital,” said Walter Brown, attorney for NRMC’s board of trustees. “We’ve got space on the fifth floor that’s not being used.”
Further, Brown said, since the hospital building already exists, the cost to create the LTACH is relatively low, approximately $800,000. That cost should be recouped within three years, Brown said.
Regional began plans for the LTACH for a year or so, Brown said. The hospital formally began the work in August, prior to the recently disclosed financial worries facing the hospital.
Late last month the hospital announced its plans to restate 2007 financials, likely to show a significant financial loss. Medicare reimbursement levels for LTACH patients are relatively high, Brown said, making the venture likely a profitable one for Regional.
“It would offset the losses that we have had in other programs,” he said, adding that the recent financial woes should not affect the CON application.
The hospital has already purchased the 35 specialty beds to be used in the facility at an approximate cost of $150,000, Brown said.
Such a facility is needed, Brown said, because Medicare will only pay for a certain number of days for hospital stays and often patients need more time to recover while still under close medical supervision. LTACH patients generally need inpatient stays of 25 days or more.
Often those patients wind up going to either nursing homes or LTACHs, he said, adding that since such a hospital does not exist in southwest Mississippi, NRMC’s plans could fulfill that need.
The health department’s staff recommended the CON be granted, Brown said.
However, Natchez Community Hospital requested that the CON be denied, which prompted today’s hearing, which is expected to continue through Thursday.
Natchez Community CEO Tim Trottier said Wednesday that he requested the CON be denied because the LTACH needs of the area are already being met by Promise Specialty Hospital in Ferriday.
“It’s a duplication of an existing service that we already have in our area,” Trottier said. “I’m concerned about the number of patients in our community that could support an LTACH.”
Mississippi’s Certificate of Need regulations generally ignore factors outside the state of Mississippi.
Trottier said while Natchez Regional is hoping to make money off the LTACH, he’s more concerned with the dilution of patient base for Promise.
Further, he said Natchez Community has no plans to open a similar facility and gains nothing from Promise Specialty Hospital’s success.
“We rely heavily on Promise as we do other providers of care in our community,” Trottier said. “(But) we have no financial interests whatsoever in Promise.”
The hearing is presided over by a hearing officer, who will make a final recommendation to State Health Officer Dr. Ed Thompson, who makes the ultimate decision.
The proceedings are scheduled to begin at 9 a.m. at the Department of Health building on Woodrow Wilson Drive. The hearing is open to the public.
Brown said that NRMC’s outgoing CEO Jeff Wesselman is expected to testify, along with Community’s Trottier.
Others on the witness list include Adams County Supervisor Darryl Grennell (who was the board of supervisors’ president when the original paperwork was filed) and Dr. Kenneth Stubbs.
Brown said following the hearing, he anticipated learning the hearing officer’s decision in a couple of weeks. From there the CON decision goes to Thompson.
Comments
Posted by Peace007 (anonymous) on March 4, 2008 at 11:21 p.m. (Suggest removal)
I thought they were drowning in debt??? One day they are talking about building a mental health care wing; the next day they are talking about going bankrupt, or becoming a non profit, or just closing down all together and now, they are asking for a grant to open a long term care unit. Well, frankly, I'm confused! lol.
Posted by NatchezEnema (anonymous) on March 4, 2008 at 11:37 p.m. (Suggest removal)
I thought someone said in a post yesterday the hospital was full of non payers from Vidalia, Ferriday and such.Oh just not this floor. Everybody watch now The attorney and local leaders are going to start spinnig on this one. Where can you be 7.5 million in the hole and be buying beds for a broke hospital, for a floor that is not being used. Here we go again Spend, Tax and it will make money! How in the hell do they get away with this. Only in Natchez! Can we get some investagative journalism from the democrat on this? Does anyone at the democrat even care? Or are you guys just working on the pilgramage edition of the paper?
Posted by natchez1 (anonymous) on March 5, 2008 at 12:18 a.m. (Suggest removal)
Why spend $150,000 on beds for a facility that they don't have a CON for? ---- with mismanagement of funds like that no wonder they are in financial trouble - If the CON is denied I am sure they could sell the beds to the new Promise Hospital being built on the riverfront in Vidalia (At a huge discount!)
Why did they build the extra floor if they did not need the extra rooms?
So many questions!
Posted by fatherof4 (anonymous) on March 5, 2008 at 12:49 a.m. (Suggest removal)
Wonder how soon it will be, for them to add the 6th floor now?
Posted by rushinghjr (anonymous) on March 5, 2008 at 1:23 a.m. (Suggest removal)
What will the Board come up with next! With the management contract out of the "window", who are these administrators of the hospital as the article relates to. Why doesn't the Board Chairperson speak and not the attorney?
Posted by frogprincenessntz (anonymous) on March 5, 2008 at 2:34 a.m. (Suggest removal)
Trottier says he wants to avoid dilution of patients for Promise, but that they have no financial interest in Promise. But I wonder????
Google NCH and read HMA's offer to support the doctors' interest who work there. Are not all the doctors on staff at Promise on the physician list at NCH?
This is not to say I am in favor of an LTACH at Regional; I am just thinking aloud.
Posted by beammeupscotty (anonymous) on March 5, 2008 at 2:49 a.m. (Suggest removal)
I too wonder why an attorney is the main spokesperson for Regional.
Posted by shedevil (anonymous) on March 5, 2008 at 3:13 a.m. (Suggest removal)
I think Walter Brown,the hospital board,David Gardner,& the board of aldermen need to be the first checked out at the new mental health care wing.Why not get back to making a profit before spending anymore of the taxpayers money.
Posted by gemccull (Gary McCullars) on March 5, 2008 at 5:36 a.m. (Suggest removal)
I hope the ND GOOFED UP when it wrote this story! It had to have gotten the facts and figures WRONG!
NO, my bet is that the story is correct.
(EXPLETIVES!)
Posted by NoWireHangers (anonymous) on March 5, 2008 at 7:13 a.m. (Suggest removal)
I hope the Certificate Of Need is granted to Natchez Regional for several reasons. It makes sense. Medicare reimbursements pay well for long-term care patients. The 5th floor is being used but not the whole floor, so this would bring in more Medicare patients. In doing so, this would provide more beds for patients in the Miss-Lou area.
A win-win for everyone. This has been in the works for a long time...way before the announcement of their financial woes. A smart move for NRMC and for all of us.
Posted by freedom42 (anonymous) on March 5, 2008 at 8:24 a.m. (Suggest removal)
Promise hospital is a speciality rehab hospital. It never has and never will take long term care or extremely ill patients. All it does is rehab after accidents, strokes,etc.
Posted by RM (anonymous) on March 5, 2008 at 9:32 a.m. (Suggest removal)
Wrong freedom42, Promise takes patients on a ventilator (ie breathing machine) and ICU Patients that have worn out their welcome by medicare so I'm told, so they are transferred to an LTACH to finish out their treatment. Also, why does Dr. Stubbs care to improve finances in NRMC when it is well known that his group transfers people to Jackson cause theyre "TOO SICK" all the time to stay in Natchez. I have a friend that had a Bleeding loss from his intestines and we were with him and his family at the ER and the doctor joked when he told me we had to go to Jackson because the on call DR for Stubbs didn't like to admit people. I was shocked and we changed doctors! No wonder the hospital is in bankruptcy
Posted by buttercup26 (anonymous) on March 5, 2008 at 9:35 a.m. (Suggest removal)
hahaha.. well the 'closing their door' need a bigger tax didn't work like they wanted soo they going back under construction..
IT'S ALWAYS THE SAME STORY WITH THIS SAME HOSIPTAL!! i remember hearing about them growing up.. lol ;)
Posted by grrbrts (anonymous) on March 5, 2008 at 9:46 a.m. (Suggest removal)
Can anyone explain to me, what a County Owned Hispital is and how it differs from any other (regular) hospitals?
Posted by tinstar (anonymous) on March 5, 2008 at 10:43 a.m. (Suggest removal)
Promise Hospital of the Ms-Lou, formerly known as Professional Rehabilitation Hospital became a Long Term Care facility approximately 5 years ago . Prior to this it was an acute rehabilitation hospital. Ltac hospitals still offer rehab in addition to high accuity nursing care. (it can be confusing to the public because rehab is still offered, but the patient has to have other medical issues that need addressing also) Not all patients admitted to LTAC hospital receive rehabilitation, only those with debilitating illnesses or conditions.
Posted by Krogers (anonymous) on March 5, 2008 at 10:50 a.m. (Suggest removal)
Makes sense to put that 5th floor to good use
I know (from having elderly parents pass away recently and being around the hospitals and nursing homes) there is a need for long term care
Seems like Trottier is druelling over hopes his competition is shut down, he ought to stay out of it
We need this hospital and anything other than MORE TAXES sounds good to me
Posted by bear45 (anonymous) on March 5, 2008 at 11:08 a.m. (Suggest removal)
Confusng, Confusing especially to the Public when you say the Hospital is broke and may close. Next day you read in the paper about the Hospital pursuing the need of a CON(Certicicate of Need) for opening a LTACF(Long Term Acute Care Facility) Word on the street is they are broke because the CEO's are running around trying to buy up all the clinics they can. Well that adds to the financial woes of the hospital. If you go into pre-admit to get some x-rays and don't have any insurance unless you can pay the total amount due you are refused services, What's up with this picture? I thought this was a county owned facility? If they are so broke how are they spending $150,000 to purchase beds for a unit that they are not yet approved for? Like I said very confusing......
Posted by tinstar (anonymous) on March 5, 2008 at 11:22 a.m. (Suggest removal)
Why open another Ltac hospital when there is one already in the works that is already recognized not only on a state level but national level for its high standards of care? To me this would just put a financial strain on the two facilities and the community is the one who suffers . The Ms-Lou area has been in need of speciality health care for far to long to not recognize the need for care in other speciality areas such as psych., alcohol abuse or oncology just to mention a few. We are in dier need of a cardiac cath lab. Many patients die each year due to cardiac complications that can not withstand the timeframe for which they have to encounter while beeing shipped to a facility that can manage cardiac emergencies. We need to look at our deficits as a whole and not get a quick fix by grabbing at straws to fix the problem.
Posted by bear45 (anonymous) on March 5, 2008 at 11:30 a.m. (Suggest removal)
What about the Mental patients, I thought they were going to pursue a grant to open a mental unit here, so there would be housing available instead fo jailing the mental patients, there is a dire need for a unit of this magnitude. Everytime the waiting list is so long at Whitfield and the jails are not equipped to house mental patients....Why are they gong in the direction of a LTCF if they are building another one right across the river?
Posted by tinstar (anonymous) on March 5, 2008 at 12:26 p.m. (Suggest removal)
I agree with bear45. Ther is a need for a psych unit that is equipped to take care of not only geri-psych patients but patients of all ages and types of mental illness. Physicians have had to hold patients over 24 hours in the ER while waiting on placement for psychiatric patients, most of which are our youth. Suicide rates are up for our youth, due to lack of affortable psychologist, most in this area work on cash up front basis and you have to file if they happen to take your insurance,( if you have insurance that covers Psych. Illnesses). Most families can not afford cash up front. Believe me the phychiatric population is bigger than realized . So many problems go unnoticed and unsolved due to lack of resources and professionals who are available to recognize and treat these types of health issues that just fall trhough the cracks . i for one wish I had the medical background and financial backing to assist the youth of today. The average lay person can not handle the crucial needs of a young person facing a crisis or an adult for that matter. Family has too close of a personal and emotion ties to help. School counselors are not the answer most do not even have the education to fill the position. But due to lack of resources the positioned is filled anyway. Thats scary.
Posted by NatchezEnema (anonymous) on March 5, 2008 at 12:50 p.m. (Suggest removal)
It' obvious this board and the "Attorney" are grabbing for straws and not being honest with the people of Natchez. Flip flop flippity flop whenever their tounge stops your taxes won't drop. These people are up to their nose in red ink, and the shady deal is about to drop on Natchez and we will have to pay for it. SHUT THIS ENDLESS BLACK HOLE DOWN!. EVERY DAY WE HEAR SOMETHING NEW. It's full it's not full, we are going to struggle to make payroll, we are going to spend money to buy beds for a floor that is not used, we need to raise taxes to keep it open, the goverment is going to bail us out, Imagine if you owned a business and ran it like this. Like I said how in the hell do they get away with this?
Posted by beammeupscotty (anonymous) on March 5, 2008 at 1:14 p.m. (Suggest removal)
Can't we combine mental patients with the long term care ones. I think if they also had a veterinarian on staff and treated animals it might help the bottom line. Start some fees like a $5.00 cover charge to get in. Coin operated water fountains and bathroom stalls. A parking fee. So many untouched avenues to raise money, let's get started people. Move it!
Posted by starfish (anonymous) on March 5, 2008 at 2:08 p.m. (Suggest removal)
Guys, I have read these comments for so long and haven't responded, but I can't hold it in any longer! Bear45 stated that in order to preadmit for any services you have to pay in full if you don't have insurance even though it is a county owned hospital, there is a big difference between county owned and charity hospitals! That is the reason Regional is in the trouble it is in, people for some reason think that they shouldn't have to pay for any services provided at Regional. Regional is not a charity hospital and if no one pays their bill, Regional can't pay their bills! It is a really simple concept, money for service! Do you think if Regional closes Community will not charge you? Community won't even accept you! Think about the whole process here PLEASE!
Posted by brod (anonymous) on March 5, 2008 at 2:21 p.m. (Suggest removal)
With the Medicare/Medicaid reimbursement at its highest level, I don't understand how NRMC wound up in such a financial mess, unless there were just too many hands in the cookie jar. Okay, they have bought these beds. Now when a patient is assigned to a bed in the LTC facility, they (or their insurance, medicare/medicaid, etc.) will be charged daily for their use of this bed. How many times over will these beds be paid for? The same goes for any bed in the hospital, any bed in the nursing home, psych ward, etc. When does it ever stop? Right now, I think it's somewhere in the area of $170.00 per day in a medicare/medicaid approved LTC facility. That's over $5000.00 a month. A person that has to enter one of these facilities as a private pay would be penny-less in a few months or a few years. I don't see the fairness in that. The care is the same. Not worth $170.00 per day. If you have a specialty unit, MAKE IT SPECIAL. To make something better, you will have to exceed "minimum standards."
Posted by tinstar (anonymous) on March 5, 2008 at 2:22 p.m. (Suggest removal)
You have a good point starfish. We all need to think about the whole picture which affects our community,families and the resources that are available . But remember most of us have to hash out our views before someone sets us straight, before someone with insight can educate us on the whole process.
Posted by ntcitizen (anonymous) on March 5, 2008 at 2:47 p.m. (Suggest removal)
To RM: I suspect the reason the doctor you mentioned is concerned about NRMC finances is because the hospital rents the second floor of the new Doctors Pavilion. He is one of the owners of that building, so I'm sure they want that check to continue to come each month, i would think they would all do anything to keep NRMC operating.
Posted by getrealnatchez (anonymous) on March 5, 2008 at 3:33 p.m. (Suggest removal)
The Internal Medicine group (including Dr Stubbs) are notorious for not admitting patients to the hospital and shipping them out to Baton Rouge or Jackson, as soon as a patient is sick enough to be in the hospital. One wonders why, Dr Stubbs is testifing for NRMC in Jackson, when these doctors do not add to any revenues for the hospital.(may be he is well connected to the Board or is well connected to Mr Brown). Why would the hospital buy beds without having a CON. God only knows what this administration is upto.
Posted by tellmestraight (anonymous) on March 5, 2008 at 4:24 p.m. (Suggest removal)
This gets more bizarre by the day! First the hospital is broke and knocking at the door of bankrupcy. Not enough money to run payroll and pay venders. Next we're told they've signed a contract to bring in another cardioloigst. Now they've spent $150,000 on beds for a unit they dont't even have a CON for. This sounds more like Keystone cops than anyting else!
Posted by freedom42 (anonymous) on March 5, 2008 at 4:45 p.m. (Suggest removal)
RM, thanks for the clarifacation. I was not aware that Promise had changed its policy. I had a family member in there several years ago, and that was what I was told then. I agree with tellmestraight - this is too bizarre! Make your minds up people - are you or are you not broke?
Posted by naturegirl (anonymous) on March 5, 2008 at 5:17 p.m. (Suggest removal)
I know the Pink Ladies (volunteers) money that they make from the gift shop has been frozen, and it is not suppose to be used by the hospital, but only for volunteer expenses. Its nice they can buy the beds, the volunteers need to take a break sometimes.
Posted by starfish (anonymous) on March 5, 2008 at 6:09 p.m. (Suggest removal)
getrealnatchez, where do you get your information? All the Dr. associated with Internal Medicine have patients in Regional. These are very dedicated Dr. who are on the floors early in the morning and late at night seeing their patients! They are trying to ensure that their patients have a good medical center at a reasonable price. They truly do what is in the best interest of their patients not their wallets. Honestly after reading all of these post, it is easy to see why Natchez ends up of the bottom! If half of the citizens of Natchez feel the way you do we can never achieve anything! Rumors and misunderstanding are all you want to talk about! Find Facts before you talk bad about other people!
Posted by NatchezEnema (anonymous) on March 5, 2008 at 6:35 p.m. (Suggest removal)
The only reason the powers to be want this hospital open is for it's tax revenue to the city. It's not patients or services, if that was the case when this red flag was starting to rise years ago someone with the goverment would have done something to start lowering it. This city is strapped for money, they have over spent on money loosing projects also like the convention center. These city officials are always doing deals under the table and in the back rooms and can't afford to loose one tax dollar. I know for a fact that this city has operated under a Peter pay Paul system for a long time. If the city looses this tax money it's going to be just that harder for them to say everything is dandy in Natchez. You never hear anything in the paper about our local leaders comenting on what this city needs or how we are to bring about change. It's a shame
Posted by gemccull (Gary McCullars) on March 5, 2008 at 7:03 p.m. (Suggest removal)
NatchezEnema, how does the city benefit from any profits when it is supposed to be a county facility? Just curious.
Posted by SayItRight (anonymous) on March 5, 2008 at 7:31 p.m. (Suggest removal)
There's lots of income in long term care if the patient has long term care insurance and is covered by Medicare. The question is how good will the care provided be.
NRMC is still in the county whether it's in the city limits or not. How much in taxes does the facility pay the county tax collector annually. What other taxes does the county/city collect on the property itself and the licenses to operate?
Posted by getrealnatchez (anonymous) on March 5, 2008 at 7:36 p.m. (Suggest removal)
Dear starfish, I am sorry if offended your feelings. Please read RM,s comments in the above posting. Know your facts. Speak to any hospital employee.
Posted by NatchezEnema (anonymous) on March 5, 2008 at 7:45 p.m. (Suggest removal)
You're right gemccull, this facillity has no tax impact whatsoever to the city of natchez or it's citizens. That's why when they try to raise you're tax to keep it open, just say shut it down.
Posted by gemccull (Gary McCullars) on March 5, 2008 at 8:18 p.m. (Suggest removal)
I am not ready to say shut it down.
Any potential tax increase will come from the county not the city. And yes, the citizens of Natchez are on the hook for any potential tax increase.
Posted by rushinghjr (anonymous) on March 5, 2008 at 9:05 p.m. (Suggest removal)
(Gemccull) i have talked to several different persons regarding subject matter. I have several different opinions and it really depends on how tax the request is written up or the call. Has been stated that it will be a County and City call! What do you hear?
Posted by bear45 (anonymous) on March 5, 2008 at 9:06 p.m. (Suggest removal)
I wasn't meaning that I wanted charity or anything like that but there are sometimes you can't afford to pay the whole bill there are people there that will help you set up a payment plan and pay for the services that a rendered why should someone be refused medical attention, that is my point????? Please explain this to me if you would.....
Posted by gemccull (Gary McCullars) on March 5, 2008 at 9:16 p.m. (Suggest removal)
rushinghjr, it is my understanding that the supervisors sign off on the refinancing.
However, I have not seen any documents so I guess I should just shut up! huh
Posted by gemccull (Gary McCullars) on March 5, 2008 at 9:17 p.m. (Suggest removal)
signed off not sign off
Posted by freedom42 (anonymous) on March 5, 2008 at 9:53 p.m. (Suggest removal)
bear, legally any hospital, private or county owned, cannot refuse EMERGENCY service. They can refuse non-emergency or elective services if they believe the person cannot or will not pay. Usually what Community used to do when I was there (don't know for sure now) was run a credit check on the person and then offer a payment plan. When my husband had to have surgery 2 years ago and we had no insurance (long story there, only time we have ever been without) we paid a lump sum that was almost half of what the original quote was. Most places will do this, but many people have a hard time coming up with that much money.
Posted by frogprincenessntz (anonymous) on March 6, 2008 at 1:15 a.m. (Suggest removal)
Someone misunderstood something concerning the Internal Medicine doctors. We have used them many times in the last three years, and they do admit to this hospital. Because of an aging, large family, I have dealt with each of the doctors there and the nurse practitioner, but if they feel you need a specialist from out of town, they will send you there. I appreciate that.
I really feel we should all give our support to NRMC. I have had to use many medical facilities over the last five or so years, and they are among the better. They provide lots of needed services here that the other hospital will not do well. We actually need all the hospital beds we have at the present time.
Do some research into LTAC hospitals in MS and LA. You will find that there are not that many. Hospitals from all over southern MS could use the LTAC beds at NRMC. There is good money paid for these beds and caregivers. Here is the opportunity for more good paying jobs.
We have found that the management team at Regional needs to be replaced, possibly along with some of the present board. Do that, realign, and move forward.
Posted by beammeupscotty (anonymous) on March 6, 2008 at 9:59 a.m. (Suggest removal)
If we would all just accept the fact that we are going to get sick and die there would be no reason to have hospitals or doctors. Stack the bodies up and burn them and there would be no use for funeral homes either.
Posted by livelaughlove (anonymous) on March 6, 2008 at 2:46 p.m. (Suggest removal)
Oh my, without doctors, we would all die.
Posted by freedom42 (anonymous) on March 7, 2008 at 8:42 a.m. (Suggest removal)
With some doctors, the dying come quicker.
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