Room for Regional?
Published Thursday, February 28, 2008
I first heard about the woes at Natchez Regional Medical Center nearly three weeks ago.
At that point, I considered it rumor, but decided we'd start checking into it at the newspaper. Now, with some shocking numbers on the table, the story is one I wish were merely gossip.
I've always thought — in my limited medical knowledge — that Natchez should be a one-hospital town. I grew up with only one hospital in a similar-sized town. And two seems a bit over the top here.
But now, with the possibility — though it's not been officially said by hospital folks — of closure at NMRC, I hope two is just right. I'd like to see the hospital board find a way to right the ship.
NMRC employs too many Miss-Lou residents and it's too much a part of the community to lose.
I'm afraid the story may get worse before it gets better. But I'm hopeful that in the end, Regional continues to be a part of the Miss-Lou, and its employees find stability.
Comments
Someone on here had a great idea....they said it would be nice if the two could combine, with Community being the mental ward.
I like the idea.
You're right: The story will get worse before it gets better, and it might not even GET better.
There are two "sides" to healthcare in this country: The caring, human side--that is, all those people who care first and foremost about helping YOU heal--and then there is the financial side: Somebody has to pay for all this. Those doctors, nurses, radiologists, lab techs, unit clerks, housekeepers, etc., do not work for free, after all. But from the "patient" side, $3500 seems a little steep for a 30-minute ER visit (Community Regional, that one--my wife was the patient, but I got the bill), especially in a state where the median family income is about $26,500, last I read.
I've worked in hospitals or on the "periphery" of healthcare since 1981. In the 1980s, "adult" hospitals started to feel the squeeze from Medicare. In the 1990s, I was working at a children's hospital, just in time for the Medicare squeeze to "trickle down" to Medicaid and pediatrics. Since 2000 or thereabouts, I've been a "free agent," not associated with any particular hospital--although in my second year on my current job, one hospital I did work for closed its doors.
It gets really, really ugly. In the 80's I watched "my" hospital fire a housekeeper who'd been there almost 30 years because there was dust in a stairwell he was supposed to clean--that particular stairwell was his first "target," any given shift, plus was near the ER; only a miracle would have made it spotless 8 hours after he had cleaned it. In the 90's I watched a 17-year employee, a nurse's aide, very dedicated and hard-worker, get laid off because the powers-that-be decided they needed an all-nurse nursing staff (and a year or so later, they backed off from that brilliant idea and started hiring "care assistants"--nurse's aides by another name).
Yeah, it gets ugly.
Bottom line is, though, a significant number of us can no longer afford to buy what the healthcare industry is producing. If gas rises to 10 bucks a gallon, how much driving will we do? If a soft drink at McDonald's goes up to $20, most of us would do without soft drinks to wash down those healthy french fries.
(The other half of what I said--dang 3000-character limit!)
Actually I'm really torn about this: On the one hand, I would hate to see NRMC close because I would hate to see all those folks lose their jobs. On the other hand, part of me is saying, well, you kinda brought this on yourselves.
In the end we will all be hurt, if NRMC closes. But maybe we will all be helped, too, when we realize that healthcare is NOT a "right," when we realize that, you know, sometimes scratches and sniffles and "just don't feel good" do NOT demand professional medical attention; and, from the other side, doctors and nurses realize that, you know, maybe it is NOT so important to research whether a person's foot position affects their blood pressure (real "research," paid for by the federal government, that is, US).
When I was a kid, we didn't go to the ER unless we were bleeding (profusely) or blue--and the doctors who worked in that ER expected to see actual emergencies. The world has changed, obviously.
So, yes, while I hate to think of the effect on all the employees, should NRMC close, at the same time I think, well, you can't expect people to pay a C-note for a Snickers bar, forever and ever.
Maybe when that walking Jesus dude left town he took the profits from NRMC with him.
beammeups, I believe that the profitable part of Natchez left long ago, along with many industries that had health insurance for their workers. Now, many of the people at NRMC are either geriatric or young children. What does that mean, the same for both...either Medicaid or Medicare, a government program and more paperwork than 10 people can do to get a payment. The other patients are the few in the middle, the working class poor, who have meager jobs(all that seems to be left in Natchez) who have to choose between paying the hospital $25 for a tylenol on their bill, or eating next week for the whole family. The problem goes back to a simple theme. If people had decent paying jobs and health insurance, NMRC would not be in this shape it is in today. I know there may be some mismanagement, but there was always some even when they were getting insurance checks in from the workers at Armstrong, IP, Diamond International, and Johns-Mansville.
There is enough blame in this situation to spread around. There is a mentality that a Medicare or Medicaid card give the holder carte blanc to visit the ER for any problem. Also, there are individuals who have no physician and use the emergency room as a doctor's office. There is a belief that government subsidized health care is free. I don't know about you, but I learned a long time ago that NOTHING is free. Eventually someone has to pay. In this case it is NRMC and the citizens of Adams county. Like it or not, a hospital is a business. NRMC has made poor business decisions. When the economy changes, for better or worse, a business must change its operations in order to survive. Blaming the mangement company will only get you so far. The board of NRMC shares the responsibility, though I have yet to see them own up to it.
Tellmestraight,
The board is never going to own up to it's involvement in this fiasco. They should have seen this coming for months. They fired the CFO because he was supposedly “cooking the Books”, but Wesselman who was the former CFO, and is all about numbers and figures didn’t know what was going on? Come on, there is more duplicity on that board and the top administration than meets the eye. If the Board of Supervisors wants to do the right thing, they should dissolve this board, appoint a new one with the provision that some of the present members who apparently were out of the loop, could be reappointed.
Now Walter Brown in the article this morning (surprisingly it doesn’t appear on the Natchez Democrat website, so alas no comments can be made!!), has stated that he is going before the Board of Supervisors to ask for the millage increase to help bail out the hospital. I hope that the Supervisors should they agree to this decision , also includes an oversight proviso which would require the hospital board of trustees to report to the Supervisors on every decision that is even remotely financial. This is going to be a difficult decision for the Supervisors. They are going to be faced with making a decision that is certain to be very, very unpopular with the property owners in Adams County, should they approve the millage increase. On the other hand they are faced with the eminent closure of NRMC should they vote no to the millage increase. Voting no would probably kill the deal with the local banks for a “bridge” loan to help carry the hospital until tax revenues start to come in. The Supervisors are in a loose-loose situation no matter how they vote. In and attempt to avoid micromanaging the hospital, they have let the present board of trustees and administration make a real hash of things, now they are being called on to come in and clean up the mess.
wood duck,
This has been years in the making. Regardless of the management source, (a management firm or board management)
NRMC has been inefficiently run. In the past, they were able to cover their losses because reimbursements were higher and the business environment was better (more privately insured patients. The days of Regional being a cash cow have been over for years--decades actually. The board has been oblivious to this fact until now. That is assuming they get it now. Considering their "Oh my goodness! How did this happen?" attitude, that may be a rather large assumption.
tellmestraight and woodduck,
Everyone in the administration and the Board have to take resposibility. The hospital financial situation has been bad for many years. The hospital survived on loaned money for the last year. When Jack Houghton left, the CFO, who was thought to be numbers guy and a wizard was made the CEO. The man could be good in numbers, but, he has no management skills and made poor decisions and misinformed the board of the hospital situation. The Hospital Board is not involved with day to day activities of the Hospital, it relies on the CEO to give an honest feedback. The CEO and the Chairman of the Board (who thinks he owns the hospital) both of whom have no health care management experience and have made blunders. For example, we have paid our cath lab director, a radiology tech, over $130K per year for the last 4 years when compared to what St Dominic's hospital pays, where cath lab director gets paid $70K and runs 5 cath labs. The CEO Mr Wesselman said did not know about this till 2 weeks ago. Our chairman Mr Bland said last week that we did not have a cardiologist in our town and that was the reason why we had to let a cardiac nurse go. My Cardiologist, Dr Dulam, has been treating me for the last 5 years and he goes to both NRMC and NCH and the person layed off was the cathlab director, a radiology tech and not a cardiology nurse. This is how misleading and mis-informative this management is.
The bottomline is, no tax increase is a permanent solution to this problem until we change the hospital administation and bring in someone who has healthcare management experience. That's where we should be spending our time and energy. The board will always be a supervisory body. The Board has to really pay attention to where the money is coming from and where and how it is going.
I cannot believe how NRMC has been run without the community knowing. No tax increase can bring the hospital back to the point where it was when Mr. Mitchell was in charge. In 1992, when Mr. Mitchell was "forced" to resign/retire, there was several several million dollars in the bank and the hospital was highly ranked in the state by Medicare. How do you screw things up to this point except by poor management and horendous decision making by the board and management company! To remotely have a hope of seeing the light at the end of the tunnel - you might want to see what Mr. Mitchell has to say?
Well, so much for NRMC learning from their mistakes! After getting themselves
up to their (excuse me, our) eyeballs in debt, guess what they have done! Well,
gone right out and signed a contract with another physician! Yes, folks, that's
right! With their backs up against the preverbial wall they went right out and
did it again! This time it's a cardiologist in his 50s who just happened to be
in town today. If it weren't in our little community it would be laughable.
Instead it screams of the gross incompetance of our esteemed hospital board.
Rather than utilizing the services of the cardiologist already in practice here,
they just couldn't resist the urge to go out and spend more money that they
(excuse me again, we) don't have! Just how long do you think he might stick
around? Long enough to complete his contract and collect those nice paychecks
for just being in town? What about the patients
Regional manages to funnel into his practice? What happens to them when he's
done his time here and moves on to the next town with a fat yearly contract?
It's one thing to buy out practices of established physicians, at least you are
relatively assured they'll be around for some time. With an older, out of town
doc, there's no reason to believe he'll stay here long enough to unpack his
diplomas, much less put down roots! You know the old saying "you can't teach an
old dog new tricks", well, I guess our old dogs can't get even get their old
tricks right.
I just hope we don't take advice from people who dont't know the facts. I'm a heart patient. I don't want to die in route to another hospital because our heart lab is closed or because the only cardiologist in town refuses to do caths here. You people better wake up! We need to take advantage of the resources we have in place already.
non-profits don't have to pay taxes, do they? hmmm, but they can still charge patients for care! sounds like a conspiracy to me.
and might I add; that while it was proposed that Natchez citizens be given an increase in taxes, it has also been proposed that Natchez Regional become non-profit and stop having to pay taxes...
Three weeks ago Julie? This has been going on far longer than that. They have reorganized, re-this, re-that for several years now. Outsourcing management of the emergency room. Changing management at the top. on and on and on.
I see so called ER patients mostly young kids running around in the ER with a band on their wrist,jumping around,giggling and mostly making noise.
Every time a kid has a little fever he,s rushed to the ER
and they give him some tylenol to bring it down, but that cost prob $1,500, when the parent could do the same at home. Medicare is sorely abused in this area, when most folks go to the ER sick,they sit very still and either moan or they hang their heads low from being in so much pain or from having the flu or a bad virus. They don,t run around causing havoc and making a lot of noise if they are sick. One of the staff that has been around for a long time said it goes on constantly.
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