Posted by dangyankee (anonymous) on March 2, 2008 at 1:05 a.m. (Suggest removal)

Agreed, Mr. Cooper--let NRMC die. We can't afford to keep it, so let it die, just like IP and Johns Manville, etc.

In the long run it likely does not matter.

Has anyone here heard of John Donne? I'm just asking.

Posted by speakeasy (anonymous) on March 2, 2008 at 6:03 a.m. (Suggest removal)

Yes, I'm familiar with John Donne, the English poet.

NRMC is, quite frankly, terrifying. I've heard of so many, sometimes critically ill, waiting for hours before they receive the necessary medical attention. Something needs to be done. How can we be expected to lure retirees here when our medical situation is so deplorable.

Something drastic needs to happen at that hospital. Perhaps it needs to be removed from politically- appointed oversight. Over the years hasn't Natchez Community/Humana/etc. tried to buy it?

Posted by shedevil (anonymous) on March 2, 2008 at 6:33 a.m. (Suggest removal)

first ...we dont need to lure retirees to natchez...we need business moving here.businesses pay property tax where retirees dont.i think they should sell the hospital..the taxpayers shouldnt have to foot the bill of a hospital that most of us dont use....kinda like the public school system

Posted by gemccull (Gary McCullars) on March 2, 2008 at 7:15 a.m. (Suggest removal)

(And, in the grand scheme of things, the debt it carries is small potatoes compared to the revenue it generates. For a business that books $113 million in revenue, the $25 million in total debt seems small.

To put that in perspective, consider a family who makes a combined total of $113,000 a year and has a house and two car notes to pay. Their debt-to-income ratio likely far exceeds that of Natchez Regional’s.)

The flaw with this analogy is that $113,000,000 is revenue not income. So to be accurate with the analogy, what is/was the income for the hospital. Now, divide the income by the debt.

I look at debt load as a percentage of income. Total montly loan payments divided by monthly income. Generally, 25% to 33% is considered a heavy debt load for individuals.

If you look at $25,000,000 debt for the hospital, I do not know the details for debt payments or the income so I cannot calculate a %. However, I would think there is some rule of thumb for the maximum %.

Posted by nowHEARthis (anonymous) on March 2, 2008 at 8:25 a.m. (Suggest removal)

Remember the hospital is the largest employer in the county. What is going to happen when it closes and what overall effect it will have on the local economy. It is not as easy as closing the doors what happens to the town after that $600,000 a month is suddenly taken out of the local economy - not to mention the other dollars (suppliers, etc.) that factor in.

All of these armchair leaders who just want to turn out the light, think it is so easy - try getting rid of half of the nurses and doctors in town and start to think about how it will affect every aspect of our lives. I personally know of two private schools who are struggling to stay open (ACCS, Trinity) that will be directly affected. I am sure there are many other areas of the economy that will be affected as well.

Posted by gemccull (Gary McCullars) on March 2, 2008 at 9:26 a.m. (Suggest removal)

The hospital will not be closed!

Any talk of a closure is a knee jerk reaction. A knee jerk reaction is used sometimes to get attention. Lord, we need some attention for the woes at the hospital.

I feel confident that our elected will come up with a solution. It will take some time to work out the kinks/details.

Posted by NatchezEnema (anonymous) on March 2, 2008 at 11:05 a.m. (Suggest removal)

No. The hospital is not one of the largest, first you have the Natachez Adams school district, that is in a mess, then you have the blood sucking Natchez goverment that is in a mess, then you have the hospital, isle of capri and a few others. If you think they will raise taxes and then roll them back a year later you are the same person that thought the convention center was going to be the savior of downtown Natchez. Let this white elephant go! or, show me a scientific study why it needs to be here and how IT can pay for IT'S mistakes before you raise my taxes!

Posted by getrealnatchez (anonymous) on March 2, 2008 at 11:09 a.m. (Suggest removal)

Dear Kevin,
“Curing hospital woes won’t come easy”, but there is a cure. You have analyzed the current situation well. It is an arms race and NRMC has failed miserably. No solutions is a quick fix, but let’s logically analyze the situation. Why are NCH and river park so successful. NCH owned by HMA are for profit hospital. They know healthcare is a business. They provide and train their administrators to be excellent health care managers. Today’s healthcare business is a complex business, that is very competitive. This is the only business where one provides care and gets paid a few months later, if lucky at a discounted rate. There are several components involved, like the patient, the doctor, the health insurance company and the hospital administration. The insured patient population is dwindling in Natchez and the uninsured have been the even. It costs the hospital few thousand dollars to maintain an ICU bed. Most of the insured patients are usually shipped out of town by our doctors as they do not want to take care of really sick patients or patients themselves want to go to bigger cities as they feel they get better quality care. All we are left most of the time in the ICU are the uninsured, which costs the hospital a lot of money. (Not because of a sick child with a runny nose –as someone was mentioning before). The uninsured somehow think that Uncle Sam is going to pay their bills. Majority of doctors take care of patients and are very poor businessman. contined

Posted by getrealnatchez (anonymous) on March 2, 2008 at 11:10 a.m. (Suggest removal)

continued
They are not trained in business and fail to understand ever changing healthcare business. Then come the insurance companies who find every way possible not to pay for the services provided. They only know to cut reimbursements. The hospital administration has to keep up with every changing insurance company policies to get paid. Then, come the administrators who need to have substantial understanding of healthcare business and have phenomenal healthcare management skills, which are both lacking in the administration of NRMC. For example, we all (including NRMC and NCH) sulked and cried when Riverpark opened and said that it was taking our surgical volume away. It is only NCH administration, who went back to the drawing board and realized that the largest admitters of patients to the hospitals in town and doctors with largest practices are the doctors at Riverpark. They reached out and partnered with them and have made their health care business very successful. It has been a win-win situation to both entities, while we still are in the blame game without making constructive changes to turn the tide. NRMC partnered with doctors who do not admit patients to the hospital, rather ship their patients immediately when they are really sick. They have a build a bridge to draw patients away form the hospital rather than to the hospital. We have an afterhours clinic right in front of our ER. The insured patients go there and NRMC is left with the uninsured. We gave them the land on lease and don’t even have a share in the clinic.
It’s about time the administration and the Board wake up to reality. This shrinking pie has to be shared. You are only going to get a piece if you are good. Increase in taxes is only a band aid. Come up with real solutions. Partner with every one involved in this business or perish. We need the entire NRMC administration and the Board to change that’s when we can hope to win this arm’s race. Get real Natchez.

Posted by woodduck (anonymous) on March 2, 2008 at 11:11 a.m. (Suggest removal)

I don’t think that closing NRMC would be in the best interests of the citizens of Adams county and the surrounding counties/parishes. As someone mentioned above, a takeover by a strong Private/non profit who would be willing to spend the money to also buy out NCH would be the “Dream” scenario. Unfortunately, most of the really strong big Private/non profits such as St. Dominic, Baptist or Lady of the Lake have shown very little interest in this area. It’s too far from the “mothership” to expect a lot of referrals, and it is in and area with a growing indigent population and shrinking economic base.

The biggest problem facing us now is how do you keep it open until any of the proposed changes can come to fruition? NRMC is drowning in debt. Everyone who works at NRMC is almost in a state of panic. Talk of closure, layoffs, reduced salaries/hours is destroying the morale at NRMC. It is a known fact that they have had a real problem meeting payroll for the past several pay periods. Administration is shifting money around, trying to plug the leaks. Vendors are not paid, so they quit shipping supplies. But if the vendors are paid, the payroll checks will “bounce” So it is a viscous cycle that cannot continue indefinitely.
The board of trustees are going to ask the county for a 5 mill. Increase in our property taxes. It was said that this would raise about 1 million dollars. That will cover less than 2 pay periods of salary. The vendors are still unpaid, and in 3-4 weeks we have used up the tax money and we are still in the same dilemma. If you cut services, you cut revenue. And where do you cut? ER, OB,OR ? I’m not sure you could cut out your ER and still maintain JCAHA accreditation, which is necessary to qualify for Medicare/Medicaid reimbursement. Close OB? Probably not a good choice as it would send all the OB doctors to the NCH. You couldn’t expect them to come to NRMC for their elective surgery cases if they can’t deliver babies at NRMC. Why do you think NCH put in an OB dept? To get the surgery that goes along with OB. Close OR? The only sure money maker in any hospital is the OR. Worst place to close of any of the choices.

Posted by woodduck (anonymous) on March 2, 2008 at 11:25 a.m. (Suggest removal)

(More)
Here are some viable choices.
Hire an administrator with proven hospital management credentials.
Make the Hospital board of trustees accountable to and required to report regularly to the Board of Supervisors. That way they don’t get blindsided next time there is a problem.
Close the cath lab, and try to sell the equipment, raise a little cash.
Cancel the contracts of all 5 of the family practice physicians who are not returning even a small percentage of what they are costing. Make any future contracts performance based. It would be nice to be able to return to the old way where a new physician got a little help like rent subsidies or a loan for equipment to help set up his practice. Unfortunately, the Genie is out the bottle, and we probably will never be able to return to those old parameters.
Cancel the contract with the Medical office building. NRMC doesn’t have the luxury of subsidizing that building by renting out an entire floor. If the family practice folks want to stay, they can rent their own offices from the Building corporation.
Get the billing department off their duffs and start collecting aggressively, start with getting the bills submitted to the carriers correctly so they don't have to be submitted 2-3 times before they are paid. Revise the patient ID's so every bill for a particular patient is entered with the same HO number. Make it less confusing for folks who want to pay their bills, and for those who won't turn them over to collections after 90 days. Lets start running it like a business.

Posted by NatchezEnema (anonymous) on March 2, 2008 at 11:44 a.m. (Suggest removal)

How many beds does this hospital have? and how many are on each floor?

Posted by getrealnatchez (anonymous) on March 2, 2008 at 12:46 p.m. (Suggest removal)

NRMC has a total of over 110 beds. Of which there are 8 ICU beds and 8 telemetry beds, rest of them are on the floors.
NCH has a total of approximately 70 beds (realistic and usable), although they claim to have close to 100. They have 5 ICU beds and out of the 70 beds they have 30 beds that have telemetry capability. NCH is a much smaller hospital than NRMC.

Posted by NatchezEnema (anonymous) on March 2, 2008 at 1:58 p.m. (Suggest removal)

Out of all the beds in both hospitals how many are being used RIGHT NOW. Or how many are being used RIGHT NOW at NRMC. When was the last time all the beds at NRMC were full or near it. If never we don't need it. If you have one child and were in the market to buy a house would you go out looking for a 4 bedroom house? Wait, no how about a 7 bedroom house with 4 baths. Of course not you don't need it! Vicksburg is much bigger than Natchez with interstate, larger population, and I'm sure more uninsured and they have only one. Go figure! It's a lot like the Natchez Convention center. I know people that work there and it has NEVER been used to it's max or near it. And the cost has been hell to pay for the tax payer. I hear a lot of people trying to justify why we need 2 hospitals in these posts, and I find nowhere anything that convinces me why we do. The city and it's former attorney are trying to find ways to pay for this grossly mis managed debacle and justify Natchez needing it. Sounds like a lot of the same hype when they were justifying that Natchez needed a convention center to "grow tourism" or a new tax to advertise to "grow tourism". I don't trust any of them anymore. These people must think Natchez is Miami or something. Where do they think the money comes from. They are still in the mindset as if IP,Armstrong, or Johns Manville is still open. They could get away with no accountability back then when the money was flush, NOT NOW. They are all in it for their self interests

Posted by woodduck (anonymous) on March 2, 2008 at 2:53 p.m. (Suggest removal)

NatchezEnema,
Suprisingly, the beds are full quite a bit of the time. Especially in the winter with more elderly folks who require hospital stays for flu, pneumonia, etc. There are also time when the ICU is full, telemetry is full and ER has patients holding there waiting for a bed. this isn't all the time, but it does happen often.
Vicksburg struggled with 2 hospitals for many years, with Vicksburg Hospital and Parkview. They had another problem that at least we don't have. Each hospital had a clinic and the Drs practiced almost exclusively at their hospital (Vicksburg Clinic at Vicksburg Hospital) Quite a bit of jealousy and animosity had to be overcome before they could finally get together and build a new state of the art hospital. I have been a strong believer in a one hospital system for years. When Natchez went through the "oil bust" in the early to mid 80's followed closely by Armstrong closing plus John's Mansville then IP, we should have seen the handwriting on the wall that with a shrinking tax base, declining population, demographic changes, we would have been better off with only one hospital.
Incidently, NRMC, the Natchez Public Schools,etc. are not the largest employer in Adams county, that distinction belongs to the Federal Govt. "Entitlement" payments are the biggest revenue source in this area!
Frankly, NCH is not big enough to handle the patient load.Were NRMC to be forced to close without some sort of contingency plan, we could very easily have a healthcare crisis in Natchez. They (NCH) would be overwelmed with patients, both in their ER and their patient care areas. They have 3 OR rooms NRMC has 5. Same with OB, they would be birthing babies in the hall for lack of birthing room space. Their ER is much smaller than NRMC's. No matter what your feelings about the hospitals whether or not you prefer NCH over NRMC or visa versa, it would not be in the best interest of the community to rush into something that we will all regret later. Just ask yourself the question, "suppose your child, wife, mother, father, or you were seriously hurt, and I mean life or death without rapid medical help, would you want to risk being in a situation where the ambulance that picked up your family member was diverted to Brookhaven or McComb because the OR at NCH was busting at the seams and they didn't have room for even one more patient? Does this sound farfetched, maybe, but it happens in busy inner city hospitals every day. Luckily, for them, it's usually just another few miles to another facility, not 60-70 miles. Food for thought?

Posted by ntzgrandmother (anonymous) on March 2, 2008 at 3:18 p.m. (Suggest removal)

I'm so sorry about the problem's NRMC are having .In all the trouble she is having now I still belive in her and our Leader's as a hold to see her though.I do hope this is an eye opener for our community on mental Illiness .You see we still have a choice we have other hosiptal's we can go to ,not so for this group of people most time jail cell's are there hospital room's with no medical care.when we see our way though this crisis please make room for this group of people.We try to belived sometime's that they are not human with the same need's that we have.They hurt big time with no place to go . YES, SOME DO NOT HAVE INSURANCE once you're diagnosied you cannot get insurance.I would love to share your thought's and true feeling good are bad on this issue.

Posted by NatchezEnema (anonymous) on March 2, 2008 at 5:18 p.m. (Suggest removal)

Well pretty full isn't going to get it. I have first hand knowledge that a lot of patients that are in the hospital for 2, 3, or 5 days didn't have to be there that long. When you come into either one instead of "what is wrong with you" it's "do you have insurance" and baby if you got it the flood gates will open! I know someone who had a mri for a STUMPED TOE! seriously! If you have insurance they will keep you there for as loooooong as possible to milk the insurance. I had a xray with no enhancement at humanna, it cost me 4200$! because I had good insurance. I went across the river and got a full blown mri for the same problem it cost me 1200$. When we had good jobs like I.P., Armstrong,Johns Manville even the broom pusher had an insurance card, now that those people are gone the hospitals will bilk anybody with insurance as long as possible. If you think they will let someone with no insurance lay in the bed as long as someone with it you have your head in the sand. Hospital motto "NO INSURANCE GET EM OUT AS SOON AS POSSIBLE/ INSURANCE, GIVE AS MANY TESTS AND KEEP THEM HERE LONG AS POSSIBLE"

Posted by snatchez (anonymous) on March 2, 2008 at 6:06 p.m. (Suggest removal)

you don't have to worry about a lot of tests at NRMC since most of the beds are taken by no paying people from vidalia, fayette, woodville, ferriday, etc.
If you are sick, the ER is full of people who think regional is a charity hospital.
Now for the real problem, no money and employees who have retirement both from the state and social security. free dental and health. Probably 20% in benefits for each employee.

Posted by seakmr (anonymous) on March 2, 2008 at 7:03 p.m. (Suggest removal)

snatchez- I corrected you the other day on this, now get it right. NRMC employees DO NOT get FREE dental OR FREE health insurance. I know this for a fact because I pay $113 every paycheck which equals $226 per month or sometimes more JUST for health insurance for my entire family. Dental is extra if you want it. Nothing is free for employees of NRMC. We have to buy our food in the cafeteria just like everyone else with a slight discount (10%), so basically that comes down to not paying sales tax. As for the retirement, we put in 7% of our own money. The hospital puts in 11%. We work hard for this money and rarely get raises. I work with one nurse who has been here for almost 25 years and she barely makes more than me. So don't you think we deserve some type of reward/benefit for saving lives? It sounds as though you are hung up on this retirement issue. Am I sensing some sort of jealousy?

Posted by topper (anonymous) on March 2, 2008 at 7:26 p.m. (Suggest removal)

All keep saying NRMC is full of no pay. I can assure you both hospital have more than there fair share of non paying patients. How come the other is not crying about debt. Management must be better at Community! you do not seeing them whinning about 7.5 million debt. They have to pay taxes too.

Posted by signmypaycheck (anonymous) on March 2, 2008 at 10:31 p.m. (Suggest removal)

It's easy to read through these blogs and tell the employees that have been living with and seeing the mismanagement for years from the "outsiders" that have opinions with not enough real information. Jefferson Davis Memorial Hospital (NRMC) was run at one time by a man that cared about doing things the right way. It was his town and his hospital and he was not governed by a management company. Our Quorum CEO's are all temporary Natchez citizens. Quorum has no history or personal interest in the success of Natchez Regional period. They are in business to make money....for themselves, not Natchez Regional. The community has to understand that NRMC and the management company Quorum are two different things. Natchez Regional is the hospital that has delivered your babies and taken care of your children, recieved your loved ones in the emergency department and you have been glad they were there during these emergencies. Your neighbors and family members are employees of this hospital. . It is unimaginable to me to understand how people say "will they close" Explain how a 2 floor hospital can service our community alone? The "powers that be" over NRMC must watch closely! Would you still have a job 10-15 years later with the same company if you had only had one productive year? I think not! As far as paying or non paying patients...do you people know that these supplies and services used for these patients have to be paid for, and most want to know at discharge, what else do I get. Do you understand that you paying people have to pay for your services and they are not!!! This is robbing your hospital. I see a comment about the management at Community...do you know this is a for profit hospital....there are people that own this hospital...it is THEIR business....they make money....it goes in THEIR pockets....of course they manage it well....IT'S THEIR MONEY!!!!! The community needs to have faith in Natchez Regional. We can become the wonderful hospital that we used to be. We need just need someone that is dedicated to running a hospital that can and will provide safe, quality care to our community. Everyone needs to have some FAITH!

Posted by SayItRight (anonymous) on March 3, 2008 at 3:19 a.m. (Suggest removal)

There is no way NCH can handle the overflow if NRMC were to close. Talk about a mess. Lawsuits from the deadbeat "sniffles in the emergency room crowd" would be enough to start a spiral for them too, unless they found a way to make them pay or turn them away.

Posted by redusmfan (anonymous) on March 3, 2008 at 7:32 a.m. (Suggest removal)

Gary Mccullars,

I can not believe that you said the elected officials in Natchez and Adams County woul ddo the right thing....Are you serious?

I am worried that it will be another nail in the coffin of Natchez if it closes....

Posted by gemccull (Gary McCullars) on March 3, 2008 at 8:06 a.m. (Suggest removal)

redusmfan. I said, "I feel confident that our elected will come up with a solution. It will take some time to work out the kinks/details."

The statement may be a bit optimistic but the elected have their backs to the wall on this one. Closure is the last option and it would have adverse consequences on the area.

I did not say that the solution would be perfect or painless.

Posted by redusmfan (anonymous) on March 3, 2008 at 9:01 a.m. (Suggest removal)

It will not be painless. there will be many more heads to roll in this fiasco. and may mean the loss of several services in the hospital. It may even mean that many emergency room patients that do not have insurance or finacial means will have to be sent to UMMC in Jackson. This will cause an uproar in many people, but in the long run, it may save the hospital.

Posted by signmypaycheck (anonymous) on March 3, 2008 at 9:03 a.m. (Suggest removal)

Woodduck seems to be "right on" with info and suggestions...I vote for his/her ideas! Way to go!

Posted by lizzerrob (anonymous) on March 3, 2008 at 2:21 p.m. (Suggest removal)

Seems like everyone wants to admit there is a problem, but no one wants to take responsibility! I think that if the Supervisors, Board of Trustees and Quorom would have pulled their heads out of their backsides along time ago ... NRMC would not be in the boat that it is today. Mr. Mitchell held the hospital's reputation in the highest regard and put more blood sweat and tears into it than anyone else I have seen - literally. After 15 years, NRMC has basically flushed millions and millions and millions of revenue down the toilet and then wants to say no one is paying - wha wha wha! If it were runned the way that Mr. Mitchell was running it - then guess what none of you would be able to say a word except for the debate over politics - Now that was interesting thinking about what our choices are going to be after George W.

Posted by tellmestraight (anonymous) on March 3, 2008 at 8:37 p.m. (Suggest removal)

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.

Posted by texasranger (anonymous) on July 8, 2008 at 12:37 a.m. (Suggest removal)

We spent 3 million dollars on some people to investigate and tell us Natchez Regional was in bad debt and might have to go bankrupt. Why do all bodies of goverment spend monies after the horse gets out of the barn. Why didn,t they take the 3 million and apply it to the debts??
It,s not like they got in debt over the weekend and suddenly some mysterious being from outer space with a cosmic dust halo put them in debt with his magic wand. Everybody has to spend millions on all these committes,hogwash.....it,s a scam from the get go. It sounds good but it don,t wash.

Posted by texasranger (anonymous) on July 8, 2008 at 12:39 a.m. (Suggest removal)

Well make sure they pay for the babys.

Posted by texasranger (anonymous) on July 8, 2008 at 12:45 a.m. (Suggest removal)

Why and how did the hosptial get in such debt? Did the unpaid bills just wind up in the trash? Whoever manages the money should let us all know what was happening like a year ahead of time. They have sent me bills for $1.60 over the 40 some odd years i,ve been using the facility. I paid every bill. So somebody is not paying the bills and somebody is writing it off or letting them slide or just putting them in file 13, the big trash can outside the building or putting it in their pockets or the management is. The monies just didn,t get up and walk off.....