|Commissioners face fallout from hospital bankruptcy|
|Wednesday, 08 July 2009 00:00|
EMS Director Michael Medlock and John Winenger, representing Saint Vincent Health (SVH), addressed the Commissioners giving an update regarding an ongoing analysis of the ambulance service at the hospital. The service has been loosing money for some time and efforts are underway to determine how to operate it on a break even basis.
Several options were discussed including ways to increase the revenues generated by ambulance service. According to Medlock the EMS/ambulance service collects less than 40% of its costs from individuals using the service. Medlock gave the Commissioners an anecdotal explanation for that disparity.
“If we make a run for someone in the county having a diabetic reaction and once we get the patient stabilized,” explained Medlock, “the patient might refuse to be transported to the hospital for treatment. We have made the run in the ambulance but no billing is produced by the hospital since the patient was never admitted.”
In addition, Medlock said that the service is used for a lot of “freebies” like transporting nursing home patients or covering events like football games.
The county already pays $266,000 a year for ambulance service. According to Commissioner Lana Sullivan, the county is required to provide that service. Winenger suggested that even if every possible cost savings practice is put in place, the county will still need to provide additional funds just to break even.
One of the cost saving options being considered is to cut service from three ambulances on duty at all times to just two. According to Medlock most likely that would be the Pekin unit. Medlock was clear in emphasizing that if that option was initiated, Pekin would still have ambulance service, only it would originate from Salem. Medlock stated that the vast majority of EMS calls are in Salem and Washington Township which makes sense because that is the area of greatest population.
In addition to the financial information, Winenger told the Commissioners that SVH wants a separate corporation set up to run the ambulance service. Winenger explained that the new corporation would not be associated with the hospital because of profit and loss issues. Winenger went on to recommend that a management agreement be negotiated with a third party to run the ambulance service. He also recommended that the billing for EMS/ambulance service be bid out to a company specializing in that kind of work.
Continuing on the same theme and in response to questions from the public regarding the hospital, the Commissioners said they expect to be faced with making a difficult decision some time in the not-so-distant future regarding the hospital and its debt. Since the transfer of all assets and liabilities from Washington County Memorial Hospital (WCMH) to Critical Access Health Services (CAHS) in May, the county no longer has any financial liability for the hospital according to attorneys for both the county and the hospital. However, the Commissioners believe it is reasonable to expect the hospital will ask the county to pay some in not all of the reimbursement charges to Medicare for overstated expenses since 2006.
“We cannot let the hospital close.” said Commissioner John Mishler, “I fully expect that we (the county) may have to come up with a sizable amount of money in order to keep it open.
Several times over in recent weeks, representatives of SVH have gone on the record as saying that they do not intend to pay for “the sins of the past.”
Last month CAHS filled for Chapter 11 bankruptcy protection. The first hearing in that procedure is scheduled for July 29. Bankruptcy will, in some form or fashion, resolve the $12-$15 million in secured and unsecured debt owed by the hospital. However, the Medicare reimbursement estimated to be in the $1 million to $4 million range cannot be resolved through bankruptcy. Only negotiation with the federal government can determine how that is to be repaid. Without increasing taxes, the current $207,000 a year payment made to the hospital by the county could possibly be earmarked to repay Medicare. Depending on the final amount of reimbursement, it could take between five and twenty years to pay off the debt if the estimates are accurate.
When asked if elected county officials have given any consideration to holding the former WCMH Board of Trustee members personally liable for any debt the county might incur to keep the hospital open, County Attorney Tom Scifres was quick to advise the Commissioners not to respond to the question. The Commissioners heeded Scifres' advice and chose not to answer the question..
In other business, the Commissioners took the following action;
Discussion of methods to get a grant money for solving storm drainage problems in the Livonia area
Approval of plan for new building to house Blue River Services
Discussion of sequence in which grant requests would be submitted
Agreement to insert a request for $20K into proposed 2010 county budget for SOAR Adult Literacy Program
Discussion of Economic Development Strategic Plan being proposed by Washington County Growth Partnership, Washington County Chamber of Commerce and Washington County Tourism Board
Acceptance of a bid for a new riding mower for the fairgrounds from Salem Rental
Approval of contract for work of Bridge 113 in Fredricksburg in the amount of $117K
Updates on the Sparksville Road projectand the archaeological dig at the intersection of Highway 56 and the new truck by-pass east of Salem
With no further business to discuss, the Commissioners adjourned until their next regularly scheduled meeting on Wednesday, July 15.
|Last Updated on Wednesday, 08 July 2009 13:47|