Tag Archives: hospitals

Sen. Yager: State law not followed in closing Scott County hospital

News release via Senate Republican Caucus
(NASHVILLE) – State Senator Ken Yager (R-Kingston) said today he has contacted the Tennessee Department of Labor and Workforce Development, the Tennessee Health Licensure and Regulation Office, and the Health Services and Development Agency in regards to enforcing state law and licensure requirements regarding the notification of closure of Pioneer Community Hospital of Scott. The action came after Pioneer employees found out on June 16 that their jobs would end in ten days when the facility is closed. Yager said this runs afoul of state law and licensing requirements.

“I have contacted Ann Rutherford Reed, who is Director of Licensure Division of Health Licensure and Regulation Office of Health Care Facilities; so that our state law is followed,” said Senator Yager. The state of Tennessee and these employees were not given proper notice. It is hard enough to find out about losing your job. Not having adequate notice makes that loss even more difficult. My focus right now is to see that these employees are treated fairly.”

Under the state’s Certificate of Need (CON) requirements, Yager said notice is required before any critical access hospital can be closed. He requested Director Reed enforce this provision against Pioneer, telling her “a 10-day notice is totally inadequate and contrary to your policy.”
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Scott County’s only hospital files notice of closing

Pioneer Health Services has notified the State of Tennessee that it could potentially close its Scott County hospital although local administrators remain hopeful that the worst-case scenario will not pan out, reports the Oneida Independent Herald.

The Magee, Miss.-based corporation filed its 30-day notice with the state last week, as required by law. Tony Taylor, CEO of Pioneer Community Hospital of Scott, said his managers learned of the development Tuesday morning.

…Taylor, who has been chief administrator at the local hospital since Pioneer opened the facility in 2012, said the notice is not a guarantee that the the hospital will close.

“This is just a way of them fulfilling their obligation of notice,” Taylor said. “After June 26, they could close the hospital, if they chose to do so.”

PHS is currently restructuring, two months after filing for Chapter 11 bankruptcy protection. As part of that bankruptcy filing, PHS closed its MedSurge program at the Scott County facility, ending inpatient services while keeping all outpatient services — including surgery, physical therapy and diagnostics, among others — along with its emergency room.

Reportedly, PHS has been willing to entertain offers to sell the Scott County hospital. It is not known whether the corporation has been able to attract potential suitors.

Taylor said Pioneer has put no timeline on the hospital’s future.

…If the hospital closed, ownership of the real estate would revert to Scott County. The county is currently in the midst of a 10-year contract with Pioneer that requires the facility — ownership of which was transferred to Pioneer in 2012 at no cost — to be operated as a hospital or be returned to the county.

However, that, too, could be complicated. First National Bank currently has a lien on the property after Pioneer borrowed $400,000 for improvements in 2015. The Internal Revenue Service has also filed a separate $500,000 tax lien on the property due to back taxes owed by the corporation.

Former GOP leader/lobbyist leads new Insure TN promotional campaign

The Tennessee Hospital Association earlier this year formed a spinoff group – named Tennesseans for a Responsible Future — to promote Gov. Bill Haslam’s Insure Tennessee proposal, a Medicaid expansion move that failed in the 2015 legislative session. Now, the group has chosen Adam Nickas, a former political operative for the state Republican party and more recently a lobbyist, as executive director.

Here’s the press release from Tennesseans for a Responsible Future:
NASHVILLE, Tenn. – Today, Tennesseans for a Responsible Future (TRF) announced Adam Nickas as Executive Director. A Nashville resident and Memphis-area native, Nickas served as Executive Director of the Tennessee Republican Party during the 2012 election cycle and Political Director during the 2010 cycle. TRF was launched in January 2016 with the goal of promoting healthcare policies that benefit Tennesseans.
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State questions merger of Northeast TN hospital chains

The state Department of Health is questioning plans for the merger of Mountain States Health Alliance and Wellmont Health System in Northeast Tennessee, reports the Johnson City Press.

The department is asking the systems for more information about such issues as finances, public impact, competition and workforce consequences. In a letter dated March 28 and posted Thursday on the department’s website, Commissioner John J. Dreyzehner cited several deficiencies in the joint COPA (certificate of public advantage) application, including the lack of a separation plan in the event of failure.

“The department’s requirement for a plan of separation is to specifically ensure that if a COPA is issued and the New Health System (as defined in the application) fails to live up to the promised commitments and understanding reached by the department and the parties, the department may terminate the COPA and require a clear plan of action to return the parties to a pre-consolidation state,” Dreyzehner wrote. “The minimal framework presented in the application does not provide the level of detail necessary to meet the department’s requirement to outline a clear, actionable plan to separate a merged entity.”

On Feb. 16, the leaders of the nonprofit health organizations submitted thousands of pages of documents to state regulators asking for a COPA from Tennessee and a letter authorizing a cooperative agreement from Virginia. The applications kicked off a review process in both states — at least 120 days in Tennessee and 150 in Virginia — giving the health officials time to ponder the proposals before making final determinations, which the systems hope will be made in their favor this fall.

Asked for comment regarding the COPA letter, Mountain States and Wellmont issued a joint statement saying ongoing dialogue with both Virginia and Tennessee is an expected and welcome part of the application review process.

…Should regulatory approval be granted, the merged system would operate 19 hospitals, dominating the inpatient care system locally, and is expected to to reach $2 billion in annual revenues in two years, according to a budget included in the applications.

Hospitals plan post-election push for Insure Tennessee

By Eric Schelzig, Associated Press
NASHVILLE, Tenn. — The Tennessee Hospital Association, a key supporter of Republican Gov. Bill Haslam’s unsuccessful effort to expand Medicaid in the state, is planning a new push to pass the measure once this year’s presidential election is over.

The members of the hospital group had pledged to cover the entire $74 million state share of Haslam’s Insure Tennessee proposal, which would have drawn down $2.8 billion in federal Medicaid funds over two years.

But Republican lawmakers rejected Haslam’s plan last year amid fears that it was too closely linked to President Barack Obama’s signature health care law.

THA President Craig Becker said the group is spending about $400,000 to found a nonprofit called Tennesseans for a Responsible Future that is aimed at gathering support for passing the measure once Obama leaves office next year.

“It really is to kind of offset some of the misconceptions and certainly to educate our legislators to what Insure Tennessee is and what it isn’t,” Becker said. “And what it isn’t is Obamacare.”
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Senators study CON reform, make no recommendations

A study committee set up by the Senate Commerce Committee, chaired by Sen. Todd Gardenhire, met Monday to hear testimony on whether to continue Tennessee’s “certificate of need” program, which requires a state agency’s approval prior to major new expansions of health care facilities. There were some calls for repeal of the CON process, but more calls to keep it in place — perhaps with some changes or new exemptions in some areas.

From The Tennessean report:

Lawmakers probably will take up efforts to reform laws governing patient amenities, such as upgrades to waiting rooms, and capital thresholds as well as some clinical specialties that could be removed from the certificate of need regulations.

“We’ve got to find those very specific clinical scenarios where the certificate of need provides a clinical protection for the patient — and then we’ll still stand on that,” said Sen. Mark Green, M.D. “I think you’ll see anywhere there’s a number we’re going to bring it to today’s inflation adjusted amount.”

Tennessee is one of 36 states, including Washington, D.C., with a certificate of need program. It has one of the heftiest CON programs with 20 laws. In Tennessee, health care providers apply with the Health Services and Development Agency for a certificate of need to build facilities or expand into new services.

Certificate of need programs are seen by many as a way to ensure health care providers provide charity care and to control the build-out of the industry.

Voices for significant reform of the programs, including the Beacon Center of Tennessee, argue that the programs keep costs high through increased regulation, which stymies competition.

“I want to see why there’s so much opposition to lowering the cost of health care and why there’s so much support for protecting the status quo,” Gardenhire said before the hearing.

Representatives of HCA, HSDA, Tennessee Hospice Organization, Tennessee Public Teaching Hospital Association and Vanderbilt University Medical Center addressed how the program gives structure to the health care system around the state and some areas that could be improved.

VUMC would like to see “modernization” of the CON rules on patient amenities and the threshold that is required to file for approval for a project, said Clisby Hall, senior adviser of health policy.

…Gardenhire was disappointed that most of the speakers, and hearing attendees, were “here to protect the status quo” and did not bring lists of areas where they want reform. He plans to meet in the coming months with those who want to help rethink the certificate of need.

“I’m going to pin them down,” Gardenhire said.

St. Jude’s hospital asks Haslam for state aid

Leaders of St. Jude Children’s Research Hospital met with Gov. Bill Haslam Wednesday and asked for state help in its multi-million dollar expansion plans, reports the Commercial Appeal.

“They would like us to have some sort of skin in the game with them,” Haslam told The Commercial Appeal Thursday. “I’m sure the city and the county, too. I don’t know yet what that will look like. We’re not that far down the road.”

Haslam characterized the meeting as largely informational and preliminary as it concerned the high-profile children’s cancer hospital’s expansion plans, which are large in scope. Haslam wouldn’t name who participated in the meeting, but added, smiling, “there were a few Memphis citizens there.”

In recent interviews, St. Jude officials have characterized the expansion plans in the hundreds of millions of dollars.

… Memphis Mayor A C Wharton said he wasn’t privy to the details of Wednesday’s meeting and that St. Jude has made no requests of the city for financial assistance. “I will simply say that I am quite aware of St. Jude’s plans for their campus and that those plans mesh well with the city’s overall view of what needs to occur around their campus and the whole north end,” Wharton said. “We’re supportive and look forward to working with them.”

Shelby County Mayor Mark Luttrell said that while he was aware of the hospital’s expansion plans, “there have not been any discussions within my office with St. Jude,” he said, regarding the potential “help” Haslam was referencing.

“I would welcome a discussion with them. … They’re certainly a valuable asset,” he said.

Feds eye cut to TN hospital funding; Haslam laments ‘heavy-handed’ tactic

The federal government is reviewing the funding provided to subsidize hospital care for low-income people in Tennessee and some other states that have not approved Medicaid expansion. Gov. Bill Haslam says that seems like a threat — the implication being funding should be curtailed with Medicaid expansion, has the governor proposed with the Insure Tennessee plan defeated in the Legislature.

“The way they’re approaching this feels awfully heavy handed: OK, well if you don’t do that, then we’re going to restrict the pool of money that we give you for indigent care,” Haslam told reporters Thursday.

Federal officials recently reached out to several states about reducing the amount of federal money that goes toward uncompensated care, or care provided to uninsured people who can’t pay for it. The officials also contacted Arizona, California, Florida, Hawaii, Kansas, Massachusetts, New Mexico and Texas. Florida, Kansas, Texas and Tennessee have not expanded Medicaid.

Ben Wakana, spokesman for the U.S. Department of Health and Human Services, told The Tennessean that a state’s decision on Medicaid expansion will be one factor the agency considers in the review.

In theory, a state that expanded Medicaid would need less federal money to cover people who don’t have insurance because more people would be covered.

Haslam tried to implement Insure Tennessee, a health insurance expansion program that uses federal Medicaid funding. But the General Assembly rejected the plan twice, and the prospect of it passing in future sessions is still unknown.

Tennessee receives half a billion dollars in federal funds every year to help hospitals with uncompensated care, with several state sources adding another $250 million.

In Tennessee, many hospitals pay a voluntary tax to also help cover the costs of uncompensated care. That money is in addition to the $750 million that comes from federal and local sources.

If the federal funding is allowed to end, the assessment will end as well, leaving hospitals with a large hole in funding charity care, said Craig Becker, president of the Tennessee Hospital Association.

That still doesn’t cover all the uncompensated care costs in the state. Tennessee hospitals provided $2 billion in charity care in 2013.

The talks with the federal government are in the early stages, and it’s preliminary to predict whether funding will be reduced. Funding for uncompensated care would be part of the state’s negotiations with the federal government to extend its TennCare agreement, said Sarah Tanksley, spokeswoman for the state Health Care Finance and Administration agency.

Congress approves bill that will send more fed money to TN hospitals

A bill that would give Tennessee hospitals and community centers more than a half-billion dollars from the federal government over the next decade is awaiting President Barack Obama’s signature, reports Michael Collins.

The U.S. Senate voted 92-8 Tuesday night to approve the measure, which was part of a broader Medicare-reform bill.

The legislation will send $53 million in Medicaid disproportionate share hospital, or DSH, payments to Tennessee hospitals each year for the next 10 years to help them recover the cost of treating patients who cannot afford to pay.

Tennessee is the only state that doesn’t automatically receive the payments every year. Tennessee hospitals gave up their automatic annual allotment of the funds in 1994 when the state created TennCare, the state’s version of Medicaid, because they thought the loss would be offset by new patients who could afford to pay.

In recent years, Tennessee hospitals have been able to receive Medicaid DSH payments through a temporary provision that had to be renewed every one or two years. The legislation, negotiated by members of the state’s congressional delegation, will keep the funding flowing into the state for a decade.

Further, from the Times-Free Press:

“This doesn’t take the sting out of Insure Tennessee, but it’s still a major victory for Tennessee hospitals,” said Craig Becker, president of the Tennessee Hospital Association.

For many safety-net hospitals in Tennessee, the funding “can mean the difference between them having anything on their bottom line or being in the negative,” Becker explained. “For some of our smaller rural hospitals it can mean keeping their doors open.”

House OKs renewal of hospital fee to draw fed money (sorta like Insure TN?)

NASHVILLE, Tenn. (AP) — The state House has voted 90-2 to approve an annual $450 million assessment on Tennessee hospitals to draw down $826 million in federal money.

Democrats were quick to point out that the about 2-to-1 match rate pales in comparison to vastly more favorable rate the state would have received if lawmakers approved Gov. Bill Haslam’s Insure Tennessee proposal.

Under Haslam’s plan, hospitals would have covered the $74 million state share to draw down $2.8 billion in federal Medicaid funds to cover more than 280,000 low-income Tennesseans.

But two efforts to pass Haslam’s proposal were killed by lawmakers wary of tapping into the Medicaid expansion element of President Barack Obama’s health care law.

The Senate Finance Committee voted 9-0 on Monday to send the hospital fee to a full floor vote.