Tag Archives: hospitals

TN ready for Ebola cases

NASHVILLE, Tenn. (AP) — Tennessee health care officials say they have implemented appropriate practices to handle any Ebola cases.

The Tennessee Hospital Association, Tennessee Medical Association and Tennessee Nurses Association issued a joint statement this week saying they’re on heightened awareness for anyone showing up in their emergency rooms and physicians’ offices who exhibit symptoms similar to the Ebola virus.

The groups say they’re working in concert with the Tennessee Department of Health, as well as appropriate federal agencies, to ensure appropriate protocols and policies are in place.

Earlier this month, Nashville-based HCA donated $1 million to the CDC Foundation to help support the international response to the Ebola epidemic.

Centers for Disease Control and Prevention Director Tom Frieden said the donation will help the agency scale and speed up its response to the epidemic in West Africa.

Michelle Obama visits St. Jude Children’s Hospital in Memphis (with transcript)

By Adrian Sainz, Associated Press
MEMPHIS, Tenn. — First lady Michelle Obama visited with young patients at St. Jude Children’s Research Hospital in Memphis on Wednesday, telling them she was inspired by their focus and courage as they battle life-threatening diseases.

Mrs. Obama was making her first visit to St. Jude as first lady, following in the footsteps of Nancy Reagan, Barbara Bush and Hillary Rodham Clinton. She chatted with the patients in an activity room and participated in a question and answer session.

The first lady’s plane was delayed by about 1 ½ hours due to a maintenance issue, but the children patiently waited for her, working on an art project.

St. Jude is considered a leading researcher of cancer and other life-threatening diseases that affect children. The hospital says it is working to increase the overall survival rate for childhood cancer to 90 percent in the next decade.

Families never receive a bill from St. Jude for treatment, travel, housing and food. Celebrities pass through the hospital on a regular basis to meet with patients.

Mrs. Obama said she was invited to St. Jude by actress Marlo Thomas, whose father, actor Danny Thomas, founded St. Jude.

The first lady sat at tables with the children, some of whom had shaved heads. She asked them how they were feeling, if they were being treated well at the hospital and if they liked sports.

She then took a seat at the front of the room and took questions from the curious kids, such as what is the best place she has visited: “That’s hard. I enjoyed meeting the Pope, visiting the Vatican”; what is her favorite sports team: “I love all of the Chicago teams”; and who is her favorite musical artist: “Everybody on the planet probably knows that Stevie Wonder is my favorite artist.”

One patient asked if she would take “selfies” with them.

“I don’t like selfies, but I’m going to do selfies for you guys,” she said. The children took pictures with her after the Q&A session.

Mrs. Obama said it felt special for her to be able to meet with the kids at St. Jude.

“Sometimes, living in the White House, and being married to the president, and trying to live a life like that, it can be hard,” she said. “But when I meet you guys, I am so inspired … You all are smart and you’re focused and you’re just so courageous.”

Note: The White House transcript of the the discussion is below.
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Fitch: Rejection of Medicaid expansion creating financial challenges

Hospitals in states that have chosen not to participate in expanded Medicaid eligibility under the Patient Protection and Affordable Care Act — such as Tennessee — are expected to face increasing financial challenges in 2014 and beyond, according to a Fitch Ratings report reviewed by the Nashville Business Journal.

Meanwhile, nonprofit hospitals and health care systems in states that have expanded their Medicaid coverage have begun to realize the benefit from increased insurance coverage, the ratings agency said.

Tennessee is one of 24 states that have so far refused to expand Medicaid, depriving at least 234,000 people across the state of health insurance coverage by 2016, according to a recent White House report.

According to the report from the Council of Economic Advisors, 5.2 million people have gained new insurance coverage through Medicaid or the Children’s Health Insurance Program in the 26 states (and the District of Columbia) that have participated in the expanded Medicaid eligibility under ACA.

For providers, the cumulative impact on revenue is substantial, Fitch said. States that participate in expanded Medicaid coverage will receive $83.6 billion in additional federal funding through 2016 while states opting out will be giving up more than $88 billion in that time.

Nashville HCA executive goes to work for veterans hospitals

The Veterans Administration has brought on a Nashville health care executive to help right the ship after a scandal over wait times, reports WPLN

Dr. Jonathan Perlin is taking a 60-day leave from his position as chief medical officer of HCA.

Perlin is no stranger to the VA. He previously served as VA under Secretary for Health. He returns as a special advisor to the acting VA chief.

A statement from the agency says he will be part of a team “accelerating access to care and rebuilding trust with veterans.”

While the VA is a massive bureaucracy, HCA is comparable in size. They both have roughly the same number of hospitals and clinics around the country.

Perlin’s pet issue is electronic health records and medication administration. Nashville Congressman Jim Cooper calls Perlin “extraordinary.”

Haywood County’s only hospital closing; lack of Medicaid expansion blamed

This week brings a sobering reality to those who thought Tennessee hospitals were crying wolf about how bad things could get if the state opted out of expanding Medicaid. The announced closure of Haywood Park hospital in West Tennessee may be just the first, according to the Tennessee Hospital Association, reports WPLN.

“We’ve seen this coming since the state decided not to do expansion,” says THA president Craig Becker. “We anticipate that there will be other hospitals that will be closing as well.”

THA hasn’t named names publicly. But it has said rural facilities are in a particular pinch. And the hospitals struggling the most sit in West Tennessee, which has been more economically stressed than the rest of the state.

Haywood Park was already in trouble, with a decline in patients from 1,300 in 2009 to fewer than 250 last year. The emergency room has been seeing just 15 patients a day on average.

“Rural hospitals such as Haywood Park are particularly impacted by new cuts in federal program reimbursement as part of the Affordable Care Act,” the hospital says in a written statement explaining its closure. “These cuts were based on more people having insurance, whether through Medicaid expansion or the insurance exchanges.”

See also the Commercial Appeal report. An excerpt:
Haywood Park has 62 beds and is owned by Community Health Systems Inc., a for-profit hospital company based in Franklin, Tenn., with 208 hospitals in 29 states. The Brownsville hospital was built in 1974 by Hospital Corp. of America, to replace a county-owned hospital built in 1931. Methodist Healthcare Memphis bought it in 1988, renovated and expanded it. CHS bought it in 2003.

…State House Democratic Minority Leader Craig Fitzhugh of Ripley, who represents Haywood County, blamed the closure on “indifference by Republican leadership” in the state. “For over a year now, we have warned this administration that refusing federal funds to expand Medicaid would result in the closure of our rural hospitals. It’s finally happened in Haywood County,” Fitzhugh said.

Federal waiver provides $80M to TN hospitals

NASHVILLE, Tenn. (AP) — Tennessee’s U.S. senators say they will continue to seek a permanent fix for the state’s financially struggling hospitals after they were granted a federal waiver that gives them $80 million.

Republican Sens. Lamar Alexander and Bob Corker announced this week that the Centers for Medicare and Medicaid Services issued a waiver that would allow a handful of hospitals in the state to receive payments for the services they provide to the poor and uninsured.

The waiver also adds Erlanger Medical Center in Chattanooga to the Public Hospital Supplemental Payment Pool, which includes $30 million of funding for the hospital.

The funding replaces federal dollars the state did not receive from another federal program after the formation of TennCare in 1994. TennCare is the state’s expanded Medicaid program that covers 1.2 million Tennesseans.

Tennessee is the only state in the country without guaranteed access to Medicaid’s disproportionate share hospital program, which gives hospitals funding based on the number of patients they serve who are uninsured or in poverty.

“There’s no reason in the world why Tennessee should be the only state without this kind of payment,” Alexander said. “I’ll continue to work with Senator Corker on a permanent solution.”

Hamilton County legislators bypass their county commission with Erlanger overhaul

Chattanooga area state senators and representatives have gone back to the drawing board on legislation they say is crucial for the survival of Erlanger Health Services, reports the Times-Free Press.

Unlike last year’s bill, which was spurned by Hamilton County commissioners, the new bill isn’t a private act and therefore doesn’t require commissioners’ approval.

The legislation instead changes a general state law. It would pave the way for the public Chattanooga-Hamilton County Hospital Authority to, if it chooses, create a new operating board that would assume management of the hospital.

Last year’s version amended the Legislature’s 1976 private act creating the hospital authority and how its 12 trustees are appointed. They currently are appointed by the city, the county, local lawmakers, the two chancellors and the Chattanooga-Hamilton County Medical Society.

County commissioners, who approve four trustees submitted by the county mayor, didn’t like that last year’s version took them out of the appointment process. They also disliked a provision that pegged the county’s annual $1.5 million appropriation to Erlanger to the Consumer Price Index’s rate of inflation.

This year’s version doesn’t change how trustees are appointed. It keeps the $1.5 million county appropriation, but there’s no longer an inflation index. It also directs trustees to create and appoint a federally tax-exempt operating board.

“We still leave them [county commissioners] involved,” said Sen. Todd Gardenhire, R-Chattanooga, the new bill’s Senate sponsor. “We just don’t go through them [for approval] because they refused to vote” on last year’s bill.

Rural hospitals at risk without Medicaid expansion

NASHVILLE, Tenn. (AP) — Tennessee’s rural hospitals are laying off workers and reducing services as they try to cope with the funding changes brought about by the Affordable Care Act and the political battles that surround expanding TennCare.

The Tennessean reports (http://tnne.ws/1ams5Ds) the federal health law reduces reimbursements to Tennessee hospitals by $5.6 billion over the next 10 years. That money was supposed to be replaced through expanding TennCare, the state Medicaid program.

But Republican leaders in the state legislature oppose expansion, saying they doubt the federal government will stand by its obligation. Gov. Bill Haslam has been trying to design a framework that will satisfy both the Obama administration and fellow Republicans.

The Tennessee Hospital Association lobbied unsuccessfully for expansion last year. Now it is organizing a grassroots campaign to fight for expansion.
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Harwell, Ramsey Not Fretting Over Potential Hospital Closures

Senate Speaker Ron Ramsey and House Speaker Beth Harwell acknowledged Thursday that some Tennessee hospitals may face closure as fellow Republican Gov. Bill Haslam delays a decision on whether to expand the state’s Medicaid program under the federal health care overhaul, according to the Chattanooga TFP
But the leaders, who back Haslam’s decision to continue negotiating with the Obama administration, say that’s life in the free market.
Ramsey, R-Blountville, said he’s heard the warnings from the Tennessee Hospital Association, but he still thinks “there’s a little bit of ‘the sky is falling’ out there with them when it really wasn’t.”
Still, he acknowledged, “obviously this is going to hurt. In some cases there may be hospitals that have to close — but look, if you want to operate in a free market, things like that happen. But I think overall they will figure out a way to cut this.”
Harwell, R-Nashville, told reporters earlier that some of her rural members have already been concerned about the fate of hospitals.
“There are some rural hospitals that will be hurt; there’s no doubt about that. But the health care industry is a changing industry and those that can’t keep up, they just simply can’t,” she said. “I’m sorry that that might happen, but again, if it was a little exaggerated, we’ll find out in the next six months.”
Hospitals have been counting on the expansion of people in the state’s Medicaid program, TennCare, through the federal Affordable Care Act to help offset special federal payments for people with no coverage at all.

Hospitals Project 90,000 Job Loss Without Medicaid Expansion; Haslam to Decide While Legislature in Session

The state’s hospitals are playing out the “what if’s” as lawmakers consider whether to expand Medicaid as part of the federal health care overhaul with a study that study says 90,000 Tennessee jobs could be lost if the expansion does not occur.
From WPLN:
Without expanding who is covered by Medicaid – known as TennCare in Tennessee – hospitals say there could be a “recessionary impact.” Hospitals agreed to cuts that total billions of dollars, believing they would see fewer uninsured. But that assumption is in jeopardy.
State Senator Brian Kelsey is trying to prevent the state from expanding Medicaid.
“Look, my job is not to bail out the special interest hospital lobby. (said Kelsey) My job is to represent Tennessee taxpayers.”
Kelsey defended his position on a panel discussion with the Tennessee Hospital Association and Medicaid advocate Gordon Bonnyman of the Tennessee Justice Center.
Bonnyman often tangles with hospitals, but he’s taking their side.
“I would be the first to say they have been known to cry wolf. The wolf is at the door now. I say that as an amiable adversary of the hospital association.”
Governor Bill Haslam says he plans to make a decision on Medicaid expansion before the legislature wraps up work for the year in the spring.

On Haslam’s comment, Andy Sher has the precise quote:
“Any decision we make, I promise you, we’re going to get the Legislature to approve,” the Republican governor said after speaking at a Tennessee Press Association and The Associated Press luncheon.
“We’d love to decide that prior to their leaving. It just makes it neater.”

The Tennessee Hospital Association study also projects that a combination of federal law factors will have a $5.6 billion negative impact on Tennessee’s economy without Medicaid expansion. From the Tennessean:
Craig Becker, the association’s president, warned of the problems hospitals face in the years to come.
“Tennessee’s hospitals are entering a serious fiscal crisis, the likes of which we have never seen in our history,” Becker said in a news release. “For our state to absorb cuts of this size and scope, without using every possible means to offset the cuts, will create a ripple effect, the likes of which Tennessee communities have never seen before.”
The THA says the $5.6 billion estimate is based on tallying the impact from the Affordable Care Act, the Budget Control Act of 2011, the Job Creation Act of 2012 and the American Taxpayer Relief Act of 2012.
The trade group used an economic impact modeling program to estimate how the cuts would affect the 78 counties in Tennessee that have hospitals.