Print
E-mail
Share
delicious
digg
Newsvine
Facebook
Stumble
Technorati
reddit
Fark
twitterBudget Cuts:
ERs could shut doors
As state payments shrink and more patients lack insurance, at least two hospitals consider an extreme move
Chris Morris
Sat, Dec 27, 2008 (2 a.m.)
Sun Archives
- Lawmakers reach agreement on $340 million deal (12-8-2008)
- Medicaid cuts compound health, economic crises (12-2-2008)
- If a hospital is unionized, might care be better? (10-10-2008)
Beyond the Sun
Nevada hospitals are in such dire financial condition that at least two are considering closing their emergency rooms and refashioning themselves as something other than full-service hospitals, according to the head of the Nevada Hospital Association.
Bill Welch, president of the trade group, declined to say which hospitals are discussing the option.
Because emergency room patients with no ability to pay are financially draining hospitals’ bottom lines, they are considering closing and reopening as rehabilitation, psychiatric or skilled nursing facilities.
Federal law requires full-service hospitals to provide urgent medical care to anyone who needs it and appears in their emergency rooms.
By converting to another kind of medical facility, a hospital would no longer have to deal with patients who can’t pay.
The effect of a hospital closing its doors would ripple through the valley’s fragile health care system. University Medical Center, the county’s only public hospital and one staggering under the burden of caring for so many people who can’t pay, would be severely affected.
Hospitals are confronting two related and debilitating forces: The deep recession has put many Nevadans out of work, taking away their health insurance and forcing many to go to emergency rooms when they become ill. Meanwhile, state government has reduced Medicaid reimbursements to hospitals by 5 percent, which has taken money out of the pockets of hospitals that treat the poor and disabled.
There are also 4,000 children on the waiting list for Nevada Check-Up, a health insurance program for the working poor. For parents with children on the waiting list, emergency room care may be their only option.
Twice a year, the state pays between 11 percent and 16 percent of hospitals’ unreimbursed costs for care of the indigent. The Legislature froze the November payment and cleaned out the account, which will mean no June payment. In total, that will cost Nevada hospitals $25 million.
Even if hospitals don’t become something else, there will almost certainly be a reduction in services, Welch said.
“I’m aware that all of our hospitals are evaluating financial circumstances and their financial viability and determining what services they need to cut,” he said.
UMC, Sunrise, North Vista and Pahrump have cut services, he said, with more likely coming.
The situation will get worse.
Unemployment is expected to rise above the current 8 percent, meaning increasing numbers of uninsured people going to emergency rooms for care. And, an additional 5 percent cut in Medicaid reimbursement is coming.
Republican Gov. Jim Gibbons has pledged to balance the budget without raising taxes, which would require cutting state government by 34 percent. That can’t be accomplished without still deeper cuts to the Health and Human Services Department, which accounts for 29 percent of the state budget. Medicaid makes up nearly half of the Health and Human Services budget.
Acute-care hospitals are running, on average, a 0.25 percent loss, Welch said.
Assemblywoman Sheila Leslie, D-Reno and vice chairwoman of the Ways and Means Committee, said the situation has become untenable.
“We’re at the point where, if we keep cutting Medicaid, we will drive some Nevada hospitals out of business. We cannot expect them to continue operating at a loss. I’d fully understand a hospital deciding they can’t do it anymore.”
Leslie also said the news of hospitals considering closing their emergency room doors is a sign of the effect of budget cuts, not just on the poor and disabled, but soon on all Nevadans.
“If we keep cutting, we’ll severely impact public health and public safety. Sickest people get taken care of first, and we’re headed back to the days when if you have a broken arm, it can wait.”
Most valley hospital administrators are on vacation this week and couldn’t be reached for comment.
Among the hospitals with the most uncompensated care, other than UMC, are North Vista in North Las Vegas and Sunrise Hospital, which recently laid off more than 50 workers.
Sunrise delivered $88 million in uncompensated health care in 2007.
More than half the patients at Sunrise Children’s Hospital are uninsured or on Medicaid.
Sunrise Chief Executive Sylvia Young said she could not foresee Sunrise closing and reopening as a different type of facility. “With the infrastructure and capital investment, I don’t think that’s feasible,” she said.
Nevertheless, she urged the Legislature to consider the ramifications of further budget cuts.
“We think we have a moral imperative, and we think that health care should be put at the top of the list of priorities,” she said.
Sasha Jackowich, a spokeswoman for St. Rose Dominican Hospitals, said there are no plans to cut programs or close St. Rose facilities.
“Certainly ongoing reductions in Medicaid reimbursements and a prevalence of uninsured patients creates serious concern for the area’s health care institutions, but as the only not-for-profit, religiously sponsored hospital system, it is our core mission to care for our community, and we hope to be able to continue to carry out that mission even in these trying times.”
Sun reporter Alex Richards contributed to this story.
Discussion: 23 comments so far…
Post a comment
Email Edition
- Most Read
- Discussed
- Most E-mailed
- Fourth fireworks light up valley sky
- Ensign’s pal lacked usual qualifications for job as senator’s senior aide
- Jay-Z lights up Las Vegas, lives life to the max
- Cousins attracting attention from college football recruiters
- Popular in their cities, could Reno or Las Vegas mayor be governor?
- Las Vegas to sizzle for the Fourth
- Strip performer is eBay high bidder for Elvis ring
- With success of Singapore campus, UNLV eyes United Arab Emirates
- Henderson house fire displaces family of three
- Swarm of crickets descends once again on Northern Nevada
Blogs
The Bull's-Eye
Real drama follows Desert Classic victory by 'The Power' (UPDATED)
Elsewhere
Spike TV's 'UFC's Ultimate 100: Greatest Fights' airs tonight
The Kats Report
LV Phil 'Spectacular' at Springs Preserve was great -- for the music
Punchy Points: UFC 100
No. 6: The Ref: Dean relishes role, making right calls (1 Comment)
The Bull's-Eye
Canadian is first in Desert Classic's final four, Barney joins him (UPDATED) (2 Comments)
Sports: Upon Further Review
July 4 at Wimbledon
The Kats Report
It's the fourth, it's the Phil, but it is not fireworks
Calendar
- Backyard BBQ at Bare Pool with Steve Aoki ( to )
- Dubfire of Deepdish at Prive (10 p.m. to 11:59 p.m.)
- Fourth of July party at Charlie’s Lakeside Casino ( to )
- Brooklyn Bridge Beer Bash at NYNY (noon to 11:59 p.m.)
The Sun
Locally owned and independent for more than 50 years.
Healthcare can become affordable. We start by reducing the massive fraud,the amount is absolutely unbelievable, and we do this by increasing the penalties for such to make it unattractive. We'll never stop it, it's too easy and too lucrative.
We next ban pharmaceutical advertising, it's sucking in too many victims, the old for every action there is an equal and opposite reaction comes into play. Too often we trade one problem for another through the use of pharmaceuticals, and many ailments can be alleviated without this risk through lifestyle changes. These are times too avoid the easy and more dangerous road and eliminating unnecessary expenses will make crucial care affordable for us. We've unneccessarily made pharmaceuticals and medical care one of the largest expenses in our budgets and when we reach retirement age it will become haunting.
(Removed by the site staff)
broken arm? I had a fractured spine and multiple other fractures and still waited over 12 hours for care at Sunrise. If it gets much worse they'll need to set up a morgue in the ER and just let people wait till they're dead.
Dsteele doesn't seem to have a good grasp of the situation...what massive fraud is he talking about? The massive fraud that exists are the insurance companies. If you didn't know already, health insurance in this country is FOR PROFIT. They make money by raising premiums and lowering reimbursements to physicians. They also siphon off about 25 - 40% of every healthcare dollar as profit to shareholders. So, next time your insurance company denies you a CT scan, ask yourself why you shouldn't get one just so some stock shareholder can make more profit. America's Healthcare Companies...the biggest scammers in the world...we need to get rid of the current system...it is broken...
Medicare should start for ALL at birth.
They can cut back on Medicare, and Medicaid,
but PEOPLE WILL ALWAYS GET SICK.
What do you tell a 55 year old woman
that NEEDS a breast exam
and CAN'T AFFORD IT?
What do you tell a 40 year old Male
that NEEDS A HERNIA OPERATION
and CAN'T AFFORD IT?
LVKen7@Gmail.com
Shutting down any hospital's emergency room services will have dire consequences. I put the blame on the economic meltdown which is leaving millions unemployed and uninsured.
Lets cut all the bull. Illegals take up over half the health care and contribute almost nothing. They are not the whole problem, the other half is the government who waste our tax money on programs. Programs that do not work, and never will work. Uninsured teens will continue to get pregnant, uninsured teens will continue to drink and get hooked on drugs. And worst of all, ignorant Americans will continue to smoke cigarettes till their on oxygen. Don't even get me started on all the useless pharmasuticals that get pushed on unsuspecting Americans every hour of the day. Maybe we should all go Socialist and pay with a national sales tax. Then thats one more thing to bitch about I guess.
The hospitals should follow Obama's wife program when she was a executive an a Chicago hospital.
She instituted a program where if a person had no insurance and if it was not life issue then she had the patient transported to the poor people's hospital.
I started a Google Doc
as a place to use to Discuss FORUM postings, and the COMMENTS that result from those postings.
THIS document is publicly viewable at:
http://docs.google.com/Doc?id=dgwzbkk9_9...
Frequently, I read in Letters to the Editor
or Callers to CSpan
that I want MORE info from them,
but I have NO idea where to go to FIND THEM.
Hopefully, THE File will be such a place.
So, PLEASE, Join in.
Try looking to the worthless admen part of hospitals and you will see what the heathcare problem is, do you think they are worth the big money they get for the nothing they do. Do you think they will get any less if they close the ER's in hospitals . not on your life they will get a whole bunch more for there worthless lives, of doing nothing for the common people
@dan2548: [CITATION NEEDED]
What about Brent Yessin, he got arrested and hospitals spend alot of money on him.
And that has alot to do with this, so why was it removed? He is paid alot of money by hospital admins to keep unions out. Maybe patients would be treated with that money.
I agree with those of you citing the health insurance companies as the major culprit for the state of health care in this country.
Capitalism does wonders for innovation. We have some the most advanced health care in the world. I remember reading a story a few years back where Canadians sometimes had to come here for experimental procedures. But the downside is that capitalism disenfranchises the poor. We need more people to have access to health care in general. I've never had health insurance. It still costs me less out of pocket to never go to the doctor than to pay insurance for the 2 times a year I might need to go.
But I understand the fear of a socialist state. In comparison, recently my apartment complex switched from measuring individual water meters to averaging the entire complex. I found myself quite upset, "Why should I pay for others' excesses?" It didn't seem fair. But it occurred to me that, as in most things in life, I am going to pay one way or another for other people's excesses.
There must be a balance between the capitalist depth and the socialist breadth.
http://query.nytimes.com/gst/fullpage.ht...
http://archive.newsmax.com/archives/arti...
http://findarticles.com/p/articles/mi_m0...
http://www.nshp.org/health/bankrupt_hosp...
http://www.newswithviews.com/Cosman/made...
If you need more 'citations' just google "hospital closure illegals".
Denying health care to the uninsured is preferable to going bankrupt and denying health care to everyone. This is the concept of triage-there are some who cannot can be saved during an overwhelming crisis with limited resources. Ironically, by closing hospitals to the uninsured, the public outcry will force the Federal government to pay up sooner than later. Increasing State funding will only prolong the agony, and delay necessary Federal intervention. This non full service hospital idea is simply brilliant.
Health insurance is not insurance. It is simply highway robbery. It needs to be either overhauled with strict new regulations requiring all to be covered(which is the DEFINITION of insurance), or it needs to be banned. By cherry picking those who are lowest risk, and then strictly limiting what procedures are covered, they are not truly providing insurance at all.
Health care in Las Vegas is horrible. I live in a town of 2900 people and even our hospital is latex free, not vegas! They have almost killed 2 family members due to lack of having english speaking nurses or personel that even really cares. We have cared for family at home instead of opting for hospitalization becasue of the poor health care there. Maybe Vegas should look at getting all the welfare abusers off the plans and give help to the people who really can not help themselves.
peanut415: They have to speak spanish because 90% of the people in the emergency room are illegals. My wife works in the industry and they are required to treat all the illegals. They cant charge them cause of the fake information they provide. The illegals take full advantage and come to the emergency room with every little thing that occurs. They bring their kids for a simple cough or stomach ache. They run up thousands of dollars in bills and never pay or have insurance to pay. They are using all of our services up.
There have been countless stories the past few years on the changes that have been made to health care for american citizens because of the abuse of our system made by undocumented workers. Last year and this year many county hospitals have closed due to the fact the illegals have crippled our hospitals because they have not paid in enough taxes(if any at all) to the state they live in. They have taken away jobs americans want to do in the hotel and construction industries and leaving citizens with no paychecks or benifits to survive. It's about time to use the e-verify database to rid our comunities of these illegals and send them back to their countries where they can march in their streets for the rights they deserve in their countries. Our politicians have screwed up enough to where our citizens should be the only ones to be able to reach out for the help our state and federal governments provide. It's time for the illegals to go home and do what they need to do in their country to make it better for them. Our government and its people have done more than enough to help them to this point.
Remind me why the illegals are being treated. Their stubbed toes and runny noses are costing us a fortune. Immigration needs to start raiding ERs. They'd soon stop going there.
We have been notified that Brent Yessin and his motley crew is back at Valley Health Care System,
hoping to keep the unions out. Why on earth would you pay him all of this money when we can't get our patients cared for due to the lack of nurses. Mr Yessin should stay in Florida and deal with his own issues. He has harrassed nurses who want to be unionized enough, he is not what we want here.