State measure could force closure of UMC, county says

Tiffany Brown

University Medical Center, which is Clark County’s only publicly funded hospital.

Published Tuesday, March 31, 2009 | 12:34 p.m.

Updated Tuesday, March 31, 2009 | 4:01 p.m.

Archive of Sun health stories

University Medical Center

A state Senate bill that would gut University Medical Center’s reimbursement for providing hospital care to poor people could force the county’s only publicly funded hospital to close, Clark County Commission Chairman Rory Reid said Tuesday morning.

But Charles Duarte, administrator for Nevada Medicaid, said Tuesday afternoon that the bill’s intention is to bring the state in compliance with federal law and to instigate discussion about indigent reimbursements, a “very contentious” issue for publicly funded UMC and private hospitals.

“We are working with Clark County to amend the bill in a manner that doesn’t harm UMC and the county to any great degree but at the same time contributes to hospitals that have been uncompensated,” Duarte said.

The state is violating federal rules, he added, by failing to reimburse some hospitals that provide care to the indigent.

The bill, SB 382, was characterized much differently to a special meeting of the Clark County Commission Tuesday morning, held as a budget primer as the county starts to figure out how it will pay for 2009-10.

Much of the talk focused on Clark County’s contribution to Nevada’s Disproportionate Share Hospital fund. Last year, the county gave $60 million to the fund. The state used that money to win federal matching dollars, effectively turning that $60 million into about $107 million. Most of that money is used to pay for indigent health care.

In return for its $60 million, the county got back $78 million after the state received the matching funds.

The bill that spurred the county’s ire reduces Clark County’s return to $33 million. The remainder would go to private hospitals to fund their own indigent care. Sunrise Hospital would get $16 million, Valley Hospital $5 million and Spring Valley Hospital about $3.5 million.

That scenario led Clark County finance director George Stevens to envision a future where UMC, which operates the only Level 1 trauma center in the county and its only burn unit, might close “because I don’t see where we could make up that $45 million.”

County commissioners had another idea: Just stop giving the $60 million to the state.

“Why would the county give away $60 million when that giving is going to ensure the death of UMC?” Reid said.

SB 382 was pushed by lobbyists for private hospitals who “would like to see UMC disappear,” one county official said.

Private hospitals argue that they care for indigents just like UMC and should be compensated for it because they are taking some of the burden away from UMC.

Clark County is, by statute, only required to fund indigent care “to the tune of about $15 million,” a top county official noted.

“So let them push this bill and get it passed,” he said. “Then the county would pay its $15 million, be done with the hospital business, save more than $100 million a year and let the private hospitals take care of indigents.”

But Duarte said the county and officials from UMC , as well as private hospitals, are in talks with his office to “have a healthy discussion about what the state’s health policy ought to be.”

“In committee meetings (in the Legislature) we stated many, many times in testimony that this bill is a strawman, because we had so little time to work it out,” Duarte added.

If some version of the bill passes, Duarte said it will have some effect on the amount of money Clark County gets back from the state. That is yet to be worked out, he said, adding that “there is no intent to harm UMC or close UMC or harm Clark County.”

Joe Schoenmann can be reached at 455-6175 or at joe.schoenmann@lasvegassun.com.

Discussion: 13 comments so far…

By laguna

3/31/09 at 12:49 p.m.

Suggest removal

Government does such a good job with hospitals, lets have them run the whole countries health care. I think Rory and his 'old man' Harry should be cleaning bedpans.
By tbvegas

3/31/09 at 12:54 p.m.

Suggest removal

Here is your state run healthcare!
By nickthebigmama

3/31/09 at 1:08 p.m.

Suggest removal

The private hospitals already destroyed UMC as a profit making hospital.UMC routinely made a profit of $15 to 25 million a year between 1994 to 2001. Then, the Commisioners got lobbied and closed Quickcares[yes, you Yovonne] Now, UMC needs $60 million/year in subsidies.
Yes, get rid of the old and re-start.
UMC should be profitable if run correctly as a business.
By ivegotcha

3/31/09 at 2:41 p.m.

Suggest removal

I would like to see this, clean house. And yes they private hospitals do take in the poor, but just long enough to stabalize them and ship them over to us. Since the reinbursement rate is better for us, which is zero. I say close it, we have enough hospitals in and around las vegas with adequate care and treatment centers..... Sunrise is a level 2 so .......
By Launce

3/31/09 at 2:52 p.m.

Suggest removal

It is amazing that people would shut down the region's only Level 1 trauma center and burn unit simply so the private hospitals can make greater profits. The health of everyone, from all economic backgrounds, would be endangered.
And UMC, despite many problems and well-funded opposition from competitors, does a damn good job.
By Patrick_R_Gibbons

3/31/09 at 3:54 p.m.

Suggest removal

Profits signal that something is highly valued and uses few resources to provide that service. That is called efficiency.

Subsidies mean something is likely not valued very high or is destroying scarce resources, or both.

Profits are not bad, if there is competition, because that means consumers have a choice.
By neiman1

3/31/09 at 8:23 p.m.

Suggest removal

If the government entities from the county to the State to the Fed cannot take care of the poor, why would we let them take care of us.

What do we do when they decide they are short on money and are the only game in the country, suffer and die.
By Randy

3/31/09 at 11:38 p.m.

Suggest removal

It is funny how people think they know why UMC is running a deficit, without actually looking at the facts. If anyone cares about the facts, George Stevens (County Finance Director) has identified the deficits as stemming from the State of Nevada's cuts to Medicare and Medicaid reimbursement. The State has cut reimbursement so far that UMC is losing money treating the people that it must, by law, treat. Nevada is among the worst in the nation for reimbursement.
By ivegotcha

4/1/09 at 7:51 a.m.

Suggest removal

UMC is so over staffed with management personnel that if they eliminated that and still kept the cut of reimbursement as it is they would now be in the green not the red.
By Patrick_R_Gibbons

4/1/09 at 8:19 a.m.

Suggest removal

With health and human services getting an extra $400 million next year, according to the governor's budget, you have to wonder where the money is going. A closure like this is merely a symbol, something tax increasers can rally behind. Close something that visibly impacts people and hope the tide turns in favor of raising taxes.
By tvegas

4/1/09 at 9:32 a.m.

Suggest removal

They were taken to UMC ...where they later died.
By betterhealthcare

4/1/09 at 10:50 a.m.

Suggest removal

Give me a break...UMC has cut more programs to the indigent than other providers, they are spending millions in advertising and investing in programs like bariatrics and urgent care centers then whining to the media that they are seeing uninsured at their centers. Not exactly a shining example of a well run county hospital.

If these funds are federally mandated for other providers NV should have been playing by the rules. What a load. One day these good ol boys will run Vegas into the ground and that will be a shame!
By afveteran

4/1/09 at 9:23 p.m.

Suggest removal

Closing UMC will escalate the private hospitals' process of shutting down their ER's and other clinics that take in indigents. Talk about a thermonuclear explosion when that happens, the trial lawyers and the ACLU are sitting there waiting.