Regional News/South: Louisiana Gov. Jindal cancels plans to end Medicaid hospice program, and other news

BATON ROUGE, La.—Gov. Bobby Jindal's administration scrapped plans to shutter Louisiana's Medicaid hospice program in February. Health and Hospitals Secretary Bruce Greenstein announced the reversal as hospice program supporters were gathering for a candlelight vigil on the state capitol steps to protest the cut. Greenstein said his department will use federal grant funding to continue the services for the poor and terminally ill. Cheers went up across the small crowd of people gathered in what they expected to be a somber vigil. The cut would have made Louisiana one of only two states that don't pay for hospice care through its Medicaid program, and the plan faced strong resistance from state senators, who were seeking ways to avoid shuttering hospice to new adult recipients Feb. 1. Sen. Fred Mills Jr., vice chairman of the state Senate Health and Welfare Committee, walked into the vigil crowd to deliver the news that the Jindal administration had backed away from plans to close the program. Jindal made a series of budget reductions in mid-December to help close a nearly $166 million deficit in the current fiscal year that ends June 30. Many of the cuts fell on the Department of Health and Hospitals. Oklahoma is the only state that doesn't offer hospice care to adults through Medicaid, according to the Kaiser Family Foundation. The health department intends to make changes to the hospice services to shrink the costs of care and improve the program, Greenstein said. Among the planned changes is a focus on community-based, at-home care. Nursing home residents will not be eligible for hospice care through Medicaid, though it might be available through Medicare.

—Associated Press

WAYNESBORO, Tenn.—Wayne Medical Center agreed to pay $883,000 to the federal government after the hospital's internal compliance department discovered what it described as documentation problems related to ambulance services. Written statements from the hospitals and the U.S. Justice Department said staff at the 78-bed medical center in central Tennessee self-reported the allegations to HHS' inspector general's office. U.S. Attorney Jerry Martin said in a news release that the hospital avoided a protracted investigation and the risks of “potential fines under the False Claims Act” by reporting its concerns. Between Jan. 1, 2004, and Dec. 31, 2009, the hospital allegedly received Medicare overpayments for ambulance services that were not medically necessary, billed under the wrong level of transport or mileage, and lacking proper documentation, the Justice Department said. The hospital said the overpayments resulted from “insufficient documentation.” “Wayne Medical Center is committed to integrity in all of our business practices, and we take our diligence in accurate billing very seriously,” said Paul Betz, the hospital's interim CEO. “We have worked closely with government officials to fully correct this issue and ensure that our current EMS billing practices meet all regulations.” Wayne Medical Center is affiliated with Maury Regional Medical Center, Columbia, Tenn., where Betz is the chief operating officer. The settlement was announced Jan. 17, and hospital officials said they were prepared to make the payment immediately.

—Joe Carlson

CHEROKEE, N.C.—Tribal leaders plan to build a bigger hospital with more services to replace the 28-bed Cherokee (N.C.) Indian Hospital on the Cherokee Indian Reservation in western North Carolina. Space at Cherokee's one-story facility is limited, said Jody Bradley, the hospital's public relations officer. “It is very tight quarters right now,” she said. “We want people to stay here for services instead of going outside the reservation, but we have to make sure they have a place to come back to.” Hospital officials have chosen a mountaintop location for the three-story, 141,000-square-foot facility and are in the process of evaluating which additional services they will provide there. Cherokee Indian Hospital functions as a one-stop health facility for the Eastern Band of Cherokee Indians, a 14,000-member tribe. The hospital's current offerings include dental services, chronic disease management and inpatient care. As part of the expansion, officials are planning to revamp the hospital's eye clinic and build a larger pharmacy. They are also contemplating adding new services, such as gastroenterology, Bradley said. “Right now we're studying each service to see if it is more efficient to add it in-house or keep sending patients out for it,” she said. The $50 million project is still in the early phases and the new hospital won't be open for patients for at least another three to five years. Bed counts may increase slightly, Bradley said, but the most significant changes will affect the hospital's outpatient offerings and administrative facilities. Much of the funding for the new hospital will come from revenue derived from the tribe's casino. In 2002, the tribe assumed ownership of the hospital from the U.S. Indian Health Service.

—Maureen McKinney

RUTHERFORDTON, N.C.—Rutherford Regional Health System finalized the major terms of a takeover proposal that would see the 116-bed hospital become a full member of Mission Health System, Asheville, N.C. The two systems first disclosed plans to enter into negotiations in September. The newly signed memorandum of understanding allows Rutherford's board of trustees to complete the negotiation and due diligence process, according to a news release. Rutherford's unanimous decision to partner with four-hospital, not-for-profit Mission capped off a search effort that took the better part of last year. The deal will inject Rutherford with new capital, increase its services and help with physician recruiting. It will also allow it to draw on Mission's management expertise and realize economies of scale, according to the release. The release added that Rutherford, also not-for-profit, will maintain a “strong, long-term voice in the strategic direction of the health system.” The ongoing negotiations will hammer out the details on the capital requirements, long-term investment plans and new initiatives that will be part of the deal.

—Beth Kutscher

LAKE CHARLES, La.—A private operator has agreed to run the Louisiana State University hospital in Lake Charles that cares for the uninsured, Louisiana Gov. Bobby Jindal's administration announced. The agreement is part of the administration's efforts to move away from a university-run public hospital system. The Department of Health & Hospitals said management of LSU's Moss Regional Medical Center will be turned over to Lake Charles Memorial Hospital and West Calcasieu Cameron Hospital, Sulpher, La. The arrangement, according to DHH, is similar to privatization plans for the operations of LSU's hospitals in Baton Rouge, Houma, Lafayette and New Orleans. DHH and LSU officials didn't provide a copy of the agreement that has been signed with the private hospitals. DHH said Lake Charles Memorial Hospital will make lease payments to the state. The money will be used to draw down federal dollars to pay for services. West Calcasieu Cameron Hospital will then sublease part of the property from Lake Charles Memorial Hospital. The health department said the privatization plans will shrink state costs, while maintaining health services and graduate medical education programs. The Jindal administration also is seeking private managers for the university system's other hospitals. Jindal stripped more than $300 million in state and federal funding for the LSU health system after Louisiana's Medicaid financing was reduced by Congress. Thousands of workers at the LSU health facilities will face layoffs under the plans and will have to reapply for their jobs with the private hospital operators. LSU board members have said they hope to move the university system out of the hospital business and return the focus to education.

—Associated Press

LEXINGTON, Ky.—UK HealthCare plans to take over management of nearby Eastern State Hospital, a psychiatric facility. The University of Kentucky system signed a letter of intent with the state's Cabinet for Health and Family Services. The transition will follow Eastern State's relocation to a new $129 million campus, which is expected to be completed this spring. The agency pointed in a news release to a number of similar deals in other states, including Arkansas and the University of Arkansas, Connecticut and Yale University and New York and Columbia University. Gov. Steve Beshear added in the release that the agreement “demonstrates our commitment to modernizing our behavioral-health treatment capacity” by creating a stronger link between behavioral and physical healthcare. As part of the agreement, UK will measure performance and outcomes at the 197-bed facility, such as improving patient care during hospitalization, providing continuity of care after patients are discharged and increasing the number of people who can live in the community. The deal also allows more opportunities for UK to conduct research on diagnosing, treating and preventing behavioral health disorders, the release said. The Bluegrass Regional Mental Health Board has overseen Eastern State since 1995. UK will take over management of the hospital over the summer, following a 60- to 90-day transition.

CHESTERTOWN, Md.—Chester River Health System and Shore Health System, two not-for-profit health systems under the University of Maryland Medical System, plan to merge into a single organization with one governance structure, effective July 1. Ken Kozel, president and CEO of Easton, Md.-based Shore Health, will serve as president and CEO of the new system, while Jim Ross, the current president and CEO at Chester River, will continue to serve in those roles until the merger is final. Baltimore-based University of Maryland Medical System has approved the plans. No financial terms of the merger were disclosed, and a name for the new system will be determined on or before July 1, a spokeswoman said. A joint announcement said the new system's middle-management team will be determined by January 2014. The merged system will operate hospitals in Cambridge, Chestertown and Easton, Md., as well as a free-standing emergency center and adjacent medical pavilion in Queenstown; a nursing and rehabilitation center in Chestertown; outpatient services and diagnostic centers in Cambridge, Centreville, Chestertown, Denton and Easton; and home-care and hospice services throughout the area. According to the announcement, the decision to merge was made after a study committee composed of board members and administrative leaders from both health systems reviewed the population needs in Caroline, Dorchester, Kent, Talbot and Queen Anne counties. The new system, the organizations said, will be positioned to address the challenges that stem from delivering healthcare in rural areas, such as provider shortages, a lack of specialty care and an aging population with chronic conditions.

WINSTON-SALEM, N.C.—Products providing more comfort to patients in awkward examination and intensive-care settings are some of the first fruits coming out of the Wake Forest Innovation and Entrepreneurship Initiative. Wake Forest Baptist Medical Center launched the division in December as part of an effort to generate more revenue from its academic and clinical research. One prototype involves a device that allows for an easier exchange of an endotracheal tube for intensive-care patients. Another prototype is for a foam device that fits over the ears to reduce the decibel levels for patients while in an MRI scanner. The two devices will be aimed initially at Wake Forest Baptist patients, said Eric Tomlinson, the hospital's chief innovation officer who doubles as president of Piedmont Triad Research Park. “If we can see a larger opportunity for commercialization, then we will surely go down that path,” Tomlinson said. Researchers also are nearly ready to debut a tracking system that collects and stores data about radiation protective devices. “The prevailing mindset for faculty for decades has been publish or perish,” Tomlinson said. “That has been supplanted by the need for faculty to be scholars and innovators, to bring products and services to patients quicker and to commercialize and monetize their innovations.”

—Associated Press