Two hospital boards have become one as the trustees of the Copper Basin Medical Center make an effort to save the struggling hospital. Current and past employees, concerned city and county officials, and members of the two hospital boards met Mondaym May 23rd in a special called meeting.
District Board Chairman Doug Collins told those present he felt dissolving the contract with the Corporate Board would be in the best interests of everyone involved. He said conducting business via the District Board would offer transparency and enable them to answer questions about the state of the hospital.
Polk County, Ducktown, and Copperhill are all named on a note backing the hospital and will be on the hook if it goes under. Collins asked City Attorney Eric Brooks to review the contract with the Corporate Board, which is contracted to run the hospital. Brooks suggested the District Board look a little more deeply to get all the information needed – such as whether or not payrolls taxes and insurances are being paid. He said he did not know what all was in default, but pointed out the Corporate Board could do loans up to $100,000 before getting approval from the District Board. Brooks said the contract had been extended in 2010, and the lease was good until the SBA loan was paid off, 30 years, or unless terminated because of default. He said in order for the District Board to say there was a breach of contract, they needed to give 120-day written notice.
Collins said they had sent a letter to the Corporate Board in December. Brooks encouraged the board to make sure they knew what they were getting into. He said he did not know if payroll tax, liability insurance, and retirement was being paid because when there are cashflow issues those are often not paid. Brooks also pointed out there were multiple pieces of property. He said the one the hospital sits on was in the District Board’s name, but another was not.
All board members present said their goal was to keep the hospital open. Doug Collins said the bottom line was that because the Corporate Board went into default, it all falls back onto the District Board anyway. Jack Collins said they had been struggling for a while. He asked if dissolving the lease made it more or less likely to stay open. Doug Collins said it would be more likely to stay open if the contract with the Corporate Board was dissolved. He pointed out that a lot of trust was gone because the Corporate Board was not open. He said commissioners and community members should not have to beg for information and that the District Board used to run the hospital.
Ron ONeal said if the hospital had to borrow money it had to come through the District Board anyway. He said all the equipment was mortgaged to the bank and the District Board had to pay that loan. ONeal said it would be best back in the hands of the District Board. Frank Shinpaugh asked what they would do – find somebody to run it or manage it? Doug Collins said there was no way to go into contract with anyone else or become an affiliate of another hospital as long as they had two boards.
Concerned employees listened in as the CBMC Corporate Board was dissolved.
Dr. Mahmood Siddiqui said to look at Etowah or Hutchesen Medical Center to see what happens when a bigger hospital comes in. He said any bigger hospital only cares about profit. “They will just shut the place down,” Siddiqui said. “We are just a number.” Doug Collins said the hospital was going to close anyway at the rate it was going. He said they needed the docs on board. Dr. Siddiqui said he had been there 23 years and 70% of the business comes from their practice. He said it was unfair to accuse them of not being committed.
CEO Anna Clark said the majority of people coming through the ER were non-emergency cases and the doctors were not sending them home but should be. She said there were people coming in over and over and the hospital was losing money on drug seekers.
Dr. Rakesh Shah said they get paid a fixed amount and it took time to document everything to find out if a case was non-emergent. He said by the time he gets to the end and all he has left is to give a shot or write a prescription, he was going to finish.
“This is a community hospital. Patients in the ER are sick people. Don’t mix apples and oranges,” Siddiqui said. Dr. Shah said every day he sees at least one person who has never been there before. He said people are impressed with the ER and suggested if they were a problem, complaints would have been heard by now. Siddiqui said there was always someone to blame. He said first it was the front staff, then billing department, then the coder, the Medicare. He said it was their job to take care of patients, not collect. He said the company now doing the billing has never billed for a hospital before.
Jack Collins said the issue of finger-pointing was not going to hep the situation. Doug Collins said the problem did not happen overnight and would not be fixed overnight.An ER employee pointed out that often a patient may come in with anxiety and it turn out to be a heart attack. She said things can come in looking very innocent, but be serious problems. Others talked about whether or not it was just coding, wording, or documentation that got claims rejected by insurance.
Daren Waters said if the hospital started turning people away, they would stop coming. One woman commented that she had been to the ER three times and only once did anyone ask for her co-pay, and that person has since been fired. She said on the other times, she had to tell the front staff she wanted to pay. Doug Collins said something had to change and that the hospital had been in a downward spiral. Siddiqui said the problem was in billing and that throwing the ER staff under the bus was wrong. Clark said they were not in compliance because they were not turning away non-emergent patients. Collins said they were laying off folks because there was no money. Shah said it was bad management and that others were getting raises.
Jack Collins said if someone else wanted to come in to manage the hospital he would not support them unless they wanted to run it as a functional hospital. Dr. Siddiqui said an outside entity would do what is best for them and not for the community. He said the hospital could do it on its own, and suggested the board not kick those who had been loyal in the rear end.
Clark said with all their efforts in the last 12 months, they had not even reached the minimum needed to get by. She said there was also too much regulation and no way to keep up.
“If we can’t run it, no one can,” Siddiqui said, adding that billing and collections is the problem.
One employee said next Tuesday would make one month since the ER was paid. She said Clark had said she was not paying them because they were not compliant.
Randy Collins made a motion to dissolve the Corporate Board. ONeal seconded. Mitchell Hicks asked what would change and if the liability would be there either way. He asked what the point was if everything was going to stay the same. Collins said they would have the liability regardless.
Hoyt Firestone said he was concerned about jobs, pointing out the hospital was the largest private employer in the county. He said the District Board had leased the hospital to itself because members were on both boards, and it seemed cumbersome.
Dr. Siddiqui said there was $7 million in accounts receivables. Clark said most of that was for old accounts. A former employee said she knew how to do the proper coding for billing, but had been fired.
Doug Collins pointed out that there was not currently a contract for the ER doctors. He said they agreed to pay $100 an hours, but nothing was ever signed. Collins said they had been running on good faith. Siddiqui said they had been working on good faith, as well.
“Just pay the ER docs,” Siddiqui said. Doug Collins said Siddiqui previously said if they can get it cheaper to do it, and he thought it might need to be rebid. “If we give you $90,000 a month, you need to at least give us that much,” Collins said. “You have to take care of the ER guys, we take care of the hospital,” Siddiqui said. He pointed out that Dr. Jones had brought in people from Fannin County since he had been there. Siddiqui said 18 practices had come and gone but his ER team had been stable for 10 years.
Jack Collins said both sides needed to work together to keep what they had. Siddiqui said they would not be held hostage. “Like we are?” Clark asked. Jack Collins suggested the board set up a committee to recruit someone to come in to run the hospital. He said their life jacket was getting full of water, adding that he did not want the ER to leave.