I received an email from our old friend, Michael, which is worth sharing. He raises good questions about media coverage of the bankruptcy proceedings of Hawaii Medical Center. I’m just going to post his entire message, as it is good reading.
Today I had begun doing a bit of reading and some web searches about the pending closure of Hawaii Medical Center, which was announced after the potential buyer of the two-hospital system had backed out. It seemed to me that the closure of those hospitals would amount to a major crisis, and that Abercrombie and the State Department of Health would be mounting some initiatives to deal with it (a task force with big names backed by research on all the implications of the closures, etc, etc.)
But there has been almost nothing. KITV had this on Abercrombie’s reaction:
“Governor Neil Abercrombie said plans to care for long-term and short-term healthcare needs are ongoing but there is no immediate solution to the closure of two Oahu hospitals.
“”I don’t want to put anything out there that would create a false impression we are working on it,” said Abercrombie.
Then tonight PBS’s News Hour had this story about Prime Healthcare being accused of major (and bizarre) Medicare fraud in California.
The last sentence of the story reads, “It also plans to acquire hospitals in New Jersey and Hawaii.” Sure enough, Prime Healthcare was about to become the new owner of Hawaii Health Center!
I did a few more web searches and quickly confirmed that there have been a lot of stories for months about the accusations that Prime Healthcare was involved in major Medicare fraud. Here’s one of the stories I came across, from July.
But I am not aware of any news stories here about Prime Healthcare’s problems. Can it really be true that no news source here has done any research on Prime Healthcare or saw fit to report on the allegations of fraud? Of course, Prime Healthcare’s fraud would have had a direct impact on the state government. If they were using fraudulent billing
practices for Medicare, surely they would do the same with their Medicaid billings, cheating the state.By the way, I think that the State Health Planning and Development Agency (SHPDA) probably has been monitoring the effort to sell the hospitals and may have had to approve the sale before it could happen.
SHPDA’s mission includes oversight of the state’s health care system. It monitors utilization of beds, services, etc., and it has the power to approve or disapprove the addition of new facilities and services. I worked for SHPDA for a year or two back in the 1990’s, so I have a fairly good sense of what they do–but of course I am a bit rusty after all the years that have passed.
Oh, yes, during my web searches I came across this article in Hawaii
Free Press.I have not read that article thoroughly, but I think Walden makes some good points and gives a good overview of the crisis that the closing of HMC would pose. I would not have expected so good an article!
I just wanted to pass this mess on to you for your thoughts.
Onward,
Michael
A quick search turns up quite a few stories about Prime Healthcare by California Watch. Links to a number of their stories can be found here.
Other information was compiled by United Healthcare Workers West, an SEIU union.
Discover more from i L i n d
Subscribe to get the latest posts sent to your email.
The S-A did make reference to Prime’s reputation. Hawaii News Now’s reporter suggested that St. Francis, by holding out against Prime’s offer, could be open to criticism for “greed” in light of the loss of transplant center, dialysis, ER, jobs et al.
But perhaps St. Francis has saved the State grief down the road.
There was talk about appointing a special commission to look into this but, as we know, there are only about 5 guys in the State qualified to be on blue ribbon commissions. These are the same guys tied up already on rail, education, land use and other stuffs like that. We will have to wait until we can find another five guys for this overflow work.
The crisis is here and now. Early yesterday morning, Hawaii Medical Center closed its emergency rooms. And Ron Mizutani of KHON reported,
“Less than eight hours after Hawaii Medical Center closed its emergency rooms at Ewa and Liliha, several hospitals have informed Emergency Medical Services their emergency room’s are over-loaded and have asked to divert patients to other hospitals. At 3:30 p.m. Monday, Pali Momi Center, Kaiser and the Queen’s Medical Center were reported to be under re-route status meaning unless patients are in critical condition they have no more room.”
Mizutani’s excellent report about the closing of the ERs can be found here:
http://www.khon2.com/mostpopular/story/HMC-closes-emergency-rooms-other-hospitals-over/OdQ4sVByEUuA0SLvPvz7Kg.cspx
Of course, people in West O`ahu will be most drastically affected by the abrupt closing of the ERs because of the delays in receiving emergency care that they will encounter. Time is of the essence in treating trauma and many other emergency conditions.
Mizutani also mentioned how many patients were routed to an urgent care clinic.
I hope that clinic, and other like it (some of which may now pop up on the Leeward side in response to HMC West closing) can pick up a lot of the patient load that had previously gone to HMC West and Pali Momi ERs.
IMO, clinics that operate on a cash basis, and which can thus offer services for lower cost than if they had to deal with insurance, should be a much bigger part of our medical system, especially in concert with high deductible insurance.
On its website, Pearl City Urgent Care states. ” We accept all major insurances. Medicare accepted.” Since they do not mention MedQuest/Medicaid, I gather that they do not serve patients in those plans.
They also provide their private pay rates. The charge for the basic level of care is $70.
I agree that urgent care clinics can help relieve the pressure on emergency rooms, but if they do not serve the large numbers of MedQuest/Medicaid patients, then West O`ahu will still have a significant health access problem.
The medical industry is facing enormous problems ranging from Medicaid to escalating costs. These problems will be coming to a head sooner than later, now that the Obamacare is set to be implemented.
The HMC mess predates these newer problems, in that the hospitals were not profitable nor sustainable prior to their initial sale. Hopefully, a new, more experienced and reputable orgaization will be able to establish new hospital operations at the facilities.
I agree with Mr. Yamashita. Rather than going though Chapter 22 (i.e., repeating Chapter 11 bankruptcy reorganization), it looks like HMC will go through Chapter 7 liquidation (in which *all* debts will be wiped out). Put on the selling block free from liabilities, HMC’s assets will be very valuable — and hopefully “a new, more experienced and reputable orgaization will be able to establish new hospital operations at the facilities.”
Since there was no sale agreement, who cares about reporting of Prime’s situation?
Bob, that’s not such a smart remark. Prime is already involved in the situation because they are financing HMC’s receivables. (slightly edited)
That crossed my mind, too; why spend a bunch of time investigating hypotheticals? I suppose it would be different had a deal been made or a bankruptcy auction held. Still, I guess it’s better to ask questions sooner, when there’s still time to do something, rather than later when it’s, well, too late.
Richard : LOL. But you know, it looks like they found a coach so maybe they could put this one Thursdays agenda.
There is plenty of capacity in the Oahu health care system without these two hospitals.
Most of the short term issues are related to staff shortages at the other hospitals rather than physical space, i.e beds. Its like going into a restaurant with 10 tables obviously empty and being told they can’t seat you because there is only one waiter working.
They will adjust, i.e, the doctors from HMC will not all just decide to quit the medical profession and become organic worm farmers, they will find spots at the other hospitals, or other doctors will be found. And I expect this will happen much more quickly than any committee can be deliberate becuase all these hospitals are seeing opportunity pass them by and are working on plans as we type.
I think the real issue is the closure of St Francis West as it is the closest hospital to the west coast. But it will find a new owner, its a modern facility in a key location (Lilliha will most likely be close and eventually raised). But smart buyers know it will be cheaper to buy from Ch 7 than ch 11, so they will wait.
No great amount of investigative work is needed. it has already been done for us by Ctr for Investigative Journalism which has an open-source cross-publication policy. In other words, any Hawaii news outlet can post CIJ materials:
http://www.hawaiifreepress.com/ArticlesMain/tabid/56/articleType/ArticleView/articleId/5698/Medicare-Fraud-FBI-Investigating-Failed-HMC-Buyer.aspx
The real story lies with St. Francis: Why did they value HMC at $25M during the buyback proceedings of bankruptcy #2 yet move the goalposts to $40M when Prime stepped up?
Remember that St. Francis failed to disclose that they were losing $1M/month when they sold the hospitals to HMC in the first place. And yet St. Francis’ CEO tried to spin HMC’s first bk filing as wholly due to HMC’s misguidance.
And now St. Francis has even asked HMC to expedite their wind-down as transplant patients are left twisting in the wind.
Lies, deception, profit before people’s lives. Surely St. Francis deserves more scrutiny than alleged Medicaid/Medicare defrauders.