Paying for indigent care.

[dave]

Should Marengo county pay the bill left by folks who can't pay it at the hospital?

[Jeff]

I voted yes to this pole, but for only a couple of reasons, and with certain stipulations. I think the county should step in and assist in getting our excuse of a hospital back on its feet. But, the county should not be paying bills for those who have know reason for not paying the bill themselves! I really don’t think that all of the bills that need to be paid are from people that don’t have a dime to their name. In fact, I would be willing to bet that a good sum of the bills are for patients that have more than enough money to pay their bill, they just see that many other people aren't and feel that they can get away with it too! The hospital needs to open its books and let the county see who owes what before a dime is issued to them. It's kind of like you going to your parents, asking for $10,000, and refusing to tell them what it is for! If the bills are weeded down to only those that truly need assistance with their bills, then the county should help. If the hospital gets "back on its feet" then maybe when can get descent healthcare back in Marengo County. But it is also my opinion, that if the citizens of Marengo county are going to help pay for the Hospital, then the citizens have the right to have some sort of say so in who runs the hospital!

[kaye334]

Good point, Jeff!!! I think that if the administration would change, then a lot of changes would be seen in that place!!! Wake up Tombigbee Healthcare Authority and the City of Demopolis!

[dave]

Here's the article that's stirring up the storm between Nabors and Tucker. CLICK HERE (http://www.tuscaloosanews.com/apps/pbcs.dll/artikkel?SearchID=73118720252342&Avis=TL&Dato=20021128&Kategori=NEWS&Lopenr=211280333&Ref=AR) By what Nabors put out as the budget as of October this year, even after ALL uncompensated bills are paid, indigent and deliquent, the Hospital is still in the hole $40,000. This is after paying the lowest wages for nurses practically anywhere and undermanning the shifts. The fact is, Nabors is failing to turn a profit there and is looking anywhere he can to get more money. I'm still leaning towards a sales tax, simply because it will get that monkey off the County's back, and give Nabors no more excuses as to why the Hospital doesn't generate the revenue it should.

[tigerfan]

As a former employee of the "Whitfield", I can say that the lack of
resources from the hospital comes from a long history of not trying to collect bills. I have heard hundreds of people say that they came to the Emergency Room for a cold,rash etc. because you don't have to pay at the hospital. If they went to the Doctor's office they must pay to be seen.

I do not think that the sales tax should be passed as long as
Charles Nabors and his group of administration are at the hospital. The only thing more money would do for them is to pad pockets or build another building for Mr. Nabors to say "look what I have done". The working people (the stregnth) of the hospital would never see a penny of this money. The hospital hires new graduate RNs at a higher payrate than the faithful people who have worked there for 5-10 years and have experience. All of the experienced RNs who can leave this area have taken jobs at "real" hospitals where they are making around $10.00 more per hour.

As for the board of directors of the hospital, I believe most of the members are misled by Mr. Nabors. Not all information is given to them at meetings, Just enough to get the approval that he desires. Have you wondered what Mr. Nabors is hiding in the books? If we get rid of Mr. Nabors and get an administrator with a good business sense and who is fair, then the tax should be passed. Strict guidelines should be in place on real indigent care vs. people who want a free ride.

[Jeff]

I agree completely. If the guy has put the hospital in the ground this much then he needs to go! We need new administration, more doctors, more specialists....... But no one in their right mind who is worth a damn will come here because of the state of the hospital. Mabey if we get new management with promise then we can better professionals working there. With more pro's then the hospital can take care of more patients in stead of taking everyone with anything more than the FLU to Tuscaloosa!! If there are more patients then tere will be more money, for better pay, which causes more incentive for more profesionals, so on and so forth. NEW ADMINISTRATION!

[kaye334]

If a tax increase is passed to pay that place, I will do my business elsewhere as much as possible!!!! I think alot of people would probably agree with me.

Don't get me wrong, Demopolis NEEDS a hospital! It needs BWWMH, but it surely needs an administration that knows what is going on, and will attend to problems (patient and staff).

Mr. Nabors, he has a very good vocabulary. I learned more "BIG" words while working at BWWMH than I did my whole 12 years in school!!!

[River Rat]

I remember when Livingston had a nice big hospital... It's just an old eye sore of a building now. The people of Livingston did'nt want to support their facility either so they chose to let Rush Hospital purchase it. Now it's a small clinic and the rest of the building is just wasting away. I think people need to stop believing everything they read in the newspaper that is written by disgruntled employees and do a little research for themselves to formulate thier own decision. The employees of the hospital do not want their salaries published - so what - do you want yours made public? I get so frustrated with all of this bashing the hospital takes. It is a quality facility with good services and we are fortunate to have it. If the citizens of this county let the hospital fold then they are dumber than I thought. Bottom line is - the county has a legal responsibility to pay for care of it's poor and they need to devise a method for indigent certification and payment.

[Jeff]

The hospital is a private organization though.... Right? I am for the county helping the hospital, but as a citizen I feel like I should be protected so my money doesn't go to pay some bill that could have been paid by the person it belongs too! And about the salaries of the employees.... The salaries of the administration should be made public when you have nurses making less than some high school kids with summer jobs! Nurses have one of the hardest jobs out there in my opinion and should be well paid for their work. But apparently that work isn't very important to the administration. If the administration was half as underpaid as the nurses at that hospital, do you think they would be so shy about fessing up their earnings? Not to mention, tax dollars alone will not pull the hospital out of debt. With the hospital in the shape that it is in, how can you really argue that it is being managed adequately? I mean the buildings look great, but what use are they if you can’t get care in them?

[River Rat]

DO YOU REALLY BELIEVE???... that all of the rural hospitals throughout our state and across the country that have closed over the past 10 years have been a result of poor management?? The fact is that reimbursement for the government programs has not kept pace with rising costs - ESPECIALLY for rural facilities such as ours. By the way - exactly how much do the nurses here make compared to DCH or RUSH. Is it comparable with living costs? Would it be worth the drive for these nurses to commute? Does the shift differential make up the difference here?

[Jeff]

Well, as far as working for DCH or some of the others, there are many nurses you can ask who travel from Demopolis to Tuscaloosa and Selma because of the pay and benefits difference. Is it fair for an individual to go to school, become a very knowledgable healthcare professional, only to work for around 7 bucks an hour? I make more than that tutoring math...and I dont have a degree yet! I think it is a joke that the hospital continues to build buildings rather raise wages and hire more nurses. The nursing staff is running scarce. I personally would rather have a nurse that hasn't worked double shifts all week, and is a little ticked after looking at that last paycheck attending to me!

[River Rat]

AMEN Brother - now let's make sure the county fulfills it's legal responsibility so the hospital can continue to grow and serve the residents of this area. The solution is not going to be found through slander and rumor. It will be found through compromise and accountability. However, the hospital needs us and you too Jeff, to be on it's side on this issue. ;)

[dave]

I would personally like to see exactly what M'care cut out of the funding. Dr. Fitz himself has said a few times they can't "shuffle around" money anymore. This has been a big problem in the Home Health agencies--they were making a killing charging for full visits where all the nurse did was draw blood and leave..this on a Client that could easily drive him/herself to the clinic and have it done. As far as salaries go, they don;t even begin to compare. Having been employed there, I can say there is alot more money to be made elsewhere. Believe me, I would love to have stayed working at the hospital, but I would have been homeless working for them full time.

[River Rat]

By the way, the options for the poll are not accurate. "No, the hospital is responsible for it's own bills and debts" - this is not the issue! The issue is the bills and debts of the patients who have recieved treatment at the hospital - not the hospitals bills and debts!!! Did Mr. Jones create this poll?

[dave]

"Bills and debts" refer's to those caused by indigent care. Since no one has offered another solution for paying these bills besides suing the County, it's obvious if you don't think Marengo County should pay the bill, then the hospital should. The poll has 2 options. Scott Jones did NOT create this poll, I did.

[River Rat]

Well then, rather than wording it the way you did, why did'nt you simply say "NO. The Hospital should pay for indigent care."??? This way the words don't seem so twisted.

[Jeff]

I am becoming a little confused as to the basis of your opinion RiverRat. Half of the people that have voted agree that the county should assist in paying for the indigent care, including myself. My issue with this is that we, as citizens paying the tax, should have say so who runs the hospital. You pay taxes to the government, and you get to vote on who runs the government, how is this any different. As far as the hospital opening the books for the commission to see, why not? If you have someone asking for money, shouldn't you know where that money is going? I myself would find it very hard to stomach if the county increased taxes to just blindly give money to the hospital, with no TRUE idea of where the money is going nor any sayso in manages that money. Now on the issue of pay for the nurses. Last I checked, the nurses for BWWMH were making right around $7 an hour. For point of comparison, The 2001 State Occupational Employment and Wage Estimates report posted for the state of Alabama, the average for LPN's is $12.05. That puts our LPN's at only 58% the state average! How is this justified? These numbers aren't taken from just large cities either, this is the state wide average. Issues like this one is why I personally feel the Administration should be re-staffed, to try and push this hospital into a different direction.

[River Rat]

Jeff, I think we should stay on the issue. The issue is not revealing salaries and rates of pay, it is Indigent Care. The Alabama Healthcare Responsibility Act clearly states exactly what the county is to do. It does not mention salaries or county control of personnel. The people who are most impacted by this whole issue are never mentioned - the poor - the people with no insurance - the people who live below the poverty level - the indigent people that are supposed to be helped by the county. I have often wondered why a citizens group of people considered as indigents has not filed a class action suit against the county to force them to comply with the law. And as far as your comment about having some say as to who should run the hospital - when was the last time the city of Demopolis asked for your approval of a new employee? Is this not the same? All we can do is elect people to these positions (county or city) and trust that they will make the right decisions on our behalf. From what I've read, the City appoints the majority of the board members and the hospital has agreed to allow the county to appoint some board positions.

[dave]

Why would the indigent folks bring a lawsuit on behalf of the hospital? Unless the hospital is still actively trying to collect money from them, they seem to be in the best position here. I personally don't believe a 1 cent sales tax wil break anyone, and would be glad to pay it if it benefits the community. I do feel though if the hospital is going to recieve tax dollars, then the people of the county should know where the money is going. According to Nabors himself, even with all outstanding indigent bills paid, the hospital is still in the hole, so all the hollering about how our hospital will close because the county won't pay isn't entirely accurate.

[Jeff]

My issue is simply giving the money to the current administration for the hospital. I don't have confidence that the money will actually go to where it is supposed to go! It is obvious by the track record of this hospital that they aren't very efficient with their spending, nor do they make sound choices with their money. What about all the money used to build the countless add-on's to the hospital that aren't needed? In my opinion it't like giving s loan to gambling addict, it's possible the money will go to what he needs, but it will more than likely get blown on what he doesn't.

[dave]

Is there a good online source for the law that says the County is responsible for it's indigent care bills?

[stickman]

Mr. Jones welcomes River Rat to engage him in any discussion he or she may want in regards to the operations, management, and funding of the Demopolis Hospital any time you see fit. You've obviously read what has been authored by Mr. Jones and printed in the papers and from the looks of your posts, I think he's pissed you off. I personally would like to know just what your involvement with the hospital is or has been and just how well versed you are in what goes on inside the Taj- Ma-Hospital. My money says you don't know your butt from a hole in the ground.

Feel free to engage River Rat.

Stickman

[dave]

Originally posted by River Rat
By the way - exactly how much do the nurses here make compared to DCH or RUSH. Is it comparable with living costs? Would it be worth the drive for these nurses to commute? Does the shift differential make up the difference here?

I think the hospital board answered that question...

Here's the meat of the whole sandwich--How does BWWMH plan to define what is considered indigent care? If the go by what Nabors has been putting in his fisscal reports, then that will be all unpaid bills. I don't think I'm alone when I say I don't want to pay for someone's hospital stay when they make the same, if not more than me; they just don't attempt to pay their bill.

[Jeff]

The issue is exactly as Dave just said! Just because a bill is unpaid doesn't make it indigent. Indigent care is that for people who are truly poor. These are the people that neither I nor anyone I know has a problem being classifying as indigent. I want my tax dollars to help these people, because I know that they may not be financially able to help themselves. But the people who make the money, and just plain refuse to pay their bill......that's just whole new issue. These people need to take a little responsibility for themselves. And with Nabors out there basically saying that all unpaid bills are indigent....then of course the same people are going to hold off even longer! I tell you what, if just not paying a bill for a long time causes it to be indigent....then will someone call BMG music and tell them that over my 3yr past due bill??