Tuesday, April 22, 2008

L. Ray's LTACH... Another Waste of Money

A Little History...

Long-Term Acute Care Hospitals (LTACHs) are specialty care hospitals designed for extended stay patients with chronic conditions. Patients are admitted to LTACHs following treatment in a traditional acute care hospital, but they no longer require intensive diagnostic procedures.

The care provided is more individualized and resource-intensive than is provided in a skilled nursing facility or nursing home.

LTACHs operate as freestanding facilities or as a “hospital within a hospital," with each type of facility operating under a different set of regulations. The average length of stay for LTACH patients is 30 days. Under Medicare guidelines, patients admitted to LTACHs must be in need of hospitalization for greater than 25 days and typically have multiple or complex medical complications.

Long-Term Acute Care Hospitals (LTACHs) have been around for nearly 20 years, but they may soon become extinct in American health care. First created to fill a vacuum in the continuum of care between the short-term acute care hospital and other post-acute care venues, LTACHs have provided a much-needed supplement to patient care, particularly the medically complex, long-stay patients that the venue was legislatively intended to serve.

Now, after several years of chipping away at LTACHs by the Centers for Medicare and Medicaid Services (CMS), Congress has imposed a 3-year moratorium on new LTACHs and additional LTACH beds.

A hospital-within-hospital LTAC must be:
  • Separately owned and licensed
  • Must maintain a separate board and administrative structure and must have a separate medical staff
  • The hospital must operate for a minimum of six months under acute care PPS to establish its average length of stay at greater than 25 days before it can be certified by CMS as a long term acute care hospital for Medicare payment.

Here we go again...another one of Ray's misguided attempts to salvage the dying DRMC. The "hospital within a hospital" description should tell you all you need to know about the fiscal "organization" of an LTACH.

Here's how it works... Hospital official to patient: "Well, Mr. Jones, you are not sick enough for us to keep you in our hospital any longer (CMS won't pay us anymore), but we are going to transfer you to our LTACH, (three blocks away), so that you can continue to benefit from our specialized treatments." (Rehabilitation for which we can get paid by CMS). "Admission to our LTACH will greatly enhance your recovery."... (and our reimbursement as long as you don't die within 25 days of admission).

Get the picture? A properly run LTACH can be a valid alternative to home health or a nursing home, but given DRMC's history, you can bet the only one that will benefit from this new "medical service" is L. Ray Humphreys!



Label Me Sick of Forthright said...

Apparently you have not had the privilage of having a loved one in need of the services of an LTACH. If you had, you would see what a benefit this is to the community. Having to place a loved one in an LTACH 150 miles away or more is draining on the family emotions, finances, etc. Patients are not visited as much as families would like because of these constraints, so having one in our own community will only aid the recover process, and keep the patient recovering with family nearby.

Can't you be positive for once? For someone who "claims" to be looking out for the community welfare with this blog, you sure seem to do alot of tearing down. You have failed the project before it is even started. You don't know everything. In fact you seem to know very little.

Anonymous said...

that last comment must have been written by one of ray ray's henchmen. you are providing this community a great service with this blog. i enjoy reading it! go forthwright!!!!!

Anonymous said...

Anonymous, you are so right. label me is one of Ray's guys. If they knew the quality of the nursing care at the hospital that already exists, they wouldn't be too positive either. Forthright, you do a wonderful job. Keep up the good work!

Label Me Sick said...

Wrong. Just a concerned family member.

Previous employee said...

I have to agree with Forthright. Why does DRMC keep adding specialized care when it can't even provide basic acute medical care? My understanding of an LTACH is that you will need more and better trained nurses. Where are they going to get them? DRMC needs to quit trying to be a major medical center and go back to providing the Delta with basic acute care. Anyone who seeks quality medical care is not going to choose DRMC. The best service DRMC currently offers is its heliport service to Jackson and Memphis.

Wait n' See said...

It does sound like "business" but that's okay....many hospitals and medical providers shift treatments and find ways to maximize their reimbursements.

Let's give DRMC a shot with this and hope - yes, hope - it IS a good decision by Mr. Humphreys and his team. The alternative is failure, which overrides any personal animosity between two people....and failure would be costly to patients....

rd said...

I don't think there is any reasonable need to accuse every dissenting opinion of being from "(enemy of choice)'s henchman ". Forthrights comments are going to make me view this with some concern but on the other hand there is nothing wrong with "chasing the money" when the national program keeps changing and there is money to be chased.

Consider the mess that "No Child Left Behind" has caused. It creates a difficult time for principles as instituting new programs drains already meager resources. But the wise pricipal will investigate what options are available and find that there is money available for after school programs that wasn't available before and focus on enriching the students education this way. Is the prinicpal being wrong or opurtunistic? No, he is using the resources he has and bringing outside money and value into the community.

Anonymous said...

To criticize the opening of an LTACH is Greenville is just plain stupid!!! It obviously came from somebody that doesn´t have any knowledge about the issue (or care about sick people)and will take advantage of any opportunity to attack Ray Humphreys and his group.
An LTACH is not a luxury or a PR strategy, it is a much needed basic healthcare service in Greenville. Now due to the moratorium, it is a mute point. However, the community´s support would have come handy when DRMC was fighting Greenwood for the Certificate of Need.
It looks like Greenville keeps shooting at its own foot over and over and over...

Wow! said...

How about DRMC's new NICU? It seems that this great new unit is all set to open, except for two minor obstables... no doctors and no nurses.

I hear the contracted rent a docs from Jackson pulled out at the last moment. As for nurses, they never had them and the few full time nurses they have are still leaving as fast as they can.

Kudos to Ray for opening yet another unit he can't staff!

Anonymous said...

rd, i would suggest you read up on the drmc hospital and what its mission supposedly is. it is not a money making business - it is a county owned hospital, not for profit, and the only choice for healthcare here in greenville. if you only knew the state of affairs at the place, you'd realize that chasing the money is the last thing ray needs. he is a power hungry monger who gets his rocks off on being in control. i can't tell you how ecstatic he was when he finally shut down ole kd. he reminded me of the grinch that day he announced it at our leadership meeting. we certainly don't need an ltac when you can't even receive basic nursing care on the med-surg floor. and the nicu, ask any employee at the place and they'll tell you its a huge waste of money. no docs, no nurses, not gonna happen even if he did have staffing. how much did that cost us ray? a brand new nicu-- empty...you are such the genius ray. i understand he is shaking in his boots as joint commission is expected any day at the plantation. i can't wait til they peg him since he thought it was so hilarious and openly laughed at bolivar medical center and northwest mississippi medical center's struggling scores. what an idiot. what goes around, comes around. i will personally be posting the jcaho results to this website for all to see as we all know its public record. let's see how creatively you can hide your secrets ray, i just hope they don't show up when you have your make shift icu in the recovery room. owwww, that would cost ya a few marks ;0

rd said...

"rd, i would suggest" -
Chasing money isn't only limited to profit making enterprises ... my school example still stands. That said ... if the leadership is really as unprofessional as all that then I certainly understand all the concern. Good choices, made with sensitivity to the community and its needs, communicated diplomatically, comes with the territory. If they can't pull that off then they really have no buisness being in a position that demands it.

Anonymous said...

The care at Delta Regional is terrible. Ask any nurse who works the floor, they'll tell you they are severely understaffed to the point of danger for the patient. But, if you ask a big wig walking around in heels they will tell you all is well. My vote is going with the folks who actually lay hands on the patients.

Anonymous said...

I was told by an ER nurse at DRMC that they are turning away nose bleeds because they don't have an ENT on staff! Yea, that's where I want to go when I have a heart attack!

Anonymous said...

you sound certain that your going to have one!!

Different Delta Thought said...

Let me ask, How can one complain about the Mississippi Flag, Then turn and enjoy the Confederate Memorial Holiday off of work? The city will not fly our State flag but takes the Memorial day off.

Humm --- Fly the flag or work the holiday!!!!!!!

Anonymous said...

I flag represents now and the vision for the future. Symbols of history aren't necessary on flags and just create awkward situations when they are not only historical but are controversially historical.

Everyone charges out to "preserve the history of the MS flag" and then wonders why nobody wants to display it. That is, besides those that, um, enjoy displaying it. Personally I would enjoy representing my beloved great state of Mississippi by displaying its flag. Sadly that seems involve backpeddling a lot of public perception and alienating my neighbors.

This isn't that hard. Everyone loved the state quarter.

The holiday? Why not unite everyone under a title like "Civil War Remembrance Day" and have it be a time of sharing history. We make it a lop-sided affair and then wonder why nobody cares to do much besides take the day off.

I'm not intending to pick on the last post. Just putting some of my basic frustrations with this whole controversy and why a compromise can't be reached that includes everyone.

Concerned in Leland said...

The Latest scandels from the wonderful "Leland School District::
A couple of weeks ago Dr. Richards had her latest cover up. She is always covering up something to keep Leland School District's reputation gleaming. This time it is not the innappropriate shenanigans of adults during the school day in front of the little students. This time we had a teacher say grossly improper sexual things to a female student. This was not the first charge of this kind against him. He even supposedly has sexually related charges against him in his own hometown which is not Leland. Dr. Richards, as usual thinks she is the judge and the jury and instead of alerting the legal authorities that Leland Schools has a sexual predator among us, she did her own investigation and apparently decided it would be wise to let this man resign and keep this all very quiet so his and Leland's reputation will not be hurt. Now he says he has offers from other school districts and since his reputation is untarnished he can go somewhere else and prey on other young girls. When he got found out though, he apparently blew the whistle on all his coworkers that are doing the same kind of stuff. The students are even talking about another male teacher who bought a female student a cell phone so that they can text and talk privately. It seems that this is not only going on at Leland School Park but at Leland High School also. It's all being kept very hush hush. But Dr. Richards is true to form and wants nothing to hurt the reputation of HER level five school district. It seems that she has crossed the line this time and put students in danger trying to further her own agenda. She has allowed so much to go on at Leland School Park this year, putting first graders to 8th graders in harms way. The principal there is apparently also unconcerned about all the innappropriate stuff going on right under her nose. How do they continue to get away with all this. Somebody with some power has got to stop them!

Anonymous said...

DRMC not only is without an ENT, but there is no neurologist or neurosurgeon. So, please plan to have a stroke while you're in Jackson or Memphis. Ooops, I forgot...Ray is building the state's next great hospital.

Anonymous said...


Anonymous said...

ent is ear, nose and throat.

Anonymous said...

thk u

Anonymous said...

One of the main reasons Greenville has problems retaining doctors is lack of support from the community in general. Ray Humphreys and DRMC's administration have nothing to do with it (in fact, they do a great job recruiting).
For example, the general perception is that, regardless who it is, any doctor outside Greenville is better. Then, people will spend 4-6 hours on the road and 2-3 hours in a doctor's office for very basic healthcare services.
The other big issue is the politics within the medical community itself. When a new doctor comes to town, some (not all) of the established physicians interfere with the growth and development of that new practice. Some refer only uninsured patients. Some openly start questioning the knowledge or work ethics of the new doctor. Some just ignore their presence.
With that small town mentality, we have allowed good doctors to leave the community and the perpetuation of a weak healthcare system.

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