Volume 18, No. 1, Winter 2010
Your Good Health Forum |
Cape Cod Hospital is one of six community hospitals in Massachusetts filing suit against the Commonwealth for millions of dollars in unreimbursed payment for healthcare services.
The hospitals are known as “disproportionate share hospitals” (DSH) because at least 63 percent of their patients are covered by public insurance. While healthcare reform has brought the state closer to universal coverage, one unintended consequence is that many DSH hospitals are experiencing significant shortfalls in payments as they treat additional patients whose public insurance doesn’t cover the full cost of care.
The other plaintiffs are Berkshire Medical Center in Pittsfield, Signature Healthcare Brockton Hospital, Holyoke Medical Center, Merrimack Valley Hospital in Haverhill and Quincy Medical Center.
They claim the state has violated a law requiring financial reimbursement equal to the costs of providing care to Medicaid recipients. They also claim that the state has set Medicare, Medicaid and other reimbursement rates so low that many of them are facing severe financial distress as they fulfill this expanded state mandate.
According to the suit, cumulative state cuts to Medicaid (the state’s MassHealth program), and an additional capping of hospital payments last December, have left the hospitals with a combined funding shortfall in excess of $70 million in just the past three years. On average, the state's Medicaid program has paid only between 40 and 86 percent of the costs of providing care to the elderly, low income, and uninsured populations it is supposed to cover.
DSH statistics show that among the six plaintiffs, Cape Cod Hospital reports the second highest three-year Medicaid shortfall, $17,212,667. It’s also the busiest of the six with approximately 590,000 patients annually seeking care and 74,947 annual emergency room visits. In the latter category the Hyannis hospital is the sole community provider.
At the request of the State Department of Public Health, Community Health Center of Cape Cod in Mashpee has come to the rescue of a School-Based Health Center (SBHC) at Barnstable High School.
The program had been operated by Cape Cod Healthcare (CCHC) until October when it was shut down in a cost-cutting measure. CCHC also ended its sponsorship of a similar clinic at Cape Cod Technical High School in Harwich, but that facility remains closed since it is well out of the Community Health Center’s territory.
The DPH has provided a grant to help finance the revived center, but Chief Development Officer Karen L. Bissonnette indicated that additional fund-raising would be required.
The SBHC in essence acts as a screening bridge between the school nurse and the student’s primary care physician. And parental consent is required for SBHC services.
The SBHC will have a full staff headed by a physician, a nurse practitioner and a licensed mental health counselor.
Faculty and staff also may utilize the SBHC as their primary care provider with access to the complete range of the Health Center’s services at its locations in Bourne, Falmouth and Mashpee.
By Mark Turley
Unfortunately, power outages on Cape Cod are hardly unusual.
Seniors and the handicapped who rely on the safety net of a medical alert service, for years have lived with the fear of a storm or other disaster cutting off their connection to the outside world until power is restored.
They need fear no longer.
The newly inaugurated Lifeline Medical Alert Service has been integrated into what is described as “a senior-friendly cordless phone communicator.”
The new product was introduced on the Cape in October.
Most seniors prefer the convenience of cordless technology, but this latest innovation is the only such device to work during a power outage, provided the client’s phone line still works.
Philips Lifeline to date is believed to be the Cape’s only medical alert service to offer this particular option.
On average, one out of every three people over 65 falls each year. Medical alert services help seniors obtain the right help quickly, providing peace of mind while improving outcomes and reducing complications related to falls and other potential emergencies.
This “cordless phone communicator” also is designed to support the independence of seniors with limitations in dexterity, vision or hearing with large buttons for dialing, high-contrast displays for caller ID and dialing and enhanced sound quality and extensive volume range.
(Mr. Turley is the Philips Lifeline independent distributor on Cape Cod, 508-398-1177 or turley@comcast.net.)
By Nate Murray, MSSW, LICSW
The shortage of qualified labor is one of the critical issues facing organizations that care for elders.
Due in part to the well documented lack of adequate staffing at all levels in many hospitals, nursing homes and assisted living facilities many individuals seek to have additional private care. Organizations that provide private caregivers to elders in these facilities can offer individuals and families a solution.
Having a companion or caregiver in the nursing home or hospital can help elders with the tasks that can make an inpatient stay more bearable such as fetching water, adjusting bedding, one-on-one companionship while eating and engaging in activities and coordination with their outside life. Usually the nursing home welcomes this involvement.
Increasingly popular assisted living facilities are different from nursing homes in that this form of supportive housing enables a senior to maintain a certain degree of independence and privacy. Personal services vary according to the degree of assistance needed by the resident and the capacity of the facility to provide that service. That capability can vary widely between facilities and residents tend to require more daily living services the longer they reside at such a facility.
If assisted living residents in Massachusetts need or desire additional care or help with daily living beyond what the facility can provide, they have the right to hire additional private care at their discretion.
What to look for in a private care agency?
That the organization is owned and administered by human service professionals and that employees are well screened, insured and bonded.
You should obtain their licensing information (in Massachusetts all such agencies must be licensed through the Department of Occupational Safety).
And finally, get references, both from former clients and professionals in the field.
Above all it is essential and generally recognized that facility staff and the private care agency are both working toward the same goal which is the health, happiness and well being of residents.
(Mr. Murray, MSSW, LICSW is President of MBC Senior Services, Inc. which operates Visiting Angels of the South Shore, a private home care service for elders, 781- 834-6355 or www.visitingangels.com. Frank Aldrich is the Director of the Cape Cod office of Visiting Angels in Chatham, 508- 432-9600.)
Sally Deane of Provincetown and Boston has been named Acting CEO of Outer Cape Health Services (OCHS), an appointment that clinic officials indicated could be made permanent within a short time. She succeeds Dr. Roberta Berrien, who was credited with playing an important role in achieving the financial turnaround of OCHS.
Ms. Dean was selected unanimously due in part to her local ties and a track record of almost 40 years in community health management.
She established a second home in Provincetown in 1993 and traces her family’s roots to Truro although she was born in California and attended public schools in Alaska. She became widely known in the early 1980s for overseeing the complete clinical and financial turnaround of Boston’s Fenway Community Health Center and its positioning in response to the AIDS crisis.
She also has served as executive assistant commissioner of the Boston Department of Health and Hospitals, assistant director for ambulatory care for the Massachusetts Medicaid program and director of special projects for Boston University’s Health Policy Institute. She has had a 20-year career as a well-respected health care management consultant in Massachusetts, elsewhere in the U.S. and in the Republic of Turkey.
In addition to a Bachelor of Arts degree in Psychology and Education from Whittier College, she holds a Masters in Education, Counseling Psychology and Higher Education Administration from Boston University’s School of Education, and a Masters in Public Health (Health Services Administration) from the Boston University School of Public Health.
Chalk up a first for Broad Reach Healthcare at Liberty Commons in North Chatham.
The independently owned multi-service facility, in operation here since 1986, recently received word that it has been awarded the highest rating possible from the Commission on the Accreditation of Rehabilitation Facilities (CARF).
CARF, founded in 1966, is an independent, nonprofit accrediting body dedicated to improving organizational standards as a means of increasing the service quality and value of rehabilitation and human services for consumers. While all skilled nursing facilities are required to undergo an annual survey by state regulators, participation in the CARF survey is voluntary.
To receive this accreditation, the Liberty Commons team participated in a rigorous review process and demonstrated to a panel of surveyors during an on-site visit in August of 2009 that their programs and services conformed to all CARF standards.
The ensuing three-year accreditation for its adult inpatient rehabilitation program made Liberty Commons the second of only two such accredited skilled nursing facility programs in Massachusetts and the first on Cape Cod.
Liberty Commons also provides long term care, assisted living and Alzheimer’s care, as well as Hospice and palliative care.