President Bush has presented heart surgeon Michael DeBakey with a Congressional Gold Medal. Houston-based DeBakey pioneered such procedures as heart bypass and has invented medical devices to help heart patients. He's also developed the idea of battlefield mobile surgical hospitals known as MASH units.
Several hospitals across the nation have instituted policies banning smoking anywhere on their properties, although enforcing these policies is easier said than done. Inspectors who certify hospitals may take an interest, however: The Joint Commission says hospitals at a minimum cannot allow smoking in buildings. Beyond that, hospitals must follow the extra smoking rules they set up, and too many violations can jeopardize government funding.
The House has moved to impose a one-year moratorium on new Medicaid rules that lawmakers argued would add to the burdens of states and healthcare providers. The Bush administration backs the rules as cost-saving measures, and there is a veto threat from the White House. The bill would "thwart these efforts of the federal government to regain fiscal accountability and integrity in Medicaid," according to a statement from the White House. The proposed changes have met opposition from states, healthcare providers and advocates for poor, however, who say they will shift costs from the federal government to the states and create new hardships for the needy.
The U.S. military's health insurance program has been swindled out of more than $100 million in the Philippines, where doctors, hospitals and clinics have worked with American veterans to submit bogus claims. At the center of the case is Tricare, a Pentagon-run program that insures 9.2 million current and former service members and dependents. Healthcare providers in the Philippines filed claims for medical services never delivered, inflated claims by as much as 2,000% and shared kickbacks with retirees.
Texas Health Resources intends to build a $100 million hospital in the Lake Worth area, with plans for roughly 100 inpatient beds. The new hospital is expected to open in three to five years, at which point a hospital eight miles away in Azle would be converted to a largely outpatient facility. Executives hope that the new hospital will draw patients from all over fast-growing northwest Tarrant County because of the facility's accessibility.
I hear plenty about the roadblocks that small community hospitals face when it comes to replacing or upgrading facilities. A dwindling population base due to an aging community or scarcity of jobs, proximity to another hospital, a lack of staff physicians to increase volumes, a lack of community support—all of these factors can hinder a hospital's ability to secure financing. And as if finding access to capital wasn't already difficult enough, now these facilities are dealing with fallout from the sub-prime mortgage crisis and changes to the way nonprofits are able to borrow money in the bond markets.
When money is tight, consumers are forced to make painful choices. Should you buy baby diapers or a new pair of shoes? On the surface, that decision seems obvious. Baby diapers are a necessity; a new pair shoes may be more comfortable or stylish than what you're wearing now, but you can survive without them. They're a luxury. But the thing is, sometimes it becomes difficult to distinguish the things you truly need from the things you merely want. With the slowdown in the economy, small community hospitals will have to take a long, hard look at what products and services their communities need versus what they would like to have.
Many community hospitals will need to take a more modest approach to their construction or expansion projects. Some decisions will be easier: "Do we really need a glass atrium, waterfall wall, or healing garden at our new hospital?" Others will be more challenging: "Do we really need a 50-bed replacement facility, or will a 40-bed facility be sufficient?"
Even though the majority of community hospitals won't be able to borrow as much money as they could have a year ago and will likely have to curtail some of their plans, postponing construction projects until the economy rebounds is not in their best interest, according to industry experts. Many of these hospitals are operating in antiquated facilities that are unable to meet the needs of their community. What's more, construction has slowed up a little bit, says Arlan Dohrmann, managing director of the Stern Brothers & Co., a national healthcare finance group, so "the cost of construction is not going up at the inflationary rates that we were seeing."
Dohrmann offers these tips to community hospital executives whose facilities are in the middle of a construction project—or about to begin one:
Get a credit assessment done to determine your hospital's debt capacity.
Decide what services are really important to your community.
Analyze your current operations, demographics of your region, the size of the project, and your vision.
I would love to hear about your hospital's construction project. Please drop me a line at the below e-mail address.
Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at cvaughan@healthleadersmedia.com.