Hospitals ill from more bad debt, credit troubles Hospitals ailing from fewer paying patients, investment losses, tight credit and other ills
By LINDA A. JOHNSON, Associated Press Last updated: 9:35 p.m., Saturday, December 27, 2008
TRENTON, N.J. -- Gainesville's first community hospital has been on life support since the Shands Healthcare system in northern Florida bought it a dozen years ago.
Now, because of the recession, the plug is being pulled on 80-year-old, money-losing Shands AGH. Next fall, its eight-hospital not-for-profit parent company will shut the 220-bed hospital and shift staff and patients to a newer, bigger teaching hospital nearby as part of an effort to save $65 million over three years across the system.
Like many U.S. hospitals, Shands is being squeezed by tight credit, higher borrowing costs, investment losses and a jump in patients -- many recently unemployed or otherwise underinsured -- not paying their bills.
All that has begun to trigger more hospital closings -- from impoverished Newark, N.J., to wealthy Beverly Hills, Calif. -- as well as layoffs, other cost-cutting and scrapping or delaying building projects.
More closings and mergers are on the way, industry consultants predict.
"They'll get swallowed up by somebody else, if they need to exist, and if they don't, they'll just close," said Tuck Crocker, vice president of the health care practice at management consultant BearingPoint.
Most endangered are rural hospitals and urban ones in areas with excess hospital beds and a lot of poor, uninsured patients.
Hospitals, which employ 5 million people, are reporting that donations and investment returns are down, patient visits are flat and profitable diagnostic procedures and elective surgeries are declining as people with inadequate insurance delay care. But those patients are turning up later at ERs, seriously ill, making it tough for hospitals to lay off nurses and doctors.
All those problems are aggravating long-standing stresses: stingy reimbursements from commercial insurers, even-lower payments that generally don't cover costs for Medicare and Medicaid patients, and high labor and technology costs.
Hospital executives and consultants say the growing number of people with high-deductible health plans is boosting unpaid patient bills. Many worry health reform efforts by the Obama administration could bring cuts in Medicare reimbursements, and many cash-strapped states already have begun cutting payments for poor people covered by Medicaid.
In the past few months, patients and insurers have been paying hospital bills more slowly. As a result, some think hospitals will start demanding up-front payments for elective procedures.
In November, Moody's Investors Service changed its 12- to 18-month outlook from "stable" to "negative" for nonprofit and for-profit hospitals, citing "prospects of a protracted recession," bad debt and the credit crunch.
"Looking forward, the cost of borrowing will likely be higher -- and may be nonexistent for lower-rated hospitals," Moody's noted, a problem because hospitals borrow for everything from expansions and equipment to payroll and supplies.
I think you are missing the point of the original article. Yes there is a nursing shortage, but who and how are these newly graduated nurses going to get paid? Hospitals are merging/closing now and more are expected in the up coming year. They are 'cutting costs'. They don't have the money!!
So even though this idea is on the positive side, where are they going to get jobs?
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
There is a GIANT aging population that needs assistance.......sure as hell wont see $70/hour......their 401k and pensions lost their value.....and besides in America we only pay alot for cars/trucks not the care of our elderly/disabled/young........we think welfare cost alot? compare car costs to rust and wages of CNA's to auto workers......
you tell me what we should do??????
You cant afford me and I cant afford you.......whether your Mr/Mrs Welfare or Mr.Madoff........
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
I think you are missing the point of the original article. Yes there is a nursing shortage, but who and how are these newly graduated nurses going to get paid? Hospitals are merging/closing now and more are expected in the up coming year. They are 'cutting costs'. They don't have the money!!
So even though this idea is on the positive side, where are they going to get jobs?
I am certainly missing someones point- Travel around the country- Vegas- Orange County Calif- and even Michigan- the most depressing state ( Next to NY - if I believe all the repeated postings in this forum ) The Sunday classifieds can be 3 pages deep looking for medical professionals- My little sister is a REGISTERED nurse- my step mother is a Licensed Vocactional nurse- one of my roomates is a REGISTERD nurse-
My point is stop reading this nonsense- you will feel much better-
Sorry somebody, but it appears that you are looking at this entire health care fiasco through rose colored glasses. FACT is that hospitals are not raking in the bucks like they have in the past.
They use to rely on insurance companies to pay for the patients. That worked just fine. In comes the HMO's (thank you Hillary) and more revenues were cut.
Next comes in the good old government. (medicare/medicaid) Well that well is also drying up.
And let's also remember the illegals and the legals without health care that gets their medical care paid by WHO?
It is what it is...and it isn't good!
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
Sure Bumble many hospitals are closing for exactly the reasons you point out- in addition to Physician-owned hospitals and outpatient imaging centers - that are sort of skimming insured patients off the top and leaving the uninsured and Medicaid patients to the hospitals-
But I dont think the current Harvard Med school grad is worried about finding a job. Is The UCLA Medical center in trouble ?
The Hospitals that are in sick financially blighted communites are the ones in trouble-
I better stop reading the Vegas Review Journal through my rose colored glasses
But I dont think the current Harvard Med school grad is worried about finding a job. Is The UCLA Medical center in trouble ?
Why is it that I can't understand most of the doctors today when they talk? And for that matter, look around the hospitals and nursing homes....how many are home grown Americans? Take a walk around Albany Med and see how many 'doctors in training' are home grown Americans. Or any other hospital for that matter.
It appears that the home grown Americans realize and are thinking twice about joining our broken medical profession. What we see as a declining Health Care system, that the people from socialist, communist, fascist third world countries find enticing. Strange to say the least.
And the same goes for the nursing profession. Some hospitals are offering FREE nurses training with the stipulation stating that they will work at that hospital for 3-5 years after graduation.
We are headed toward government run universal health care. And in that case, the doctors that we can't understand, will feel right at home....cause that is just what they came from.
When the INSANE are running the ASYLUM In individuals, insanity is rare; but in groups, parties, nations and epochs, it is the rule. -- Friedrich Nietzsche
“How fortunate for those in power that people never think.” Adolph Hitler
Why is it that I can't understand most of the doctors today when they talk? And for that matter, look around the hospitals and nursing homes....how many are home grown Americans? Take a walk around Albany Med and see how many 'doctors in training' are home grown Americans. Or any other hospital for that matter.
It appears that the home grown Americans realize and are thinking twice about joining our broken medical profession. What we see as a declining Health Care system, that the people from socialist, communist, fascist third world countries find enticing. Strange to say the least.
We are headed toward government run universal health care. And in that case, the doctors that we can't understand, will feel right at home....cause that is just what they came from.
Because I pay for my own insurance with an extreamly high deuctable I will be going to an Apollo Hospital in either Banglore or Delhi India- http://www.apollohospitals.com For some " basic " testing- ( I think you can get a triple bypass for 25 grand - catscans 350 bucks )UCLA trained doctors and absolute state of the art facilities- so again my perception is completly different
A friend of mine on vacation in The Dominican had a very bad scare.....they had to enter a hospital......she wouldn't let them draw her blood.... they didn't have a ventilator in the hospital........
that is one view and maybe that particular hospital was more like a 'clinic'....the one's our government wants dotted all over the US......that's fine....
however, I think the public needs a drastic edumacation on what medicine is and learn to prioritize.....and medicine itself, needs to explain the end to our means......
This all gets mucked up when the insurance companies/governments get involved and make their own outlines and 'truth tables'........
dont think for one minute the taxpaying public wont demand it's own 'truth table' and outline......everyone will be 'equal'------EXCEPT for those with $$$ no different????.....more fish caught???....nah,,,,just new rules/regs.........
...you are a product of your environment, your environment is a product of your priorities, your priorities are a product of you......
The replacement of morality and conscience with law produces a deadly paradox.
STOP BEING GOOD DEMOCRATS---STOP BEING GOOD REPUBLICANS--START BEING GOOD AMERICANS
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