News Analysis

Dr. Salahuddin Farooqui, MD attends patients on his rounds at Greene County Physicians Clinic

By: John Zippert, Co-Publisher and Chairperson of Board of Directors of Greene County Health System (GCHS)

We, the citizens and leaders of Greene County, must work together immediately and urgently to save our hospital (20 beds), nursing home (70 beds), physicians clinic, and home health services, which are grouped together as the Greene County Health Services. This is a public non-profit corporation, whose board of directors is selected by the Greene County Commission.
As a small rural hospital our future and finances have been clouded by the uncertainties surrounding Federal health care policy, the refusal of Alabama’s Governor and Legislature to expand Medicaid funding to the working poor, the low reimbursement rates for Medicaid and Medicare recipients and the high level of poor people in Greene County that we do not and cannot turn away for needed health care services.

GCHS needs your support to stay open.

Another problem, we have, is one that we are all responsible for and can solve. Many of us in Greene County do not use the health facilities and doctors at the GCHS like we should and must if the hospital is to be there when we have an emergency and need it most.
Our Emergency Room (ER), which is staffed 24/7 is available for emergency injuries and life threatening conditions at home, on the job and on the highway. Many Greene County residents and others on the Interstate Highway have been medically stabilized and their lives saved by the ER. Once they were stabilized, we were able to send them to other facilities, by ambulance or helicopter, for more intensive care and treatment.
A community that wants to grow and attract industry and jobs must have an operational health system or industry will pass us by. One of the first questions a prospective industry asks is whether there is a health facility, in the community, that can respond to safety concerns and emergencies for employees at their plants, offices and business locations. If we are forced to close the hospital, we will loose the chance for industrial development and we will loose the jobs of the people who work at the facilities.
We have twenty vacant beds in our Residential Care Facility (Nursing Home), which should be filled up. There are Greene County elderly in nursing facilities in other places who could be at home getting the same or better care closer to family and friends.
We also provide swing beds for Medicare 21 day rehabilitative hospital stays. You will receive the same services as in other facilities. We have trained physical, occupational, speech and other therapists and nurses on staff and you will be closer to home. It is up to you to insist upon returning to the GCHS facilities for health services even if other facilities are aggressively promoting you to go elsewhere.
The GCHS has faced tight financial times for many of the twenty-five years that I have served on the Board of Directors. In recent years, the financial pressures have mounted and the facility has no cash reserves. Our patient mix is one third Medicare, one third Medicaid, 5 to 10% Blue Cross-Blue Shield and 25% with no insurance or payment source.
The GCHS, as a small rural facility, we receive 65 cents for each dollar billed to Medicare; only 32 cents for each dollar billed to Medicaid; 75 to 80 cents for private insurance payers and nothing from people without insurance. Our Administrator says: “Our Medicaid reimbursement is like walking into a store and paying $1 for a $3 dollar gallon of milk. The store could not stay in business very long, but this is the way our health system operates.”
The GCHS is audited each year by an accounting firm that reports its results to the State of Alabama for approval. The accountants also prepare a cost report which is used by the Federal and state governments to determine reimbursement rates and “disproportionate share payments” to help cover deficits.
For the current fiscal year, for the 10 months from October 1, 2016 to July 31, 2017, the GCHS has a deficit of $894,227, about $90,000 per month after all direct and indirect revenues have been calculated. This deficit correlates with the $100,000 a month of “uncompensated care” the GCHS provides for very low income residents of Greene County, some of whom are “working poor people”, who have a minimum wage job but who do not have or qualify for insurance or a payer source.
The GCHS receives 1 cent of the 3-cent sales tax, which is received by Greene County on all retail sales in the county. This is generally $30 to $40,000 a month. Currently the GCHS has pledged these funds for ten years on a bond issue that generated $2.5 million to pay accumulated debts for the past five years of operations, including a $1.2 take-back by Medicaid for “over payments in past years”.

GCHS needs support from electronic bingo

The GCHS is currently receiving minimal support from “electronic bingo” in Greene County. When Amendment 743 was passed, support for the hospital was named as one of the major reasons for use of the charitable bingo contributions. For the past five years, the hospital and nursing home have only received minimal contributions from bingo and we were not included in the formula for use of the $200 fee per machine, which goes to support the Board of Education, County Commission, Sheriff’s office and four municipalities.
We have been discussing our financial situation and problems with Sheriff Joe Benison for five years. In June 2016, the Sheriff imposed a 4% tax on the companies that provide bingo machines in Greene County. This tax was supposed to generate $20,000 a month for the GCHS. Unfortunately, the Sheriff did not enforce his own regulations and none of these funds were paid to the hospital. For the 15 months since June 2016, the GCHS has not received the $300,000, this tax was supposed to generate.
On Friday, August 25, 2017, the GCHS Board of Directors met with Sheriff Benison to discuss our critical financial situation. We asked the Sheriff to collect the outstanding 4% tax that he imposed on machine operators and provide an immediate infusion of funds to the hospital. Secondly, we asked that he immediately, as of September 1, 2017, increase the base fee, on all machines, at all bingo parlors by $25.00 from $200 to $225, and provide that increase on a monthly basis to the health care system.
Based on a minimum of 300 machines in each of the 5 bingo establishments, this would generate $37,500 in new revenues, on a stable monthly basis, to help the hospital toward financial solvency and covering the cost of uncompensated care. We feel Greene County health services must be included in the basic fee formula per machine or in whatever basic revenue formula is developed for bingo. We really feel the gaming industry in Greene County can afford and must support our hospital and related health care facilities.
In our letter to Sheriff Benison, we gave him until this Friday, September 8, 2017, to give a positive response to our requests. This is a critical problem and we need the help of the Sheriff and the gaming industry in Greene County to help to do their part to solve this problem.
To summarize, we must all work together to save our Greene County Health System. The people of Greene County, Black and White, must use our facilities more, fill up our nursing home, use our laboratory testing, our rehabilitative services, our three doctors and two nurse practitioners at the clinic, our home health services, our mammogram machine, CT scanner and every service we have available.
Our community leaders including the Sheriff, County Commissioners, School Board, Mayors and City Councils, preachers and lay church leaders, civic organizations, and everyone in a leadership position in the community must help us save the hospital and health services so that they will be there when you need them.