Hospitals

April 6, 2014

Someone Let Me Talk on the Radio for 10 Minutes About an Abandoned Hospital

It’s now no longer recent, although it could qualify as semi-recent, but I appeared on WBEZ’s The Morning Shift back in February to talk about Edgewater Medical Center, a long-empty hospital on Chicago’s North Side. This came after I wrote “The Saga of Edgewater Medical Center” for Gapers Block, which is part four in the “series” called Monica Writes About Hospitals. (This is a bit delayed because I’ve been busy for the past month and I didn’t think, “I should put this on my blog.”)

It was mildly terrifying because I hadn’t been on any broadcast outlet since my sophomore year of high school and I was worried I’d sound like some silly little kid who think she’s a journalist and I’d say “hahspital” a lot. After sitting down in the studio and starting to talk and thinking of it as just being a conversation with Tony Sarabia, the host, everything came easy. I regret not jotting down some notes to take in with me because there is some stuff I forgot to mention, but now I know next time I’m asked to be on TV or the radio.

If you haven’t heard the interview, I embedded it below for your listening pleasure. A quick note, the part where I very faintly say “Hi!” was the result of my mic not being on, not my anxiety. (Also, the email asking me to come on The Morning Shift came on my birthday, which was pretty great timing.)

April 17, 2013

A Brief History of Kickback Schemes at Chicago Hospitals

Edgewater Medical Center in Chicago. Photo via Flickr/Zolk

Edgewater Medical Center in Chicago. Photo via Flickr/Zolk

News broke yesterday that six have been arrested in an alleged kickback scheme at Sacred Heart Hospital on Chicago’s West Side. According to the Tribune, the hospital was performing unnecessary procedures on patients in order to increase the money it received from Medicare. The procedures in this case appear to be tracheotomies, which is where an incision is made into the neck and trachea so a person can have an airway other than their mouth or nose. Usually a tube is also inserted to help the breathing occur.

According to the Illinois Department of Public Health, Sacred Heart is a for profit hospital and in 2011 it provided $11,742 of charity care. What’s interesting is in the breakdown of patients and revenue in the annual report it says 38.2 percent of inpatients were Medicare patients but 60.1 percent of inpatient revenue came from Medicare.

Since the raid and arrests happened on Monday, this news story is still unfolding. What’s unfortunate beyond people being heavily medicated and having unnecessary procedures performed on them is if this is all true, this isn’t the first time there has been Medicare fraud committed by a Chicago hospital as part of a kickback scheme.

Edgewater Medical Center is an eyesore that has sat empty for more than a decade due to closing after numerous staff members were found guilty of Medicare fraud. The most detailed explanation I’ve found of the hospital’s closure comes from Ken Fager of American Urbex:

Vice president Roger Ehmen and medical director Dr. Ravi Barnabas were able to turn the nearly bankrupt hospital into a lucrative profit center. The pair tapped Dr. Sheshiqiri Rao Vavilikolanu and Dr. Kumar Kaliana to recruit potential patients. For years the doctors sent hospital employees into the Chicago community to find potential patients. It did not matter if they did not have heart conditions, were drug addicts, were unable to speak English or even had no health insurance coverage. Recruiters instructed the potential patients how to feign symptoms in order to mandate services rendered by Edgewater Medical Center. In return the patients were offered money, food, cigarettes and other amenities for their cooperation.

In addition to this doctors at Edgewater Medical Center performed unnecessary angioplasties, which is a procedure where arteries are widened. People were killed as a result of these procedures. As I said earlier, news broke, people were tried and the hospital closed. A simple look on Flickr for “Edgewater Medical Center” will return numerous photos from inside the hospital, many of which make it appear as if the staff simply up and left the building, forgetting to take the patient records and chemicals with them.

There are numerous questions to be brought up with both of these cases. What would compel these hospitals to do this? It’s possible that they did this simply so they could stay afloat as other hospitals in Chicago have had to close because they couldn’t afford to keep running. (RIP Michael Reese Hospital.) There are also questions that could be brought in about what it is with Medicare’s set-up that makes the use of dangerous procedures seem like a good way to increase hospital revenue. I’ve heard some things from doctors I know about the set-up of Medicare sometimes pushing them to treat more patients, but I don’t know how much of that is true.

I also find it interesting no one criticized Sacred Heart Hospital for how little charity care it provides since it’s on the west side of Chicago. Rush University Medical Center has been criticized for not providing a large amount of charity care–although it’s right next to John H. Stroger Jr. Hospital of Cook County–as has University of Chicago Medical Center on the south side. Again, numbers on charity care aren’t everything and I imagine its status as a for profit hospital came into play with the lack of criticism, but it does strike me as odd no one criticized this hospital.

Let’s hope this story doesn’t become worse as time progresses.

April 3, 2013

A Look at Data on Chicago Hospitals

charitycare

(All data for this post comes from the Illinois Department of Public Health.)

The graph above looks at the amount of charity care given by teaching hospitals in Chicago during the 2011 Fiscal Year. The charity care expenses are for both inpatient and outpatient care. The hospitals were chosen from looking at a list of teaching hospitals from the Illinois Hospital Association and picking hospitals listed as “major teaching.” Both St. Joseph Hospital and Lurie Children’s Hospital of Chicago barely show on this graph due to having only gave 0.7 and 0.3 percent of the respective hospitals’ expenses compared to net revenue going to charity care.

One hospital on this graph has raised a bit of controversy due to its lack of higher charity care amounts. University of Chicago Medical Center, located on Chicago’s South Side, had only 1.2 percent of its expenses compared to net revenue going towards charity care. The following graph shows the charity care amounts over a five year period. (Additional data: 2010, 2009, 2008, 2007)

uchicago

Over this period the amount of charity care given by University of Chicago Medical Center has stayed fairly consistent, only slightly climbing in recent years.

stroger

In this figure we see John H. Stroger Jr. Hospital of Chicago, which had the highest amount of charity care given, receives a majority of its revenue from Medicaid. Stroger Hospital is the main public hospital in Chicago and is operated by the Cook County Health and Hospitals System.

lurie

Lurie Children’s Hospital of Chicago, which was still Children’s Memorial Hospital during the 2011 Fiscal Year, received a majority of its revenue from private insurance but also received a third of its revenue from Medicaid. This sizable amount could be the result of Illinois’ program to ensure low-income families have insurance for their children.

January 9, 2013

Hospital Planning and Flu Patients

Currently the hospitals of Chicago, as well as other cities in Illinois, are seeing such a large amount of flu patients coming in that some are among the 11 hospitals in Illinois that will only handle patients with life-threatening illnesses. This is such a huge problem that my mother saw a story about it on the evening news on CBS 58 in Milwaukee.

What interested me in the Tribune‘s article on the problem was a quote from an emergency department doctor at Northwestern Memorial:

Zich estimated that more than 35 patients with flu-like symptoms passed through the emergency department’s waiting room while Northwestern Memorial was on bypass Monday night.

 

The majority of those ER visitors did not require medical attention, he said.

 

“The flu in and of itself is not a reason to come to the emergency department,” Zich said, noting that an ER visit is “not necessary” unless the flu is coupled with difficulty breathing or another serious illness, such as heart disease.

For the longest time, people have been going to ERs for minor problems. I tend to not be this type of person because of how my mother raised me. This has been speculated to be the result of people not having a primary care doctor, although I’d also point out that urgent care clinics seeming to be a relatively new thing–and incredibly scarce in Chicago as I discussed in an op-ed for Gapers Block–people might tend to go to Emergency Rooms on weekends since most doctors don’t have appointments on the weekends.

There are some hospitals in Chicago that are trying to curb the occurrences of people coming in to the ER for problems that don’t really require attention at that high of a level. According to a spokesman at Rush University that I spoke with in the spring for an article I was writing, that hospital wants to help connect patients with primary care doctors in the patient’s area. University of Chicago Medical Center has a well-intentioned program that directs patients who come into the ER for minor problems to primary care clinics. (I say well-intentioned because the program has been accused of resulting in alleged patient dumping by University of Chicago Medical Center.)

In many ways it makes sense that ERs are doing this. I can see though that a potential problem with flu patients coming in–especially since this flu strain sounds to be a bit harsh–is that in some cases flu should be taken very seriously. But in most cases, a person should stay home and wait for the bug to pass. Last February, I went to the ER at Northwestern Memorial for a shoulder injury and found that the ER was packed. Based on what I was hearing, most of the patients who were there with masks on their faces had been waiting for five hours to be seen. In addition to going to the ER being very costly, you’re going to have to wait a very long time.

However the question that I have after reading about this is if John H. Stroger Jr. Hospital of Cook County is being horribly affected by this. When I visited Stroger Hospital to write about the Cook County Health and Hospital System for Gapers Block, I learned that the hospital divided up the Emergency Department into three different sections and triages the patients with problems like the flu separately from other patients. That hospital acknowledged that people will come to an ER for problems that can be treated elsewhere and figured out a way to help streamline and find a more efficient way to run an ER with this occurring.

It is inevitable that people will go to the ER for non-life threatening conditions or conditions that aren’t serious like a major injury. Something that Chicago hospitals might want to look at after this flu outbreak is how to help make an Emergency Department run more efficiently as people come in for things like the flu.