Midwest Regional Dr. Threaten HMA

[bombermwc]

So if you haven't hear about this, here's a not so big shocker. The doctors at MRMC have given the management company, HMA, an ultimatum. Either get out, or they will.

Doctors ask HMA to walk away


The article doesn't really pain the whole picture. Had they been invited to stay for the entire meeting, they would have seen a much less hospital-friendly environment. My contacts with the doctors/staff passed on more of their side of the story to me. At this point, the staff is so tired of the facilty being taken down to the crap level that it has, then they (the doctors) have informed HMA that if they did not leave, that the physicians would and would simply open their own hospital. Guess what happens when doctors leave a hospital? They have to close because they dont have doctors. This isn't just a small disgruntled group either, it's the entire physician staff...and that includes a HUGE portion of the nursing staff as well.

Basically, they're voiceing now (in a very public way) what the public has known for years. HMA took a great place and flushed it down the crapper.

Here are some more articles:
Editorial
Staff members not drinking HMA Kool-Aid anymore



There were some very interesting opinion articles in that issue as well. They were stories from recent patients of the facility....eye-opening to someone that doesn't know how bad it's gotten at MRMC. I have to say, the last few times someone in my family has had the unfortunate experience of needing to go to MRMC, our situations were very similar. And those are NOT good experiences. Contrast to the experiences i've had at Baptist, Mercy, and OU which have all been excellent.

[mmonroe]

Not to mention, a lot of those physicians are missing out on $$$ because everything with HMA is billed out from each department separate. SAH has 1 bill. ONE!!!

[bombermwc]

Well part of that is the groups. That's not something HMA has done. It's typical for different groups like ER, Anesthesia, Radiology, etc. all art part of groups that the hospital contracts out with rather than employ. Doctors like to be part of a group these days to get themselves out from undernead the hospital management. Most of those same groups do their own scheduling and payroll as well, so they really are a "contractor" not part of the hospital. There are good and bad things to that though. Your bill from the actual hospital is smaller..lol, but of course you get 5 different bills along the way.

In most cases, the physicial is still under the umbrella of the hospital as far as insurance participation goes though. Imagine if you had to check each doctor for being in-network! Hospitalist relationships go in the same world too.

So while i loathe HMA, i can't really blame them on this. But there's plenty blame to be had by them. I tell people these days "i wouldn't take my dog there".

[mmonroe]

Well part of that is the groups. That's not something HMA has done. It's typical for different groups like ER, Anesthesia, Radiology, etc. all art part of groups that the hospital contracts out with rather than employ. Doctors like to be part of a group these days to get themselves out from undernead the hospital management. Most of those same groups do their own scheduling and payroll as well, so they really are a "contractor" not part of the hospital. There are good and bad things to that though. Your bill from the actual hospital is smaller..lol, but of course you get 5 different bills along the way.

In most cases, the physicial is still under the umbrella of the hospital as far as insurance participation goes though. Imagine if you had to check each doctor for being in-network! Hospitalist relationships go in the same world too.

So while i loathe HMA, i can't really blame them on this. But there's plenty blame to be had by them. I tell people these days "i wouldn't take my dog there".

I have been misinformed then, but I still don't like the fact that my hospital bills were all separate. What happens if your insurance misses a claim, (happened to me with 4 bills after moving a few years ago) and you don't get the mail on them? Thats 4 bills that can potentially go on your credit if delinquent, vs 1. Just for that reason, i'm only going to St. Anthonys East. Heaven help 'em if I ever need to ride in an ambulance and it try to take me to MRMC. From my location, i'm even a mile closer to SAH than MRMC.

[bombermwc]

Very true. When we had our twins, i was annoyed to see so many different groups' bills....and i'm very familiar with billing.

The key is just getting the info updated as soon as you can and checking those online portals with your insurer. If it's been 30+ days and you haven't seen a bill after an EOB posts, call the provider and ask. It's not as though they would have forgotten you, but you might be able to correct address information. If they subscribe to address standardization, updates do get to them from the post office, but the smaller the group, the less likely it is that they do that.

I just hope HMA gets out and that the new company isn't worse. Personally, i'd LOVE to see the physicians complete the buyout and turn the place back into a community hospital with a focus on its patients, and not the bottom line for outside investors. The not-for-profit hospital is a thing of the past and doctor's hospitals always seem to struggle, but there has to be a better solution than what we have now.

[MWCGuy]

I read the articles from Eastword News. I have to say I am not impressed with the either side of this argument.

I work for one of the large hospital systems in the city. I am only going to touch on a few of the issues here.

1. The employees need to take ownership in the hospital. You can't expect corporate to fix everything. It starts with treating your patients like you would want to be treated. You meet every need and you always go out of your way to take care of them. After all without your patients you have no job and no reason for the hospital to exist.

2. I had a close friend pass away last year at MRMC and the experience was night and day to what we do for our families who go through that same experience. At our facility, the family is taken into a private area when things start taking a turn for the worst, the hospital chaplain is called and he/she talks with the family, (our chaplains are trained to deal with all religions and can just be a friendly presence to those who aren't religious) the doctors and staff walk hand and with you through the process. At MRMC we got simple "She didn't make it." in the open with every other visitor present for the breaking of the bad news. The doctor and house nurse then acted as if they didn't have time to deal with the family and friends present.

Fortunately, her ex husband stepped up and pulled everyone together, said a prayer and helped everyone keep their composure by saying "Everybody meet at Braums, I am buying." We were all so shocked at her passing and so frustrated that the staff acted so carelessly. I think if we hadn't left we, probably would have been escorted out of the hospital by Security and Midwest City Police.

3. It's going to take a lot of work to turn MRMC around. Even if HMA were to walk away, it will take years to rebuild to a first class facility. The community does not build trust with a hospital overnight. It takes time and dedication from staff and hospital mangement.

4. HMA is up for sale and they are likely going to be bought out by the same company who operates Deaconess (Which is not much better than HMA.) or by HCA who owns OU Medical Center. On a good day INTEGRIS, Mercy or SSM (Saints) may purchase it but, I don't see that happening because MRMC needs a major overhaul facility wise and staff wise. That overhaul will cost millions to complete. I don't see anybody other than HCA taking on that kind of task.

5. Healthcare is about go through a major shake up with Affordable Care Act changes. In order to operate, hospitals are going to have to cut and consolidate every part of their operations to survive. If MRMC does not get its act together, it will likely face closure because their are other facilities in the area that can/already pick up the slack from MRMC. The facility I work at takes a lot of transfers from MRMC.

6. Lastly, HMA is a for profit company with stock holders. I have come to the conclusion that for profits cannot provide the same care non profits and not for profits can. At my company, every dime of profit is re-invested in the company. Sure we have are executives that some would say are overpaid but, they pull their weight and they work to provide for as many people as they can. We have many homeless and working poor that come and in out of our hospital that pay nothing or next to nothing for care. Care gets paid for by charitable donations, medicare and medicaid funding.

I will end with this, MRMC can be a first class medical center if all involved with it will take ownership in the place and work to provide the best care and customer service possible.

[bombermwc]

1. - somtimes in order for the corporate problems to be brought to light, you have to have things fail first. Also, when you're so short-staffed, there's only so much you can do. If you're a floor nurse and you're doing 3 nurse's worth of work, you're probably not firstly concerned with how the hospital looks corporately.

2. - point in case and that's just plain not thinking on the staff's part right there.

3. - very true, it took time for it to get this bad after years of the dedicated staff trying, but being fed-up and leaving. It will take time to convince them to come back, or to develop it back to where it was.

4. - Agreed on Deaconness' front. And their website says they're still independantly owned. So many of the MRMC staff went to Deaconness, only to be met with the same sort of crap. HCA would be a step in the right direction in comparison though. In the days of for-profit healthcare, you have to hope for the "less evil" emperor to take over. St Anthony's free-standing ER and Mercy's Southside Heart Hospital have both made a big hit to the MRMC ER/Fast(yeah right) Track patient count.

I totally agree about healthcare. The day for-profit took over, was the worse day for patient care. When they money is no longer put back into the patient's care, the patient suffers. It's too bad too because it really doesn't take much overhead to run a hospital when you consolidate administrative services to a back-office world. When the greed comes into play and people want their money instead of to help patients, that's when things go down the pooper.

[mmonroe]

Business is the economy's best friend and worst enemy at the same time.

[Lauri101]

Wonder where I've been the past few months? Recovering at Jim Thorpe from back surgery and a MRSA from Midwest Regional.

Four surgeries and resulting infections of not only staph, but also VCE and E-Coli - all from same place! Plus, another patient was ahead of me with same doctor and same OR also got the same infection.

I'm done with MRH and any doctor who insists on operating there. They should tear it down or burn it to ground!

[kevinpate]

Welcome back, and sorry for the major ick while you were away.

[Lauri101]

Thanks Kevin- I've missed this place. Sorry I can't make meet-up. Still in wheelchair and grounded from driving.

[JamesFiend]

HMA bought out by CHS for 7.6B http://www.tennessean.com/article/20...-HMA-7-6B-deal

[bluedogok]

Glad to see you are back on the road to recovery, it takes awhile to get over infections of that sort. Took me months to get over staph and e-coli that I contracted somehow because of a skin condition, and I wasn't in a hospital.

[MWCGuy]

INTEGRIS sold all but a 10% stake in Mayes County, Marshall County, Blackwell, Clinton and Seminole hospitals to HMA. CHS specializes in running small community hospitals.

CHS's largest hospital is Deaconess. I don't see INTEGRIS continuing that deal with CHS. From what I understand from my family members that work at INTEGRIS. INTEGRIS sees Deaconess as a competitor not a counterpart. I am wondering if INTEGRIS might work out a deal to sell their remaining stake in the five small hospitals in exchange for Midwest Regional or Deaconess.

I have a feeling MRMC will be sold to new owners. I just don't see CHS wanting to have two large hospitals in the same city when they already struggle running Deaconess. It would be one thing if Midwest City was primarily a White Collar suburb but, its not. It's a working class suburb surrounded by OKC's SE Ghetto and NE Ghetto areas. It's not going to be a money maker it will always be hospital that will need to supported by a larger system. It might just be a perfect fit for Mercy or INTEGRIS in the end.

[bombermwc]

I'm not sure i agree with that statment MWCguy. Perhaps you aren't aware of it's coverage area....and more directly, that it's ambulance service covers. MRMC ambulances staff all of Choctaw's services, TAFB, parts of Moore, and SE OKC. That's in addition to the obviously MWC and DC areas and NE OKC. It pulls patients from a pretty broad base because there really isn't another significant facility on the EOC side. So as far as a possible patient base, it is on good footing. The problem is, people are requesting that the ambulances not take them there (for good reason) and if you can drive, you drive elsewhere like the St Anthony Free-Standing ER or Heart Hospital. <- and the heart hospital can take plenty more than just heart patients folks.

Something interesting to note is that the City of MWC (or more accurately the MCMH Authority) does have a say in the sale. While the actual transfer of the lease (sale) wouldn't be interferred in, the authority (by contract of the lease) must approve a new management company to operate the facility. So while they own the place, they authority could deny them access to operate it....what a tangled web that would be.

Let's be honest though. All of the doctors aren't going to get up and walk out one day and close the place down. Never gonna happen. Not to mention the fact that they wouldn't abandon their patients. What's funny is, the hospital tries to make it sound like they're all excited that all these new doctors are coming on board there all the time. That's happening because when they get there, they realize what a mess the place is and they leave....so it's EXTEREMELY high turnover from the physician's side. Normally that's a pretty stable workforce. It's especially interesting when a doctor gets visitation there and the patients refuse to go there.

Top 5% my ass......

[Zuplar]

INTEGRIS sold all but a 10% stake in Mayes County, Marshall County, Blackwell, Clinton and Seminole hospitals to HMA. CHS specializes in running small community hospitals.

CHS's largest hospital is Deaconess. I don't see INTEGRIS continuing that deal with CHS. From what I understand from my family members that work at INTEGRIS. INTEGRIS sees Deaconess as a competitor not a counterpart. I am wondering if INTEGRIS might work out a deal to sell their remaining stake in the five small hospitals in exchange for Midwest Regional or Deaconess.

I have a feeling MRMC will be sold to new owners. I just don't see CHS wanting to have two large hospitals in the same city when they already struggle running Deaconess. It would be one thing if Midwest City was primarily a White Collar suburb but, its not. It's a working class suburb surrounded by OKC's SE Ghetto and NE Ghetto areas. It's not going to be a money maker it will always be hospital that will need to supported by a larger system. It might just be a perfect fit for Mercy or INTEGRIS in the end.

From my understanding, there is a good chance Midwest Regional will get some kind of Deaconess branding. They have been wanting to increase their presence every since the other hospitals have done the same. I think CHS has something up their sleeve.

[bombermwc]

Well, this looks like it will feed into that theory Zuplar.
CHS Trying to Buy HMA

Unfortunately, it looks like what most had hoped WOULDN'T happen, is what is happening. We'll have to see what happens with the investors, but i can't imagine that it will end up being a big fight once all the powers sit down to talk. The bad thing is, since Deaconess was handed off to CHS, their level of care has been going down as well. Both hospitals "ain't what they used to be".

There's a related thread here about CHS buying HMA.

It never rains, but it pours.

[Zuplar]

I know someone within CHS, and they've heard the complaints and are working to turn things around. More or less focusing on what they can do best instead of doing everything sub-par.

[bombermwc]

Unfortunately, that's the same line HMA used to give at MWC. It's the first line in a string of promises that will never pan out. Why? Because the solutions cost money that take away from the profit margins. Quality care isn't something the smaller groups do well. When your business focus is on the smaller hospitals, it's a LOT more difficult to keep them all profitable. If you at least have a mixture of sizes, you can absorb some of the issues.

In MRMC's case, it was THE largest in HMA for quite some time and was seen as a piggy-bank to the cash-strapped locations. So rather than re-investing, HMA just used money from it to pad the failing locations. So that's a case where being the big fish was a bad thing.

[Zuplar]

Well they won't be the biggest hospital this time around. Who knows maybe it will be better.

[MWCGuy]

Expect a huge news crap storm (lack of a better term) in regards to HMA and the hospitals they manage coming in the next week. I can't say anything more because it's all rumor right now. If the rumor's are true it might just give Midwest City an out and lead to a few changes in the Oklahoma hospital playing field.

[bombermwc]

So here's some new news. The citizens of MWC have approved the hospital authority to gain access to the funds (not just the interest) of the lease.

If HMA is sold, the city already had the option to prevent the new owner of HMA from managing the hospital, this is just an action to help ensure that things go the way the city wants, which is to get the citizens a good facility.

Midwest City voters pass measures

I've briefly spoken to some folks from inside the hospital and they have said that since the actions earlier in the year, that HMA has been working to try to correct a lot of the issues and that things were getting better. My fear is that these are just actions to make things look better for the purchase of HMA.

More drama unfolding.

[woodyrr]

I think I have been seeing billboards and other advertising since all this lease termination business started - the lessee trying to improve the hospital's image.

I voted yesterday to give the Authority access to the funds. There is way to much broad based discontent for there not to be a serious problem that needs to be addressed.

[bombermwc]

Personally, i dont feel like anything will change if CHS is allowed to take it over after buying HMA. They're the exact same pile of crap.

What i'd like to see is the city buying the place back and then if they dont lease the place back out, then do like OU and just lease out the management of the facility to someone. I would prefer that it go local like Integris (non-profit) or Saints.

I dont really see Saints happening because their flagship is so close and the new free-standing ER is there now too.

Norman is a possibility, but it's in the same boat the other options were (like Mercy), they're for-profit now. And Mercy also sits like Saints with a new facility (Heart Hospital) nearby. Had Deaconness not had been gobbled up by CHS, it would have been a perfect marriage if they could have raised the capital to do it.

It will be a very interesting next few months....more so once the HMA/CHS deal is done.

CHS was the aboslute worse possible outcome for MRMC though and the citizens of the area. HMA has done so much permanent damage, they've lost any/all support from the citizens. All they did was increase the size of the place to make the physical assets worth more for when they sell....while sacrificing care by treaing the staff like crap.

[MWCGuy]

I think you will likely see INTEGRIS sell their stake in the five rural hospitals in exchange for Deaconess or MRMC. I could see CHS taking them up on that offer because from what I understand rural hospitals are their specialty. I know a few people who used to work at Deaconess and they stated Deaconess is CHS' largest hospital. Often times their operational decisions hurt more than they help when it comes to competing with other hospitals especially when Baptist is so close and has so many specialty services under one roof and don't exactly offer anything to put them in the running with Baptist.

What I do know is that another for profit hospital operator will not serve the people of Midwest City and East OKC. A non profit or not for profit would be a better match. This would allow them to offer more services, be candidates for federal grants and put every dollar earned back into the operations of the hospital in the name of jobs, renovations and charity care. There is no reason why MRMC cannot be a top hospital that provides first class illness and injury services. They have the facility they just need be modernized and properly staffed with right people.