When Nonprofit Hospitals Sue Their Poorest Patients

[eridani]

http://readersupportednews.org/news-section2/318-66/27624-when-nonprofit-hospitals-sue-their-poorest-patients

On the eastern edge of St. Joseph, Mo., lies the small city's only hospital, a landmark of modern brick and glass buildings. Everyone in town knows Heartland Regional Medical Center — many residents gave birth to their children here. Many rush here when they get hurt or sick.

And there's another reason everyone knows this place: Thousands of people around St. Joseph have been sued by the hospital and had their wages seized to pay for medical bills. Some of them, given their income, could have qualified to get their bill forgiven entirely — but the hospital seized their wages anyway

Nonprofit hospitals get huge tax breaks — they are considered charities and therefore don't pay federal or state income tax or local property tax. In exchange, they are obligated to provide financial assistance or "charity care" to lower-income patients.

Some nonprofit hospitals around the country don't ever seize their patients' wages. Some do so only in very rare cases. But others sue hundreds of patients every year. Heartland, which is in the process of changing its name to Mosaic Life Care, seizes more money from patients than any other hospital in Missouri. From 2009 through 2013, the hospital's debt collection arm garnished the wages of about 6,000 people, according to a ProPublica analysis of state court data.

[gerogie2]

1. Patients must pay their hospitakl bills or non-profits will not exist.

Nonprofit hospitals get huge tax breaks — they are considered charities and therefore don't pay federal or state income tax or local property tax. In exchange, they are obligated to provide financial assistance or "charity care" to lower-income patients.

Just because a hospital provides charity care doesn't mean that patients can blow off their hospital bills. Most non-profit hospital will enter into a payment plan based on the patients income. It is important that people pay their bills they owe otherwise non-profit hospitals will go under and/or be bought out by for profit corporations. This has become a crisis in California where non-profits hospitals and medical clinics are being replaced by for profit hospitals because the non-profits don't force patients to pay their bills. For profit hospitals only provide charity care for less then 1% of their patients.

[eridani]

2. So explain why most non-profits are not constantly suing their poorest patients

The article made it clear that this isn't the norm.

[gerogie2]

4. Non-profits that don't collect their bills due

go out of business or get bought out.

[davidpdx]

19. That's very true

While I think suing people should be the very last resort, I have heard of instances where non-profits essentially become so in debt that they have no choice but to be bought out. My mom works for a regional non-profit that was originally one hospital. That hospital ended up buying the two in the nearby town she lived in and as some of the other hospitals have begun to have problems they have ended up getting bought out by the company she works for. The company is far from the largest one in Oregon (that would be Legacy and Providence), but if the consolidation continues there is talk that one of those two could eventually buy the regional non-profit.

[Scuba]

20. Depends on the volume of non-paying patients. Fact is, "No margin, no mission" is a hard truth.

Who's going to pay the nurses, radiology techs, heating bill, etc. if the hospital doesn't collect enough revenues?

How is the hospital supposed to acquire new medical equipment, fix the plant or build another wing to serve the community if no one pays their bill?

[Control-Z]

3. Really, gerogie2?

I guess those hospitals should no longer receive huge tax breaks as they are considered charities and therefore don't pay federal or state income tax or local property tax if they're going to abuse their charity status.

[gerogie2]

5. This has nothing to do with collecting payments due.

As a matter of fact non-profits do pay taxes and property taxes. It doesn't mean the people the hospital hire, the mortgage for the hospital and other bills don't have to be paid. Have you ever heard the saying, " There is no free lunch?"

[Enthusiast]

6. Those that cannot pay should just die? That's what the Republicans believe. They made it clear.

This is why we must have a single payer national health care.

There is no alternative. Unless, if we believe as the Republicans do, that people should simply die if they cannot afford care.

Which is it?

We can afford 3 trillion dollars for a war based entirely on lies but we cannot afford to take care of sick people? Fuck that noise.

[gerogie2]

8. What in the hell are you talking about?

People need to pay their medical bills to non-profits so they can continue to exist. Otherwise people will die from lack of medical care because for profit hospitals will let them die.

[Enthusiast]

17. You cannot get blood out of a turnip.

[Scuba]

21. Eggzaklee!

[ColesCountyDem]

9. Many non-profits fail to tell poor people about their right to low- or no-cost care.

Over the years, I've had many friends go to the hospital for various reasons, and the hospitals almost always failed to inform them of their right to low- or no-cost care. When I made them aware of their right, they've called the hospitals back and the hospitals' business offices reluctantly admit that yes, the bill can be adjusted on a sliding scale based on income. The only reason I've known about this right is that my father was a physician, and used his knowledge about this to persuade patients who were reluctant to be hospitalized because of the cost to agree to be hospitalized.

[gerogie2]

10. Actually...

Such notices for non-profits that do offer such programs are in the paperwork the patient sign, but hardly anyone ever reads them.

[ColesCountyDem]

13. Actually...

I've seen the paperwork, and in the majority of instances, no such notice was included. Furthermore, in the cases where it was included, it was usually buried in the midst of several other pages of voluminous verbiage, frequently badly photocopied and often blurred.

[Jesus Malverde]

11. How much are the administrators and doctors at these non profits paid.

I'm guessing six figures.

LULZ on edit

Tama Wagner, the hospital's chief brand officer who is paid 1.2 million dollars a year, said the hospital does everything it can to fulfill that mission - but of course, we all no that Tama Wagner is full of shit.

http://www.dailykos.com/story/2014/12/20/1353123/-Heartland-Regional-Medical-Center-in-St-Joseph-s-Missouri-NPR-Nails-Them-to-a-Wall

[ColesCountyDem]

14. The administrator of our local, 16-bed, critical-access, non-profit made $97,200 last year. n/t

[Jesus Malverde]

15. I just edited my last post with the salary of the "brand manager"

Crazy!

[PoliticAverse]

12. "Heartland made $605 million in gross revenues last year, and $45 million of that was profit."

They seem to be doing ok financially according to the article.

[gerogie2]

16. Non-profits don't make profits

Any money received in excess of revenues is put back into the non-profit. I'm sure a part of that excess revenue was put into programs to pay for charity health care.

[nationalize the fed]

18. Or to pay a collection agency.

When the hospital's chief brand officer makes $1.2 million dollars per year (that's $100,000 per MONTH) maybe it's time to re-define Non Profit. Absurd.

$100,000 per month. From a Non Profit.

[Feron]

24. I think you're missing the article's point.

In this case the hospital is not informing low-income patients of charity care, charging them the chargemaster rate for care, and then adding interest to their debt.

The article also goes on to state that payment plans are available, but patients often cannot pay off a large amount of debt within a 15 month timespan. Micropayments such as twenty dollars every two weeks are not accepted. Some states also allow significant pay garnishments.

Furthermore other non-profit hospitals are doing well without engaging in Heartland's tactics.

Basically this is just a way to wring money out of the people who can least afford it and they calculate will be least likely to fight back.

[davidpdx]

22. Really quickly my story on this

I have been living in South Korea for almost 11 years. About 3 1/2 years ago my wife and I went to the US. I had been somewhat sick before leaving, but got progressively worse. By the time I made it to Oregon, I was fairly sick. My mom took me to the hospital she works at (mentioned in the post above) and I went to their urgent care clinic. After having x-rays and visiting a doctor they gave me some medication. A few days later I went from there to Portland, where I continued to get worse. I went to an urgent care clinic (a different one this time) and the doctor said to me that he could not treat me, that I need to go to the emergency room immediately because my illness had progressed so far.

I went to the emergency room and waited and finally went back and saw a doctor. Their initial diagnosis was pneumonia, but given I had been overseas they wanted to rule out several other things. They told me I had to be admitted which had me in tears. My wife who is Korean was with me and she wasn't familiar with Portland and I didn't have family there. So they put me in a private room (because they weren't 100% sure at the time what I had) which required anyone visiting to wear masks (the nurses had to wear masks and bodysuits).

At some point I remember talking to a patient representative about whether I had insurance or the ability to pay. I was cringing at that point (both of which were true, although technically I was starting a new job in China the next month..a much longer story for another time). She explained that because I was a student and unemployed that I could apply for assistance through the hospital's foundation. When I was released I was really dreading whether or not I was going to be handed a hospital bill. I wasn't thankfully and applied for the assistance right away. It covered the $30,000+ in medical bills for the five days in the hospital (no that wasn't a typo).

Even if they hadn't, I don't live in the US anymore and they wouldn't have been able to get much from me. I am glad that it worked out though.

[newfie11]

23. To bad you can't bring your own meds to hospital

Sorry must take $10.00 asprin etc.
There are ways for hospitals to reduce expenses but no incentive.

There's a not for profit hospital near me. It looks like the Taj Mahal. Windows 3 story's up over mezzanine and polished brass hand rails.

They have been profitable for years ( my husband was director of the cancer center) at this hospital.

In my area most folks don't make more than around $10/hr. I've seen the change in medicine over the years. Iveseen doctors order test that were not necessary but to protect themselves.

I also have a medical background, now retired after 43 years. I've worked from Los Angeles to
Washington DC and states in between.
ive seen an elderly woman with one lung full of fluid but on medicare sent home because surgeon refused to come in until morning. Medicare reimbursement wasn't enough.
One hospital I worked at was taking people's homes if they we unable to pay their bill.
The mother of a radiologist I knew got such a letter. Her son was outraged and he worked at that hospital.
There are others but what I want to say is we need totally free health care.
The doctors and hospitals fight this of course.
We would have many more doctors if we educated them for free like other countries.

But this is America and ruled by the wealthy.
Nuff said

[Mariana]

25. My mother has two friends who were intimidated into paying

for their deceased adult childrens' hospital bills. They had no obligation - they weren't their childrens' heirs or anything like that - but the hospitals (or their collections agencies) tracked down these women, contacted them and convinced them they had to pay. So these women were making monthly payments they couldn't afford for hospital bills they didn't owe.

My mom was astounded the first time she heard about this, and absolutely enraged when she heard it the second time. She told each of them to talk to a lawyer. Slimy as hell, preying on the elderly like that. Makes you wonder how many more elderly people have been scammed into paying bills they aren't responsible for.