TUCSON, AZ (Tucson News Now) - By Craig Reck
The potential closure of a nursing home in Willcox is the latest example of ongoing struggles for health care providers to remain open and above the red in rural areas of southern Arizona.
Administrators at Northern Cochise Community Hospital met with the community Thursday morning to hear concerns and address any questions.
The event had a good turnout, according to Dan Douglas of Charles William Leighton Jr. Hospice. He said he is worried that closing the hospital’s nursing home would hurt his business and negatively impact families in the area.
Jared Wilhelm, Director of Community Relations for the hospital, said the hospital has always operated on a very thin budget. He said the administration learned about severe losses after a line-by-line breakdown of the services offered at the hospital.
Preliminary numbers were complete by late September and the hospital’s board learned in early October that NCCH was losing close to $2 million a year, according to Wilhelm.
He said closing the nursing home would save almost $750,000 annually, so departments would have to cut their budgets in order to make up the remaining $1.25 million.
Part of the problem, according to Wilhelm, is the drop in collections. The hospital used to collect 51 percent of its money owed, but he said that number has dropped to 37 percent, causing the administration to miss out on approximately $6 million.
The hospital’s district board will make a decision Wednesday, Oct. 28 on the nursing home’s future. It could be part of the solution to keep NCCH from closing like other critical access hospitals before it in southern Arizona.
“We don’t want to be the next one,” Wilhelm said.
Tubac Regional Health Center closed its doors earlier this year, but a new facility opened up farther away in Sierra Vista. Cochise Regional Hospital shut down less than three months ago, but there is now an urgent care in operation with plans to open an emergency room as well. All of these closures are on the radar of the Arizona Center for Rural Health, according to Executive Director Dr. Daniel Derksen.
Do you have a healthcare provider in your state that exemplifies a "Real Doc Hollywood"? NOSORH would like to use National Rural Health Day to honor "Real Doc Hollywoods" or other healers who have made a positive impact on their local community, brought services that may not have been there before, has shown local leadership, or has been a dependable partner that has helped made a change for the better. We welcome you to showcase that individual and help NOSORH promote all of the amazing Real Doc Hollywoods and other Healers around the nation. Please take the time to fill out to provide the following information, showing what makes your choice. You may enter as many individuals as you would like, this is not limited to one submission per person. If all goes well we'll work on media stories and a publication to honor their work. To make your submission, click here.
By Mark Brodie | Aug. 28, 2015
This week’s ruling by a Maricopa County Superior Court judge that the assessment used to pay for part of Arizona’s Medicaid expansion is constitutional has set the stage for an appeal to the state Court of Appeals.
It also brought at least temporary sighs of relief from expansion supporters, including Dan Derksen. He’s director of the Center for Rural Health at the University of Arizona. Derksen said small towns face big health care challenges.
Listen to full audio broadcast at link below:
- Report credits accountable care organizations with more care coordination
by Shannon Firth
WASHINGTON -- Medicare Accountable Care Organizations (ACOs) continue to improve care quality and to lower costs, according to a new report from the Centers for Medicare & Medicaid Services (CMS).
Eligibility is open to medical students (allopathic or osteopathic) in their final year of a U.S. accredited school who are planning to pursue a career in primary care, and are committed to working in underserved communities with limited access to care.
Students to Service loan repayment award recipients receive up to $120,000 (tax free) for three years of full-time service or six years of half-time service. Upon completion of residency, recipients serve as primary care providers in an NHSC-approved site in a Health Professional Shortage Area (HPSA) of greatest need. The 2016 Students to Service application cycle closes on October 22, 2015 at 7:30 pm, ET.
There are two Students to Service infographics that help explain the benefits of this program. One shows how the award can greatly reduce a medical school student’s debt by more than 45 percent, and the other shows overall benefits of the award, such as training and financial support.
The program is expected to be competitive. Please note that applicants who have federally-serviced loans will need to create a FSA ID before beginning the application process. The FSA ID replaced the Federal Student Aid PIN on May 10, 2015. Additional instructions can be found in the 2016 NHSC Students to Service Application and Program Guidance.
Also, please encourage applicants to join us on Thursday, September 17 from 7:00 pm – 8:30 pm ET for the Students to Service Technical Assistance Webinar, to get questions answered about the application process, program eligibility, and service commitment. The login information is below:
Access link: https://hrsa.connectsolutions.com/s2sapplication/
Dial-In Number: 1-888-566-6151
Participant Passcode: 4221465
Thank you for your continued support in helping us spread the word about the opening of the Students to Service Loan Repayment Program.
National Health Service Corps
HRSA Awards $2.7 Million to Improve Rural Health
The Health Resources and Services Administration (HRSA) announced $2.7 million in grants for two pilot programs to increase access to and improve health care in rural communities. These 3-year grants will provide rural communities an opportunity to collaborate in training allied health professionals and expanding health insurance coverage.
The Rural Network Allied Health Training Program, funded at $1,994,150, will support 10 awards for budget requests up to $200,000 in each of eight states to develop networks for improving rural health care through the recruitment, clinical training, and retention of allied health professionals. Emphasis is on integrated rural health networks that can partner with local community colleges and other accredited educational institutions to develop formal clinical training programs for allied health professional students. The program is in response to the Administration’s Job-Driven Training Initiative, which calls for effectively placing ready-to-work Americans in jobs that are available now, or training them in the skills needed for better jobs.
“The strength of this program is its collaborative approach to training allied health professionals,” said HRSA Acting Administrator Jim Macrae. “This program builds on HRSA’s efforts to help those living in rural communities have access to the comprehensive care they need.”
The Rural Outreach Benefits Counseling Program is funded at $749,915 to support 10 projects in nine states with budget requests up to $75,000 each. The program is designed to expand health insurance outreach, education and enrollment efforts to eligible uninsured individuals and families; help educate the newly-insured about their benefits; and connect these individuals to primary and preventive services to which they now have access. Both programs are managed by the Federal Office of Rural Health Policy (FORHP) at HRSA.
“With the large number of uninsured individuals living in rural areas, this program addresses a critical need,” said Tom Morris, FORHP director. “It will help us identify the creative and effective models that are reaching the rural underserved.”
tucson.com | The Arizona Daily Star | June 26, 2015
By Stephanie Innes
After the U.S. Supreme Court’s decision on the Affordable Care Act Thursday, Tucson insurance broker Raymond E. Magnuson had one reaction — a huge sigh of relief.
By Associated Press | June 25, 2015
The U.S. Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama's health care overhaul, in a ruling that preserves health insurance for millions of Americans.
The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.
The decision means the 126,000 Arizonans receiving tax subsidies won’t have to find another means of paying for health insurance.
The outcome is the second major victory for Obama in politically charged Supreme Court tests of his most significant domestic achievement.
Dan Derksen, director of the Arizona Center for Rural Health at the University of Arizona, said this will likely be the last time the ACA will be challenged in the Supreme Court.
"I think at this point we’ll be seeing efforts to try to fine tune the patient protection and affordable care act there may be efforts to try to change the way it’s financed and budgeted certain portions," Derksen said.
Earlier this year, lawmakers in Arizona passed a law barring the state from setting up it’s own exchange. Arizona is one of 34 states that don't run their own marketplace for health insurance.
Chief Justice John Roberts again voted with his liberal colleagues in support of the law. Roberts also was the key vote to uphold the law in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.
"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote in the majority opinion.
Nationally, 10.2 million people have signed up for health insurance under the Obama health overhaul. That includes the 8.7 million people who are receiving an average subsidy of $272 a month to help pay their insurance premiums.
Of those receiving subsidies, 6.4 million people were at risk of losing that aid because they live in states that did not set up their own health insurance exchanges.
The challenge devised by die-hard opponents of the law, often derided by critics as "Obamacare," relied on four words — established by the state — in the more than 900-page law.
The law's opponents argued that the vast majority of people who now get help paying for their insurance premiums are ineligible for their federal tax credits. That is because roughly three dozen states opted against creating their own health insurance marketplaces, or exchanges, and instead rely on the federal healthcare.gov to help people find coverage if they don't get insurance through their jobs or the government.
In the challengers' view, the phrase "established by the state" demonstrated that subsidies were to be available only available to people in states that set up their own exchanges. Those words cannot refer to exchanges established by the Health and Human Services Department, which oversees healthcare.gov, the opponents argued.
The administration, congressional Democrats and 22 states responded that it would make no sense to construct the law the way its opponents suggested. The idea behind the law's structure was to decrease the number of uninsured. The law prevents insurers from denying coverage because of "pre-existing" health conditions. It requires almost everyone to be insured and provides financial help to consumers who otherwise would spend too much of their paycheck on their premiums.
The point of the last piece, the subsidies, is to keep enough people in the pool of insured to avoid triggering a so-called death spiral of declining enrollment, a growing proportion of less healthy people and premium increases by insurers.
Several portions of the law indicate that consumers can claim tax credits no matter where they live. No member of Congress said that subsidies would be limited, and several states said in a separate brief to the court that they had no inkling they had to set up their own exchange for their residents to get tax credits.
The 2012 case took place in the midst of Obama's re-election campaign, when he touted the largest expansion of the social safety net since the advent of Medicare nearly a half-century earlier. But at the time, the benefits of the Affordable Care Act were mostly in the future. Many of its provisions had yet to take effect.
In 2015, the landscape has changed, although the partisan and ideological divisions remain for a law that passed Congress in 2010 with no Republican votes.
The case is King v. Burwell, 14-114.
KJZZ's Carrie Jung contributed to this report.
Updated 6/25/205 at 10:30 a.m.
Cochise Regional Hospital wins Corporate Turnaround of the Year in a Small Market, awarded on June 23, 2015 at the Turnaround Atlas Award Gala & Dinner in Chicago, IL.
TURNAROUND ATLAS AWARDS honoring the best value-generating transactions, outstanding firms, teams and influential leaders, worldwide.
tucson.com | Arizona Daily Star June 15, 2015 By Stephanie Innes
Rural hospitals across the country are closing, but a newly formed organization in Southern Arizona is looking to buck that trend.
WHY THE WALK?
A bipartisan grassroots movement to petition Congress, state legislatures, and Governors to pass measures to ensure the sustainability of rural hospitals in America. The Walk will begin on June 1, 2015 in Belhaven, North Carolina and end on June 15, 2015 on the US Senate lawn in Washington, DC. This is a 14 day, 283 mile walk, each mile representing the 283 rural hospital in danger of closure, from Belhaven, North Carolina to Washington, DC. The Walk will be led by Civic Rights Legend Bob Zellner and Belhaven Mayor Adam O’Neal.
By Stephanie Innes
With the number of local deaths from drug overdoses now outpacing that of motor vehicle crashes, there’s a growing concern both in Tucson and nationally about prescription pain medications.
Arizona ranks sixth highest in the nation for individuals misusing and abusing prescription drugs, says Alyssa Padilla, a special projects coordinator at the University of Arizona’s Mel and Enid Zuckerman College of Public Health.
The Pima County Medical Examiner in 2013 handled 327 deaths due to overdoses, with the vast majority occurring because of opiate drugs, including oxycodone, morphine, heroin and hydrocodone.
By comparison, the office completed 197 autopsies on people who had died due to a motor vehicle accident in 2013, the most recent year for which complete data was available.
MultiPlan, Inc. today announced the recipients of its 2015 Rural Health Outreach Grant.
TUBA CITY, Ariz. - The American College of Surgeons (ACS) in March designated Tuba City Regional Health Care Corporation as a level III trauma center enabling the hospital to see and take care of more critically injured patients.
ACS has only verified one other Native American Level III trauma center. That one is located in Anchorage, Alaska.. The designation moves TCRHCC up a ranking.
Four and a half years ago when Dr. Ralph Zane Kelley, a trauma surgeon and also the chief of surgery and trauma medical director at TCRHCC, arrived he said the hospital was designated by the state of Arizona as a level IV trauma center. The designation by ACS is a national ranking.
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients. ACS is dedicated to the ethical and competent practice of surgery, according to its website.
In a recent statement, ACS emphasized that the allocation of trauma centers should be based on the needs of the population, rather than the needs of individual health care organizations or hospital groups. And, at their core, trauma systems are developed to achieve care that is optimal for injured patients.
In the state of Arizona there were only 11 verified Level III ACS trauma centers. Tuba City is now number 12 on that list. By comparison, Flagstaff Medical Center is a Level I.
"The others are ... big names that you don't normally see Tuba City on that list with," Kelley said.
He said the designation is a big deal across Indian country because of the amount of trauma on reservations, which has been verified by studies.
"I'm Native American and I was trained in Las Vegas in trauma on the agreement that I would come out here because they have such a need for trauma surgeons on the reservation," Kelley said, adding that four of the five trauma surgeons in Tuba City are Native American. The hospital employs a Native American hand surgeon and an ER doctor as well.
In trauma terms, Tuba City sees everything from car crashes, ATV accidents, assault, gunshot and knife stab wounds, patients who were bucked off a horse, gored by a bull and elderly patients falling.
"We even see a number of trauma's that are from international tourists at Monument Valley or Grand Canyon," Kelley said. "The majority are native traumas."
Shannon Johnson, RN director of trauma program services, and Kelley worked the last few years for the current Level III designation with an initial visit by ACS in 2013 and the final visit coming a year and a half later. ACS specifically looks at the trauma patients an emergency department cares for - whether they are cared for or operated on at the hospital or whether they are shipped somewhere else. The organization also looks at how the ER department tracks care of patients, how they do peer reviews of all trauma patients, how the surgeons receive trauma credentials, and the equipment and infrastructure each hospital has.
Even with the new designation, TCRHCC still has limitations on head and spine injuries - those patients are still treated in Flagstaff or Phoenix.
In addition to providing a higher quality of care, trauma surgeons and orthopedic surgeons are on call 24-7, the trauma process is tracked so it is up to the standard that ACS sets for trauma centers.
"It definitely increases the quality and competency of care that trauma patients receive here," Kelley said. "Tuba City is probably the only place on the rez that has ER residency trained board certified ER physicians. Also we have general surgeons who are advanced trauma trained."
Johnson said, in addition, the hospital has trauma nurse core curriculum certified nurses and emergency pediatric certified nurses as well.
One of the biggest things that Johnson and Kelley want people in the region to know is that the designation means something because it is one of a limited number in the state and only the second Native American hospital to be designated.
"We're accredited by a national organization and we do care for a high level of patients and definitely care for and have a higher acuity of care than the majority of other reservation facilities," Kelly said. "Tuba is constantly adding new services and new specialties to keep patients on the reservation rather than having to ship them to Flagstaff or Phoenix where it is an inconvenience for themselves but also their families."