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Pahrump Mirror
Pahrump, Nevada
March 6, 1997     Pahrump Mirror
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March 6, 1997

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Conttmed fiom page 1 motion "'from a business standpoint. It would give us some breathing room." He stressed that filing tbr bankruptcy would allow the medical center to continue operating. Commissioner Bobby Revert of Beatty, who was absent, said on Wednesday he would that he would not have voted for bankruptcy and, in fact, had tried to phone the other commissioners. "While I do believe the hospital will have to be downsized" Revert told the Gazette, it's essential for the hospital to pay its bills. "If they don't then every clinic in the county is in jeopardy. The county's credit is in jeop- ardy." Revert said money could be saved by holding off on new county buildings in Beatty and Pahrump, or by asking vot- ers to approve new taxes or bond measures to finance them. "The hospital's very important," he said, noting that Beatty is part of the hospital tax district. "People must support the government," Revert said. "Government cannot support the people." Revert also expressed dismay that, except for Commissioner Davis, "there was never an attempt to meet with [the hospi- tal managers]. He tried very hard. I feel very bad that I didn't have a chance to help. The whole board abandoned him?' No one objected that McRae's move to declare bankruptcy was not specifically on the trustees' agenda. Indeed, the agenda promised "Presentation and discussion only of.pos- sible solutions to financial difficulties of the district." Re- vert said he believed the motion came under "old business" but, he said, "I don't think that was the correct way to go" Earlier that day the commissioners agreed to entertain a proposal from the Nevada Rural Health System (NRHS), whose executive director spoke of making the Tonopah medical facility the geographical "linchpin" of its opera- tions in this region. Kenneth McBain, the executive direc- tor of NRHS said the organization, which already runs clin- ics in Beatty and Amargosa Valley, was eager to take over the very medical facility that a private management com- pany is abandoning as a shipwreck. "We are looking at Tonopah because of the impact it could have on our other operations," he said. He also claimed NRHS management could save the county money. McBain promised to bring recommendations for restructuring the Nye Regional Medical Center to the commission at its next meeting, on March 18. All agreed that it would be a scaled down version of the current operation. The community would have to decide which of the center's present compo- nents it was willing to pay for, McBain said. The NRHS was formerly the Central Nevada Rura! Health J , ;ll Consortium. run by the counties it served. In 1994, said McBain, it restructured itself as a nonprofit, in IRS par- lance a 501(c)(3) organization. The NRHS is now feder- ally qualified as a community health program, a designa- tion that brings with it advantages the! could save the county money. In addition to getting 16 percent of its operating funds from the federal government and qualifying for high Medicaid reimbursement rates, NRHS employees are con- sidered federal employees, said McBain. That means they are protected from lawsuits by federal liability coverage, "so we do not have to pay medical malpractice insurance." Because of its federal mandate, McBain said, the NRHS must be in complete control of the operation. Later he told the Gazette that would involve dismissing the entire staff, approximately 100 people. "We will have to have a recruit- ment,' he said. The staffers are now county employees, he explained, and "we're a package deal; all of the staff [would be] our employees. But he added that the trained, creden- tialed work force would be the logical source of that staff and that NRHS pay rates would be "comparable" to county pay scales, as are the rates for NRHS employees in Beatty and Amargosa Valley. During his discussion with the commissioners, McBain said he thought a NRHS-run facility would be viable if it could attract the approximately 7,000 residents of Tonopah, Smoky Valley and Esmeralda County, many of whom have become accustomed to going to Bishop for their medical needs. Whatever the range of services the community fi- nally decides to offer, said McBain, emergency services are a key element. The NRHS, McBain said, has a "mandate to provide health services to under-served [areas]" and does not expect a hos- pital in a place like Tonopah to be self-sustaining. He re- peatedly stressed that the county would have to contribute funds to the operation _ and the size of the county's share would determine how many of the current medical center's functions NRHS might continue. The need for taxpayer subsidy, noted McBain, will not go away. "There aren't private practices in rural Nevada. It doesn't pay. [Health care] is always going to be dependent on public support." Commission Chairman Richard Carver echoed that point in the late afternoon, during the contentious hospital dis- trict meeting, when he argued that people support the county jail, an operation "that doesn't return a dime" to the county. "Let's talk a little reality here; we're talking about saving people's lives:' In the throes of the debacle, it is unclear how much less the hospital's debt might haxe been had it been operated on the * Primary care, laboratory and radiology services - Affiliated visiting medical specialists Special series of educational lectures for seniors Most major insurances accepted Office Hours: M-F, 8 am to 12 pm and 1 to 5 pm Have questions? We will be happy to assist you. Pahnlmp Valley Gazette, Thursday, March 6, 1997 3 principles outlined by McBain. There was that opportunity: McBain told the Gazette that he had approached the county before. "I came here two years ago, met and had a conver- sation with the then manager, Mr. Offutt." Instead, the county contracted with Quorum Health Re- sources, a California company, to run the facility. Quorum, in turn contracted with physician search companies and bill collectors. Now, Quorum's resident manager, Roger Mayers, told the Gazette, the company has told the board "we would be phasing out." He said the county pays Quorum a monthly management fee of $15,000 plus compensation for himself and the on-site financial officer that total $30,000 a month _ a total of $540,000 a year. Quorum, Revert told the Gazette, "has overstayed its wel- come." He said the company should have shown results long ago. During the meeting, Carver declared himself "disap- pointed at what we got out of Quorum?' In his brief, unchallenged presentation to the board, Mayers reminded them to make their flight and hotel reservations for the "Quorum Board seminar" to be held in Nashville on March 13 and 14. At this point, McRae broke in to say, "If there was any misunderstanding, the insurer, not the county, is paying for the trip." Mayer confirmed that the insurer, LiCon "does allot a certain amount per hospital for educa- tion." And McRae, in an apparent jibe at the Gazette, con- tinued, "it was only in the press that there was a misunder- standing." Revert said he had decided it was "not appropriate" for him to go to the seminar, but that he expected the commission- ers who do go will learn valuable techniques for avoiding liability. In another action, the board, without discussion, voted to accept the resignation of Dr. Jon Schwartz. In his presenta- tion, Kenneth McBain expressed optimism that NRHS could recruit competent physicians. I ...... -" - i CbDCKS  WATCHES south wl 0011/ m. NV ego,m lr LEE GREEN MICHAEL K: SMITH I I I I I 1-"* 00Summit Family Healthcare A Division of Desert Springs Hospital 727-5509 1 1 5 1 S Highway 1 60 * Pa h rum p, Nevada 89048