what is "money losers" of a community hospital?

[treeye]

We are a 220 bed community hospital with a very high percentage of the patient population being medicare and medicaid. We were just officially informed that our hospital is 1.7 million in debt and 7 million short for next year. We were told that everything is on the table and the hospital could get much smaller.

I am sure the layoff and closing of community hospitals are norm around this country with the cut back of medicare medicaid spending. Just wondering what units are considered "money losers" of a community hospital? is it safe to say that the older the patient population is, the less money the unit will make? thanks.

[laydiebuug]

No necessarily, I work for a MCO for medicare/medicaid and it just depends on the rembursement rates that were negociated. Its nearly impossible to say who get paid less and where but I can tell you that sometimes the negociated rate is way less then what the hospital is charging.

[MunoRN, RN]

Procedures tend to make money, pt's with extended periods of only being able to charge a "room charge" won't make much and will potentially lose money. Typically, heart cath patients are big bucks and chronic med-surg patients are poor money makers. What really loses money though are the uninsured (and executive salaries).

[NICU Guy, BSN, RN]

labor and delivery. County hospital spent a lot of money renovating their L&D dept. only to close it a few years later. Most of the patients were medicaid and they lost a lot of money on them. The pregnant women with private insurance went to hospitals that had NICU in case something would happen.

[TakeTwoAspirin, MSN, RN, APRN]

Money loser = ED. You can't turn a patient down in the ED and everyone has to go through triage and be evaluated/stabilized, regardless of their ability to pay.

Money maker = OR. Other than for trauma/emergent surgeries, surgery is for the most part scheduled and elective. Even if the patient's insurance doesn't cover all of the expense, the majority of the expense is usually reimbursed by insurance.

[AgentBeast, BSN, RN]

Without a doubt L&D. You need to do something like 300 deliveries a year just to break even on cost of the Liability Insurance. Most community hospitals don't get anywhere near that many deliveries.

[calivianya, BSN, RN]

The funny thing about L&D is that it is a money loser but service bringer. I worked for a hospital chain that intentionally bought a women's hospital because the theory was that if these mothers had a good birth experience in that hospital chain that they would also come there for other problems that would actually make money. I always wondered if that theory panned out for them.

[jadelpn, LPN, EMT-B]

Money losers are the uninsured. Money makers can be the older population, as some community hospitals have an option of making some of their med/surg beds "skilled care" beds, which can make money.

The push will be on nurses to document accordingly in order to make the most reimbursements regradless of what unit one is on.

[treeye]

by "skilled care beds", do you mean long term care / nursing home/ rehab that is attached to the hospital? As I understand, this type of units rely greatly on Medicare/Medicaid too. When the reimbursement diminishes, these units are struggling to survive too.

Money losers are the uninsured. Money makers can be the older population, as some community hospitals have an option of making some of their med/surg beds "skilled care" beds, which can make money.

The push will be on nurses to document accordingly in order to make the most reimbursements regradless of what unit one is on.

[Morainey, BSN, RN]

I could be wrong but I have heard that lower back pain inpatients in particular are a "money loser". I have heard that the ED is a money loser also, d/t the uninsured patients that come through.

[DoGoodThenGo]

Money losers are the uninsured. Money makers can be the older population, as some community hospitals have an option of making some of their med/surg beds "skilled care" beds, which can make money.

The push will be on nurses to document accordingly in order to make the most reimbursements regradless of what unit one is on.

Uninsured patients do not always equate into "money losers". Persons who do not pay their bills obviously cost a facility money and often are written off as a loss. However there are persons whom lack insurance but pay their bills via cash, credit cards or some other funding.

Having been uninsured a very many years but can assure you never did my primary care physician, the various labs tests were sent nor anyone else connected with my healthcare lose any money as all were paid in full. Indeed do not have dental insurance but just financed >$3K worth of work that simply must be done.

[jadelpn, LPN, EMT-B]

by "skilled care beds", do you mean long term care / nursing home/ rehab that is attached to the hospital? As I understand, this type of units rely greatly on Medicare/Medicaid too. When the reimbursement diminishes, these units are struggling to survive too.

Proper documentation, however, will insure a larger reimbursement. The hospital negotiates a rate with other insurers. Perfect for patient who are no longer acute, but can't go home due to function.