My hospital-owned unit is the latest to fall prey (to one of the Big Two). Our hospital fought tooth and nail in three years of litigation, after a major player snuck in through the front back door.
These national "McDialysis Chains" as I call them, have been trying to get into our little slice of dialysis nirvana for years...and one of them, due to some sneaky maneuvering involving changing state regulations with CON's finally managed to pull it off. We are now undergoing shall we say...a hostile sale.
Dialysis as a business, has experienced exponential changes over the last 20 years. Some good, some bad. It began when people realized there was cash to made on the backs of renal failure patients, and Corporate America took notice.
The last twenty years (the last four especially) has seen times of rapidly changing regulations and reimbursement requirements, and those that rise to the top and survive are these cut-throat corporations with enough money to pay the right people playing the right people, at the state and federal levels. Indeed, these corporate entities are imo, the very ones controlling the changes.
I moved here ten years ago and took the position in large part, because it was a not-for-profit. Best position I've ever had.
I've researched a bit about the company taking over, including a recent whistleblower lawsuit against it for medicare fraud brought on by a nephrologist and an RN. It was imho egregious and obvious, but the suit was...swept under the rug and dismissed: it pays to have certain "Health Czars" on your side (my speculation only of course, based upon playing connect-the-dots).
The moral is, change faster than everyone else, or be eaten.
Pushing the phoslo and venofer was tolerable, but the pushing the pharmacy services is a royal pain for nurses. The pharmacy calls so the RN's can contact the MD and get authorization for refills or fax them an RX. Now the nurses are the middle people for the pharmacy. If a nurse refuses, one is told, that they are not providing "ultra care" services to the the patient and it's their right to get the medication from FMC pharmacy. I prefer that patients get their meds. at walgreens so I can focus on dialyzing. A co-worker who works home therapies, and has to travel to different clinics and to patients homes was just informed she will not get mileage payment because she is "On The clock- kronos" so she does not get mileage. So I guess her hourly rate goes down if she has to travel on the job to pay the gas. The big corporate dialysis centers need a huge a nationwide union take over. Problem is the facilities, are so widespread, the employees don't unite. Anytime, the company hears the whispers of a union movement, they squash it. They even have their own anti-union videos. They rule by fear.
Pushing the phoslo and venofer was tolerable, but the pushing the pharmacy services is a royal pain for nurses. The pharmacy calls so the RN's can contact the MD and get authorization for refills or fax them an RX. Now the nurses are the middle people for the pharmacy. If a nurse refuses, one is told, that they are not providing "ultra care" services to the the patient and it's their right to get the medication from FMC pharmacy. I prefer that patients get their meds. at walgreens so I can focus on dialyzing. A co-worker who works home therapies, and has to travel to different clinics and to patients homes was just informed she will not get mileage payment because she is "On The clock- kronos" so she does not get mileage. So I guess her hourly rate goes down if she has to travel on the job to pay the gas. The big corporate dialysis centers need a huge a nationwide union take over. Problem is the facilities, are so widespread, the employees don't unite. Anytime, the company hears the whispers of a union movement, they squash it. They even have their own anti-union videos. They rule by fear.
The internal pharmaceutical services are trumpeted publicly as a patient service to simplify their lives and provide easy access to their meds ...("see how wonderful we are?"). May also provide (negligible) increased compliance with medication adherence and compliance.
However, we all know the real reason, is revenue $$.
These for-profits are scrambling in the wake of and anticipation of, decreased Fed/State reimbursement. And in their defense, I doubt they "enjoy" passing off the sh*t rolling downhill to the direct caregivers. Nonetheless, party lines and propaganda will be frontlined.
IMHO, it's a house of cards. The dialysis bubble has burst.
Marisette, BSN, RN
376 Posts
Pushing the phoslo and venofer was tolerable, but the pushing the pharmacy services is a royal pain for nurses. The pharmacy calls so the RN's can contact the MD and get authorization for refills or fax them an RX. Now the nurses are the middle people for the pharmacy. If a nurse refuses, one is told, that they are not providing "ultra care" services to the the patient and it's their right to get the medication from FMC pharmacy. I prefer that patients get their meds. at walgreens so I can focus on dialyzing. A co-worker who works home therapies, and has to travel to different clinics and to patients homes was just informed she will not get mileage payment because she is "On The clock- kronos" so she does not get mileage. So I guess her hourly rate goes down if she has to travel on the job to pay the gas. The big corporate dialysis centers need a huge a nationwide union take over. Problem is the facilities, are so widespread, the employees don't unite. Anytime, the company hears the whispers of a union movement, they squash it. They even have their own anti-union videos. They rule by fear.