Grady Hospital/Indigent Healthcare ...
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5-21-10: Grady Hospital
Rated “Worst Than Expected” by Online Hospital Rating Service
In a
section called “Patient Safety Ratings, “Grady Memorial Hospital was rated
“worse than expected” by Healthgrades.com in the following areas:
-
Prevention of death
in procedures where mortality is usually very low
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Lack of pressure
sores and bed sores acquired in the hospital
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Ability to diagnose
and treat in time
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Avoidance of
collapsed lung due to a procedure or surgery in or around the chest
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Lack of deep blood
clots in lungs or legs after surgery
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Avoidance of severe
infection following surgery
Source:
Patient Safety: Centers for Medicare and Medicaid Services for 2006-2008
Click here to
view the “Grady Memorial Hospital Patient
Safety Ratings”, Healthgrades.com
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5-21-10: Georgia Funds
to Grady Hospital Delayed
State
funding to Grady Hospital under the Indigent Trust Care Fund (ICTF) due
December 31, 2009 in the amount of $39.6 million dollars has been “delayed”,
according to the “Independent Auditor’s Report (Grady Hospital
Corporation)”. It is not clear how the delay affects the Hospital’s
Operations “bottom – line”.
Under the
ICTF Program, Grady contributes funds to be used by the state in the
Medicaid Program that are then supplemented by federal funds. The
“contribution dollars” are then returned to Grady as an additional Medicaid
inpatient reimbursement. Although an “interim” disbursement of the annual
ICTF funding is typically disbursed in December of each year, in December
2009 the payment was delayed. To provide the cash required to operate the
hospital, Grady Hospital has only two “financing sources” according to the
Auditor, “(Fulton and Dekalb) Counties and (the combined state/federal)
Indigent Care Trust Fund (ICTF).”
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4-13-10: "2nd Quarter Grady Standard (Quality) of Care Report"
Grady Health
System (GHS) fails to meet "customer
service/satisfaction measures". Overall Customer Service Satisfaction
Rating: 56% (Target: 85%)
Click here for “Grady
Health Systems Standard (Quality) of Care Summary and Analysis"
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4-1-10" "Grady Hospital 4th Quarter Compliance Report: 106
Exceptions Noted"
In a review of
288 patient accounts by Grady Hospital, 106 “exceptions” were noted by the
Fulton County’s Internal Auditor for the period October 2009 – December 31,
2009. Exceptions included income eligibility and residency. 11
patients were eligible for Medicare and 13 were eligible for Medicaid
Coverage (and should not have been classified as “Indigent” or “Charity.”)
44 patients’ financial files contained no picture identifications in the
files; 5 patients had no valid Georgia driver’s license.
These
exceptions were not in compliance with the Grady Hospital Operational
Patient Identifications Policy revised 9/17/08.
Under the
terms of the (amended) Memorandum of Understanding (MOU) dated November 4,
2009, the Hospital is to provide medical services to Fulton County residents
classified as “indigent” or “charity” patients as defined by the MOU.
Prior to the
end of the 4th
Quarter and the completion of the subject
Auditor’s Report, the Board of Commissioners approved an appropriation to
Grady Hospital in the amount of $36 million dollars.
Click here for “Audit of
Grady Fourth Quarter Data” and related materials
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"3-19-10: Grady
Hospital System: Residency and
Quality of Care
Audit Policy and
Procedures Legislation held for
two (2) weeks
The (Proposed) “Standard
Operating Procedures (SOP)” to
be used to monitor the contract
between the Grady Hospital
System and Fulton County was
held for two (2) weeks at the
request of Commissioner John
Eaves.
Developed in coordination with
Grady officials, the procedures
will be used to meet the
requirements of the MOU as
amended as follows: (1) That
reimbursement shall be based
upon services to eligible Fulton
County residents (2) That the
quality of care shall meet goals
in specific areas including
“patient safety” and “customer
satisfaction”.
Click here for Agenda Item
#10-0267 to “Request Board
approval of the standard of
operating procedures for the
Financial and Standards of Care
reviews to verify the Fulton
County contributions to
Fulton-DeKalb Hospital Authority
as required by the MOU”.
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"3-12-10: GRADY HOSPITAL
SYSTEM (GHS)
1.
Click here for the "Grady
Memorial Hospital: "Patient
Safety Ratings" (3-12-10)
2.
Quarterly Reporting
and Disbursement Process
Disbursement (Advance Payment)
by Fulton County on the 10th
day of the first month of each
quarter. Fulton County will
disburse ¼ of the annual
(operating) appropriation
approved to GHS.
3.
Quarterly Report by
Grady Hospital
Not later than 30 days after the
end of the quarter, GHS
will provide information
regarding the residency and
eligibility of patients, costs
and quality (standard) of care.
4.
Reconciliation/Over-Payments and
Adjustments
Fulton County will complete the
reconciliation between the
amount disbursed and the
information received not more
than 30 days after receipt of
the Quarterly Report. Any
over-payments by Fulton County
determined by the reconciliation
will be deducted from the next
quarterly payment.
Click here for more: “Fulton
Quarterly Reporting and
Disbursement Standard Operating
Procedures”
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2-5-10:
Grady Outpatient Dialysis Clinic
Closing: Financial Data
Unavailable
A claim by Grady administrators
that the Outpatient Dialysis
Clinic was “losing millions”
when it closed in October 2009
could not be validated by the
application of General
Accounting Standards according
to Fulton County’s Internal
Auditor (Anthony Nicks). A
discussion of the clinic closing
also disclosed that 17 uninsured
patients were identified as
Fulton County residents and 1
has deceased since the clinic
closed.
Click here for more information
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2-2-10:
GHS (Grady Hospital System)
A.
Fulton-Dekalb
Hospital (Grady): Fulton
(Outside) Audit Report, "Total Income for
2008", "Total Equity" as of 1-1-09
B.
Fulton Auditor’s Report: Grady
(Outpatient)
Dialysis Services: December 28, 2009
C.
Fulton Auditor’s Report: Grady
Residency and
Eligibility Reports with Timeline, November
2009
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1-29-10:
Grady Hospital System Financial
Status Report as of 1-1-09, “Net
Assets” (Fund Balance);
Auditor’s Report
Click here for the detailed
report..
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1-26-10:
Uninsured Fulton County
Residents (24)
17- Paid treatment contract with
local clinic for 3 months
(Fresenius)
4- Referred to Mex-Care, Mexico;
1 deceased
3- Provider Unknown
Operating Loss (at time clinic
closed): Unknown
Grady officials have stated the
Dialysis Clinic showed a loss of
$1.9 million for
2007 and $2 million for 2008.
However, a “Deduction of Revenue” at $6 million could not
be substantiated by Fulton
County Auditors.
Source: "Auditor's Report: Grady
Dialysis Clinic"
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1-5-10:
Medical Homes Focus U.S. House
and Senate “Health Reform”
Legislation
The development of community
based health teams to support
the development of medical homes
is a key provision of the –
Managers Amendment to “the
Patient Protection and
Affordable Care Act” (H.R. 3590)
adopted by the U.S. Senate on
December 24 as part of its
“Health Reform” legislation.
Further, the House Bill (H.R.
3962) provides for the expansion
and reorientation of a medical
home demonstration project in
Medicare and establishes a
medical home pilot program to
the feasibility of reimbursing
for qualified patient-centered
medical homes. Actions on Health
Reform legislation has been
scheduled for early January.
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1-5-10:
(30-Day) Audit Work Plan and
Timeline: Grady Health System (GHS)
Week
Agency Activity
1
Fulton Review MOU
data; select sample and
forward
to GHS
2 GHS Prepares demographic forms and
returns to FC
3 GHS Prepares for FC on-site tests at GHS
4
Fulton Completes test
work at Grady
5
Fulton Reviews data
with Authority auditor
(CBH)
lists outstanding items; Review
with GHS
an CBH Prepares
Final Report
Click here for more information
regarding the “GHS Quarterly
Audit Work Plan and Timeline”
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12-17-09: Grady Dialysis
Out – patient Clinic; Four (4)
Former Patients Deceased
Since Grady closed the
Out-patient Dialysis Clinic in
October of this year, four (4)
former patients of the Grady
Dialysis Out-patient Clinic have
died, according to a report from
Advocates for Responsible Care,
a local advocacy group for Grady
patients.
Representatives of the
Fulton/DeKalb Hospital Authority
have confirmed that of 17 Fulton
County residents receiving “re –
location assistance” following
the close of the Clinic, seven
(7) patients received travel
expenses to Mexico. The
Authority had no information
regarding the health status of
any of the 17 former patients of
the Grady Out-patient Dialysis
Clinic including (10) patients
who live within Fulton County.
The County Manager (Zachary
Williams) and his staff will
present a full report on the
Out-patient Clinic closing at
the January 6, 2010 Meeting of
the Board of Commissioners.
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12-3-09:
Closing of Grady Dialysis Clinic
Update
The Board of Commissioners
received the following “up-date”
of information related to the
closing of the Grady
(Out-patient) Dialysis Clinic by
Grady Corporation officials.
Click Here to review a copy of
the Corporation’s Report, “Close
of Dialysis Clinic”, November
17, 2009
On November 18, at the Recess
Meeting of the Board of
Commissioners, Pamela
Stephenson, Chair of the
Fulton-DeKalb Hospital Authority
(Authority) indicated the
Authority would provide
additional information to the
Board of Commissioners regarding
1) the length of time dialysis
care would be provided (to the
71 Fulton County residents who
are no longer served by Grady 2)
a verification of the
operational cost of the Clinic
in FY 2008 and 3) the quality of
care received by clients who had
been accepted by private
clinics. Commissioner Darnell
also indicated a formal request
for the information was
submitted to the Authority on
November 25. No reply had been
received on December 2.
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