Grady Hospital/Indigent Healthcare ...

 

 

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

  • Lack of pressure sores and bed sores acquired in the hospital

  • Ability to diagnose and treat in time

  • Avoidance of collapsed lung due to a procedure or surgery in or around the chest

  • Lack of deep blood clots in lungs or legs after surgery

  • 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

     
 

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).”

 

     
 

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"

     
 

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

     
 

"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”.

 

     
 

"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”

 

     
 

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

 

     
 

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

 

     
 

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..

 

 

 

 

     
 

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"

     
 

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.

 

     
 

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”

 

     
 

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.

 

     
 

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.