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Administration position on Healthcare crisis
Including letter from DHHS on Medicare and Medicaid
November 26, 2002




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Administration press release Letter from DHHS on Medicare and Medicaid Greater Southeast Community Hospital operational update

Government of the District of Columbia
Anthony A. Williams, Mayor
Department of Health

Alive and Well!

Tuesday, November 26, 2002

In the past weeks, there have been a number of news broadcasts and newspaper articles about the financial problems facing National Century Financial Enterprises. According to the reports, National Century is one of the largest providers of hospitals bonds in the country.

Doctors Community Healthcare Corp, which owns Greater Southeast Community Hospital Corp. (GSCHC) sad Hadley Memorial Hospital is one of the customers of National Century. National Century has filed bankruptcy. Doctors Community Healthcare Corp fled bankruptcy on November 20, 2002. This unfortunate incident lass a significant impact on the financial status of GSCHC and Hadley Memorial Hospital.

GSCHC is the prime contractor for the DC Healthcare Alliance which provides inpatient, outpatient, primary care and emergency services far the District's uninsured individuals.

The DC Healthcare Alliance will continue to serve the uninsured residents of the District despite the troubles at the hospital. GSCHC is only one hospital provider in the Alliance. There are four other hospitals, 28 clinics, and over 800 primary and specialty care providers. DC General's Emergency Room and Clinics will continue to provide services. What's even better is that the dollars of the Alliance are in the District's bank account. GSCHC does not hold the health care dollars .... so even though the hospital is in bankruptcy, the Alliance dollars are safe!

The Alliance Partnership will continue regardless of who is the prime contractor. The prime contractor serves to manage certain elements of the partnership.

The DC HealthCare Alliance has much to celebrate!

  • Over 37,000 District residents were eligible to receive health care through the Alliance during the first year of operations.
  • There were over 60,000 primary care and specialty care visits
  • 153,000 member prescriptions were filled
  • 97,000 Dental visits
  • 1,600 members received inpatient care provided
  • 12,000 Emergency Room visits provided

The Department of Health (DOH) has oversight responsibility for the DC Healthcare Alliance Contract. The Safety Net Administration was created to play this role.

The following actions have been taken so far by DOH:

  1. Currently looking at other options for prime contractor for the Alliance.
  2. Monitors have been placed at GSCHC to ensure that the quality of patient care meets the appropriate standards.
  3. Daily meetings or conference calls have been initiated with key DOH staff members to review information collected each day.
  4. Discussions are being held with the leadership of the hospital to acquire real time information.
  5. The Safety Net Administration is collecting information regarding the ongoing financial status of the hospital.
  6. DOH General Counsel is reviewing contractual and other legal issues that have an impact on the situation.
  7. DOH is reviewing several options for ensuring continuity of patient care in the Event that GSCHC is unable to maintain its financial responsibilities.

EMS is also increasing their staff to ensure the timely transport of. patients to appropriate facilities.

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Centers for Medicare and Medicaid Services
Washington, DC 20201

November 27, 2002

The Honorable Anthony A. Williams
John A. Wilson Building
1350 Pennsylvania Avenue, NW,
Washington, DC 20004

Dear Mr. Mayor:

Thank you for inviting me to visit Greater Southeast Community Hospital with you today. Due to a prior scheduling issue, Secretary Thompson could not make it, but I can assure you that we are both committed to doing whatever we can to work with you to keep the DC public health system operating. I'm glad to have the chance to see first-hand what the city and the hospital are doing.

For our part, I want to inform you that that the Centers for Medicare and Medicaid Services is taking the following initial steps to help the hospital through the next several months:

First, we're suspending monthly collection of Greater Southeast's federal debt payments for one year. Suspending those payments, which equal $82,000 per month, should free up close to $1 million in annual cash flow for the hospital.

Second, we're going to direct accelerated payment of Medicare claims that Greater Southeast has filed and will file with their fiscal intermediary, which should improve cash-flow.

Finally, we're going to expedite payment of amounts the hospital estimates it is owed by the Medicare program. Doing that will allow w to promptly pay $3 million in outstanding Medicare claims to the hospital. While we'll have to ultimately work the final numbers out with the fiscal intermediary, this will provide au immediate cash infusion to the hospital.

We recognize that you some tough decisions when you re-structured the District's public health system last year, Mr. Mayor, and we're confident that you are moving is the right direction. The Medicare and Medicaid programs are committed to helping you and the DC public health community work through what we believe is a short-term crisis.

Tom Scully

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November 26, 2002
Contact: Gwen Russell
(202) 373-5990 or (202) 302-0497


1. Greater Southeast Community Hospital

Census as of November 26, 2002:

Effective November 20, 2002, in consultation with the Prince George's County and DC EMS, Greater Southeast Community Hospital is accepting Priority 3 and 4 level patients. (Patients that are less likely to require placement on a critical care unit)

Greater Southeast Community Hospital's contract with PhyAmerica to supply ER physicians to both Greater Southeast Community Hospital and DC General emergency rooms will end on November 30, 2002.

NES will have a proposed contract for supplying Emergency Department physicians prepared by November 26, 2002 with a December 1, 2002 start date.

A meeting was held on November 21, 2002 with the Medical Directors of the area Hospital Emergency Room departments. Dr. Michael Richardson was also present from Department of Health. The focus of discussion was on critical lack of capacity of ICU beds and the need to accomplish efficiently inter-hospital transfer of critical care patients awaiting a bed. Dr. Richardson agreed to support the recommendation of the group to maintain on onsite EMS supervisor on duty 24-hours a day - The recommendation was implemented on Friday, November 22, 2002.

NOTE: The hospital only goes on diversion for two hours at a time based On our existing policy and procedures.

Critical Care Units

Our Critical Care Units arc operating at a reduced capacity based on our ability to adequately staff the unit with registered nurses. As patients are discharged new patients can be accepted. The target capacity has been reached.

Corrections unit

No change or reduction in clinic, Emergency Room department or inpatient services.

2. DC General Ambulatory & Emergency Card Center

There have been no changes in operations of the clinics or the Emergency Room at DC General.

3. Hadley memorial Hospital/Skilled Nursing Facility

Census as of November 26, 2002:: LTAC: 32, SNF: 89
No change in operations.

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