An organization’s recent probe into how well hospitals in Mississippi and Louisiana informed low-income and indigent patients of their charity care policies found one Golden Hospital Triangle lacking.
However, issues the Southern Poverty Law Center identified at North Mississippi Medical Center’s West Point branch as potentially out of compliance with federal guidelines have since been corrected.
The hospital and its administration in Tupelo received a letter from SPLC representatives. Among the claims: NMMC-West Point has not adequately advertised its charity care polices and opportunities to its uninsured patients.
But Chief Legal Officer Bruce Tobbin for the Tupelo-based medical group said NMMC hospitals — including West Point — have been advertising the policies for years.
“(West Point) provides charity care, free care assistance to those that don’t have insurance and we’re very generous as an organization,” he said.
SPLC senior staff attorney Sara Zampierin, who authored the letter, told The Dispatch last week representatives visiting the West Point hospital in March could not find copies of the policies available in waiting rooms and other public areas of the hospital, nor were staff able to provide the representatives with copies of a plain language summary of the policies. SPLC employees could not find copies of the policies on NMMC’s website, either.
“When these policies are not made widely publicly available, or they don’t include all the information that somebody might need, it just makes it hard for low-income people to make decisions about their health care and to obtain medically necessary care,” Zampierin said. “If they’re worried that they’ll be stuck with the bill and be sued, that their credit will be harmed … it makes it more likely that people won’t seek medical care.”
A SPLC spokesperson said an NMMC representative had reached out to them by April 21 to address the issues.
“I immediately called them and said ‘I appreciate the letter and I appreciate what you’re trying to do,'” Tobbin said.
Tobbin said the policies were available online but admitted they were hard to find when SPLC employees checked it. They corrected the issue within 24 hours.
He also said the policies are available at NMMC hospitals, including West Point.
“I went back and checked and we have signs posted at West Point that have been up,” he said. “There’s been signs about charity care and financial assistance … going back more than a decade. They were up there in March. I verified that with administration.”
Whether the financial assistance policies were online when SPLC representatives checked, The Dispatch confirmed they are available now. NMMC’s website provides a PDF copy of them under Financial Assistance — along with a plain language summary of the policies, billing and collections policies, the charity care application for patients who want to apply and a frequently-asked questions page. Tobbin said patients receiving inpatient care can request assistance from case managers who can help explain and apply for financial assistance.
Policies
As a nonprofit, NMMC and other hospitals are subject to federal regulations dictating how they care for low-income patients. Patients at or below 100 percent of the federal poverty guidelines receive emergency and medically necessary care free of charge, according to NMMC’s policies, while patients above 100 percent of the guidelines are eligible for discounts depending on income. The hospital also implements policies to ensure uninsured patients don’t pay more in out-of-pocket expenses than patients with insurance.
Still, Tobbin said, these policies have to be balanced with running a hospital and making sure all patients — regardless of income and insurance — receive adequate care.
“Nonprofit’s really a misnomer,” he said. “You have to have excess revenue to cover expenses, to keep doors open and reinvest in your facility, update your facility to new technology that comes aboard. There’s a lot of cost, and you have to have that capital to do it. … It’s basically like your household. If you have that money saved, you can make the improvements when the roof starts leaking. But if it doesn’t, then the roof gets worse and then the house falls apart eventually.”
Some hospitals bring in more capital than others, Tobbin added, meaning in some years the NMMC system is supporting smaller hospitals like West Point, which is generally a break-even hospital.
“I’ve seen some months (this year) where West Point is great and some months where West Point is break-even,” he added.
In fiscal year 2014-15, NMMC-West Point provided a $1.37 million in charity care, and $1.39 million the following fiscal year.
Other hospitals
SPLC, a Montgomery, Alabama-based legal advocacy group for vulnerable citizens in the South — including minorities and those with low incomes — claimed six hospitals were out of compliance with federal regulations. Two of those had no policies at all that SPLC could find, Zampierin said.
Like NMMC, other local hospitals provide charity care for low-income patients. OCH in Oktibbeha County provided more than $2 million in charity care in fiscal year 2015-16.
“OCH’s patient assistance program was designed to benefit those who are un- or underinsured and who need medical care,” OCH Chief Financial Officer Susan Russell said. “We believe a patient’s ability to pay should not prohibit him or her from receiving necessary care, and this fund is just one of the ways we ensure our patients receive the care they need.”
In Columbus, Baptist Memorial Hospital-Golden Triangle did not provide The Dispatch exact dollar amounts by press time but said that Baptist’s charity care — which includes service for low-income patients as well as community benefit programs — made up 10 percent of annual expenses.
“Baptist Memorial Hospital-Golden Triangle has a responsibility to provide quality medical services to all patients regardless of their ability to pay and hospital leaders take this responsibility to heart in all decisions,” said Keith Siddel, Baptist Memorial Health Care vice president of revenue.
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