Jackson Health System loses $4.9 million annually with undocumented patients


Undocumented patients in Jackson nursing homes continue run up huge bills paid for by Miami-Dade taxpayers.

While federal healthcare reform will help many uninsured people, it will not cover 70 uninsured patients in nursing homes of the Jackson Health System, so paying patients must make up for them, Jackson’s board was told Thursday.

Jackson Vice President Kevin Andrews said all of these long-term patients are undocumented immigrants brought by ambulance to Jackson trauma or burn centers because of car accidents or gunshot wounds. Many are paralyzed or on ventilators.

Andrews estimated that each of those patients costs Jackson about $70,000 a year — $4.9 million for the group. Because federal and state lawmakers are adamant about not paying for healthcare for people in the U.S. illegally, their care is funded by Miami-Dade taxpayers.

Jackson has made considerable progress in getting foreign patients out of its hospitals. In the past two years, Andrews said, about 60 have been sent back to their countries of origin, as far away as Russia and China. It is easier to move patients from a hospital, as part of a discharge plan, than from a nursing home, where they have certain residents’ rights, Andrews said.

At its monthly day of committee meetings, Jackson’s board also dealt with a negative financial report, a big payment to get out of a bad contract and an update on the lengthy negotiations with the University of Miami medical school that were supposed to have resulted in an agreement by Dec. 1.

Despite an ambitious plan to transform Jackson’s relationship with UM, Chairman Marcos Lapciuc said that for the immediate future, the partnership “is going to look pretty much the same as in the last two or three years.”

In the spring, Jackson announced plans for a radical change in which it would hire or lease some UM doctors and collect all the revenue they generated from patients and insurers. At present, Jackson pays UM a lump sum for doctors’ services, and UM also collects from insurers.

The original plan was to craft a deal by June 1, the start of UM’s fiscal year. That didn’t happen. Executives then set a Dec. 1 deadline, and if an agreement wasn’t reached by then, monthly “transition payments” of $3.6 million to UM would end, with the possibility of UM then reducing services to Jackson.

Jackson’s board was told Thursday that the transition payments would indeed stop Dec. 1. UM did not immediately announce any plans to cut services, said Jackson’s chief strategy officer, Jeffrey Crudele.

Steven Falcone, the UM doctor leading the medical school’s negotiating team, told Jackson’s board: “We will continue to work with Jackson leadership. We have a 60-year relationship. Any changes that will take place will be based on thorough... cooperation.”

Jackson Chief Executive Carlos Migoya said discussions with UM are continuing weekly. Joe Arriola, a Jackson board member and former UM trustee, praised UM doctors but added, “The administration at UM does not have the best interests of Jackson at heart. They have their own hospital, their own problems.”

In other developments Thursday:

•  The system lost $2.5 million in October after seven months of surpluses, with 12 days of cash on hand. Chief Financial Officer Mark Knight said higher labor costs, particularly overtime, were a major reason for the decline. Jackson executives said they were working to reduce overtime.

•  The board agreed to pay $7.9 million to buy out a 2008 contract from Johnson Controls. Under the contract, the company installed devices that were supposed save on utility bills , such as chillers and low-flush toilets, and then received 90 percent of the savings.

Jackson’s present leadership questioned how those savings were calculated and decided the system would save $3.2 million by buying out the remaining nine years of the contract while agreeing to a new 10-year contract with Johnson Controls — the same company — under more favorable terms.

Arriola called the settlement “kind of hard to swallow,” but Jackson executives said it would save money in the long run; the board voted unanimously to approve it.

•  Chairman Lapciuc urged Miami-Dade County commissioners to maintain the concept of a seven-member board to govern Jackson. Commissioners voted last week to reconsider the concept they had approved earlier. The seven-member board had been pushed by Commissioner Joe Martinez, whose term has now ended. The commission will take up the matter at a December meeting.

•  Executives postponed until next month an item formalizing Jackson’s plans in responding to federal complaints about improper healthcare for county inmates.

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