Natchez Regional Medical Center, as we know it, appears to be on the brink of disintegrating.

Despite all the excuses thrown about blaming everyone but its own leadership — bankrupt NRMC is a victim of the malfunctioning system that drives the county-owned hospital.

The system lacks accountability.

NRMC leaders whine about the more than $2 million impact of audits by the Recovery Audit Contractors (RAC), a federal program that seeks to find and recover improper Medicare payments.

Yet, in NRMC’s case no one has ever publicly explained why the losses were so large. Were internal controls over paperwork so lacking that the auditors had a field day finding errant billings?

The hospital has suggested the RAC system is unfair and improper. That may be the case, but had the hospital followed the guidelines correctly, reviewed the files before the audit, perhaps the auditors wouldn’t have found much to cite. In addition, does anyone know if the claims were properly appealed? If not, why not?

But RAC audits are the only unexplained excuse.

Apparently, the hospital — and its medical foundation — hired a bunch of doctors who didn’t perform well enough to cover their own expenses, costing NRMC millions.

Why was this allowed to go on so long?

Last July, as the hospital apparently spent tens of thousands of dollars on resurfacing the parking lot, they also stopped paying the company contracted to provide meals to patients.

It’s difficult to know from the court paperwork if some underlying dispute existed which caused the payment delays or if NRMC just chose to “ride” on the backs of its vendors. Valley Systems Inc. claims NRMC owes it $540,000.

Did no one in the hospital’s leadership see a problem?

What about the failure to keep current on benefits for employees? In most businesses, payroll and benefits payments are considered sacred, but at NRMC, finances apparently were handled as loosely as the rest of the organization.

Approximately one year ago brokers representing Health Management Associates, the former owners of Natchez Community Hospital, courted Adams County.

HMA allegedly wanted to buy Natchez Regional. An offer of some $25 million was reportedly thrown about, but nothing was signed.

The county supervisors — thinking they were doing the right thing — let the NRMC board know of the interest.

What was set into motion next is almost too baffling to imagine. The county — at the hospital’s behest — rehired the firm that failed to sell the hospital in 2008-2009, paying the company approximately $500,000 for this go around.

Elaborate sales schemes were created and all sorts of requirements mandated for would-be buyers.

As the months have ticked by NRMC has failed to deliver on its grand scheme to sell the hospital.

Last week, in typically secretive fashion, NRMC’s mouthpiece — board attorney Walter Brown — said a sale is forthcoming.

Sources involved suggest the potential offer is coming from — no surprise — Natchez Community’s parent, Community Health Systems.

Supposedly the offer will be for approximately $10 million and approximately $8 million in “prepaid property tax.” Think of the latter as a 10-year tax abatement. If the reported offer is true, and supervisors accept it, the county could quickly be out of the hospital business, but with virtually nothing to show for its decades of efforts.

NRMC will effectively be given away for the value of its own bloated debts and the county will have nothing to show for it.

The county could, potentially, lose money in the deal if CHS opts to vacate the existing Natchez Community location and demolish it thus lowering its taxable value while operating out of NRMC’s building for the next 10 years.

In the end, however, the county must get out of the hospital business one way or the other. Clearly the current management system is broken, with no hope for being repaired.

 

Kevin Cooper is publisher of The Natchez Democrat. He can be reached at 601-445-3539 or kevin.cooper@natchezdemocrat.com.