Copper Basin Medical Center is precious to the people of Polk County. In the 1950’s, employees of Tennessee Copper Company and other Polk County business deducted money from their paychecks to pay for building the hospital. While it was being constructed, trades people in Polk County would volunteer their time to help with construction like laying electrical wires and build brick walls. As one Polk County resident said at the meeting, Copper Basin Medical Center first stop during a medical emergency. It is the hospital that stabilizes you and keeps you from dying before you can receive intensive care at a large regional hospital.
The hospital is precious to the Polk community and its economic health. Copper Basin Medical Center employs 140 full- and part-time staff. It is one of the largest employers in the Copper Basin area. Losing an employer this size would affect the livelihoods of many residents.
Copper Basin Medical Center owes Polk County, Copperhill and Ducktown approximately $703,000. This debt comes from a $1.4 million loan Polk County gave the hospital in 2010. Copper Basin Medical Center has paid back half the loan to-date; there has not been any extra money from local government or tax payers that has been used to pay for the loan. If the hospital cannot pay the remainder of the $703,000, Polk County would be responsible for approximately $351,500 and Copperhill and Ducktown for approximately $175,000 each. More than likely, local government would need to raise taxes to be able to pay for the $703,000 remaining on the loan. This has not happened yet and may not be a problem. It depends on how the Copper Basin Medical Center District Board steers a new course for managing the hospital.
The future of the hospital is so important to the local governments that Mayor Cathy Stewart of Copperhill, County Executive Hoyt Firestone and Polk Commissioner Darren Waters have attended the series of meetings. Doug Collins, Chair of the District Board, is also Mayor of Ducktown.
The hospital has had troubling finances for the past 10 years. Its financial problems come from several different angles. When the District Board regained control of the hospital from Murphy Medical Center, financial assets of the hospital were already low. As Anna Clark, CEO of Copper Basin Medical Center, describes it, it is getting more difficult to get claims from Medicare especially with the non-emergent health care law that Tennessee passed this year. Also, after former patients leave Polk County, oftentimes there are not new patients to fill in the gap. Then there are questions about how efficient and effective the hospital’s medical billing procedures are.
The turmoil around Copper Basin Medical Center’s future have been rumored throughout the hospital and Polk County for some time. On May 23rd, Copper Basin Medical Center’s District Board began a series of legal maneuvers to take complete control over the hospital, its finances and its administration, doctors and staff.
The first maneuver was to revoke Copper Basin Medical Center Corporate Board’s lease on the hospital. To date, it had not paid around $147,000 for leasing the hospital. The Corporate Board must pay Polk County $49,000 per financial quarter to lease the building. By revoking the Corporate Board’s lease, the District Board was able to take over all areas of hospital administration.
Prior to the May 23rd decision, the Corporate Board and District Board had very different responsibilities. The District Board was more like a landlord, leasing the building to the Corporate Board. The Corporate Board made administrative and financial decisions. Now the District Board will have all the responsibilities. All seven District Board members are appointed by Polk County, Copperhill and Ducktown governments. The Corporate Board members were appointed by different groups. Two came from hospital doctors, two from staff, the hospital CEO and also local government appointments. Now that the Corporate Board no longer exists, all decisions are made by the District Board; there no hospital doctors or staff on the Board. This is an important difference because some members of the District Board believed that hospital staff on the Corporate Board were having too much influence over administrative decisions and that the influence was a conflict-of-interest. Neither District Board nor Corporate Board members are paid for their service on the Board.
May 24th, the District Board of Copper Basin Medical Center began the process “cleaning up” the hospital to bring it into a better financial and administrative position.
As in the May 23rd meeting, Doug Collins, District Board Chair, stated his resolve to keep the hospital open for the sake of the community and hospital employees. He also asked all District Board members present what their allegiance to the hospital is. All six members agreed that their priority is keeping the hospital open.
The first move of the District Board is to rewrite the by-laws. Currently, the City Attorney for Ducktown is reviewing the by-laws and suggesting changes. The District Board must rewrite the by-laws so that the District Board can hire and fire both medical and administrative staff. Also, the District Board wants legal authority to examine financial records of both the hospital and departments inside the hospital.
One of the first ways the District Board wants to reform the hospital is regarding emergency-room billing because it will have an immediate financial benefit.
Though questions about how Copper Basin Medical Center bills emergency procedures have been around for a while, the new 2016 Tennessee law covering reimbursement for emergency procedures makes the issue urgent. Tennessee sent out a specific list of emergency procedures that TennCare will cover. Any procedure not on the list will not be reimbursed. Anna Clark, CEO of Copper Basin Medical Center and the hospital’s billing company, Medical Billing Services of Tennessee, sent a strict policy statement to emergency room doctors about emergency room procedures they can bill for.
The emergency room doctors are provided by Dr. Mahomood Siddiqui. Dr. Siddiqui and his group of doctors have a 24 hours a day, 7 days a week contract with the hospital. Dr. Siddiqui also has an internal medicine practice located at the hospital, in Cleveland, TN and Blue Ridge, GA. Dr. Siddiqui’s internal medicine practice and how it bills is not under question. Some of the emergency room staff, like RNs, LPNs and Paramedics are employees of Copper Basin Medical Center. These employees are not under question.
Ms. Clark believes that Dr. Siddiqui and his emergency room doctor staff knowingly perform procedures that TennCare will not reimburse. Tennessee law states that all people arriving at an emergency room must be seen by a doctor. Once the doctor diagnoses the problem and explains it to the patient, the patient must then decide how to pay for the treatment. Life-threatening situations that TennCare reimburses for can be done at the hospital. According to Ms. Clark, Dr. Siddiqui did not tell patients they needed to go to another doctor or medical facility to continue their treatment. This left the hospital in debt with thousands of dollars in bills the hospital will never see money from. Also, Ms. Clark and Mr. Collins say that there is $360,000 in bills that emergency room doctors have not signed. This means that the hospital cannot get reimbursed for these yet. Ms. Clark says that Dr. Siddiqui’s actions have created an atmosphere of distrust between herself and Dr. Siddiqui and his emergency room employees.
Mr. Collins wants to make it clear that there is no question about Dr. Siddiqui’s ability as a doctor. He said several times that Dr. Siddiqui is a good doctor and that he had kept Mr. Collins’ father from dying during one medical emergency.
An additional problem with the hospital that the District Board must solve is that some hospital staff and District Board members are unsatisfied with Ms. Clark’s performance as CEO of Copper Basin Medical Center. They feel that she is uncommunicative with staff and disregards their questions. Some of these people also believe that Ms. Clark is unqualified for the position in terms of education and work experience.
Five out of the seven District Board members have set up a Special Called meeting for this evening, May 31 at 6 pm to continue the process of “cleaning up” the hospital. The meeting will be in the cafeteria of Copper Basin Medical Center.