Signs of hospital in dire financial straits

[nexus73]

Any experience about inferring that a large health system is in bad financial shape?

My assumption is a hospital system, like any business, will minimize disclosure of its financial situation getting bad. Giving out such information would lead to worry, panic, staff departures to pursue new employment hopefully on better financial footing.

Hearing about ongoing costs of travel nurses, and lack of revenue from elective procedures, and articles like this Hospitals' finances are hurting . So clearly some hospitals financial info is more accessible than others.

---

Members don't see this ad.

 

[wolfvgang22]

When the hospital is no longer building new facilities or updating old facilities, trouble is already here. We complain about construction, but if a hospital isn't growing, it's probably dying.

 

[PikminOC]

Any experience about inferring that a large health system is in bad financial shape?

My assumption is a hospital system, like any business, will minimize disclosure of its financial situation getting bad. Giving out such information would lead to worry, panic, staff departures to pursue new employment hopefully on better financial footing.

Hearing about ongoing costs of travel nurses, and lack of revenue from elective procedures, and articles like this Hospitals' finances are hurting . So clearly some hospitals financial info is more accessible than others.

Then they will just merge with another large hospital system

 

[Sushirolls]

I got to take part in the closure of a small hospital as a teenager. Got stiffed out of last few paychecks. Class action lawsuit, got only percentage of wages owed.

 

[Mad Jack]

Then they will just merge with another large hospital system

A lot of the time that results in cuts or closures of existing services. In the worst cases, it can lead to entire shutdowns like when our part of the state lost its only children's psych unit due to a big for-profit psych hospital shutting down after they realized the money just wasn't there. It reopened, but now the new owner is bleeding red as well.

For general hospitals the first thing you tend to see is pay and hiring freezes, followed by supply and testing restrictions, followed by layoffs, followed by unit or facility closures, followed by petitions to merge with other organizations. You will also tend to see high turnover as staff are forced to work under increasingly more taxing conditions and with ever more stressful staffing ratios. I've been through it in my prior life and seen how it has gone down on multiple occasions in various systems.

 

[Fpg1245]

Usually it’s not a surprise when a hospital closes. It’s consistently underperforming under many years.

Nonprofit explorer can also give you some insight. You can see if hospitals are in the red or black. Ofcourse the data isn’t up to the minute but as I said closures are a usually years in the making

 

[Select All That Apply]

Any experience about inferring that a large health system is in bad financial shape?

My assumption is a hospital system, like any business, will minimize disclosure of its financial situation getting bad. Giving out such information would lead to worry, panic, staff departures to pursue new employment hopefully on better financial footing.

Hearing about ongoing costs of travel nurses, and lack of revenue from elective procedures, and articles like this Hospitals' finances are hurting . So clearly some hospitals financial info is more accessible than others.

hmpmetrics.com

 

[whopper]

It's funny how money is not supposed to be discussed in medicine. There was a case on NPR where a woman got a rabies vaccine in the ER and it cost her about $15,000 and no one told her the price. Had she waited a few days and got the same vaccine through a state agency it would've cost her a few hundred dollars. (edit found the link for the story: In D.C., Preventing Rabies After An Animal Encounter Can Cost More Than $15,000)

For a hospital to remain viable it must be in the black. And yet despite this we're not supposed to discuss money. IMHO any medical organization should immediately jump onto any options that increase profits while simultaneously improve healthcare. As an attending of mine told me, if you can do that, you should have enough wiggle room to at least take on the charity cases without fearing going out of business.

At an institution I worked, I was told consistently over and over how the department was losing money but nothing that could've fixed the issue was being done, and everytime I tried to push for something the guy right above it torpedoed my ideas. Another sign it was time to leave (among many) was someone came up with an idea of an independent financial examiner and "efficiency expert" could audit us to tell us how we could improve ourselves. The idea was kicked around for weeks and no one was executing the idea. Finally someone said "so we're so inefficient we can't even get someone to get on the phone and get an efficiency expert to see us. Is that what I'm hearing?" It wasn't the straw that broke the camel's back but it was a sure sign things were extremely screwed up.

 

[nexus73]

It's funny how money is not supposed to be discussed in medicine. There was a case on NPR where a woman got a rabies vaccine in the ER and it cost her about $15,000 and no one told her the price. Had she waited a few days and got the same vaccine through a state agency it would've cost her a few hundred dollars. (edit found the link for the story: In D.C., Preventing Rabies After An Animal Encounter Can Cost More Than $15,000)

For a hospital to remain viable it must be in the black. And yet despite this we're not supposed to discuss money. IMHO any medical organization should immediately jump onto any options that increase profits while simultaneously improve healthcare. As an attending of mine told me, if you can do that, you should have enough wiggle room to at least take on the charity cases without fearing going out of business.

At an institution I worked, I was told consistently over and over how the department was losing money but nothing that could've fixed the issue was being done, and everytime I tried to push for something the guy right above it torpedoed my ideas. Another sign it was time to leave (among many) was someone came up with an idea of an independent financial examiner and "efficiency expert" could audit us to tell us how we could improve ourselves. The idea was kicked around for weeks and no one was executing the idea. Finally someone said "so we're so inefficient we can't even get someone to get on the phone and get an efficiency expert to see us. Is that what I'm hearing?" It wasn't the straw that broke the camel's back but it was a sure sign things were extremely screwed up.

that is awesome. I propose a committee to determine whether we need more committees.

 

[michaelrack]

It's funny how money is not supposed to be discussed in medicine. There was a case on NPR where a woman got a rabies vaccine in the ER and it cost her about $15,000 and no one told her the price. Had she waited a few days and got the same vaccine through a state agency it would've cost her a few hundred dollars. (edit found the link for the story: In D.C., Preventing Rabies After An Animal Encounter Can Cost More Than $15,000)

For a hospital to remain viable it must be in the black. And yet despite this we're not supposed to discuss money. IMHO any medical organization should immediately jump onto any options that increase profits while simultaneously improve healthcare. As an attending of mine told me, if you can do that, you should have enough wiggle room to at least take on the charity cases without fearing going out of business.

At an institution I worked, I was told consistently over and over how the department was losing money but nothing that could've fixed the issue was being done, and everytime I tried to push for something the guy right above it torpedoed my ideas. Another sign it was time to leave (among many) was someone came up with an idea of an independent financial examiner and "efficiency expert" could audit us to tell us how we could improve ourselves. The idea was kicked around for weeks and no one was executing the idea. Finally someone said "so we're so inefficient we can't even get someone to get on the phone and get an efficiency expert to see us. Is that what I'm hearing?" It wasn't the straw that broke the camel's back but it was a sure sign things were extremely screwed up.

I think a majority of the cost is for the rabies immunoglobulin, rather than the vaccine. Either way, I would not want wait several days to start treatment

 

[splik]

that is awesome. I propose a committee to determine whether we need more committees.

my institution has this, it's called the committee on committees!

 

[PikminOC]

These are all paper losses. They made investments that have decreased

 

[whopper]

I think a majority of the cost is for the rabies immunoglobulin, rather than the vaccine. Either way, I would not want wait several days to start treatment

In the case it was waiting 2 days. The person got ER treatment on the weekend but the office that could've given her the vaccine could've done so on the immediate Monday.

 

[michaelrack]

In the case it was waiting 2 days. The person got ER treatment on the weekend but the office that could've given her the vaccine could've done so on the immediate Monday.

If you were exposed to rabies, would you want to wait for 2 days?

 

[FlowRate]

If you were exposed to rabies, would you want to wait for 2 days?

I was initially in agreement with you but after reading up on rabies more I don't think 2 days from time of exposure is clinically significant. I agree that emotionally I would want to start PEP IMMEDIATELY because the risks of treatment failure are death.