Tax documents show CEO pay exceeds charity care at some Calif. nonprofit hospitals
Ron Shinkman, editor of the trade newsletter Payers & Providers, spent four months reviewing tax documents filed by 120 nonprofit California hospitals in 2007 and 2008. He found that base CEO compensation was somewhere around $517,123 in that period, which is more than double national numbers from a survey published in 2001.
To add perspective to the numbers, California Watch’s Christina Jewett looked at Shinkman’s research – especially the sentence that mentioned “11 hospital executives whose compensation exceeded the cost of the charity care provided by their hospitals during the reporting year” – and evaluated it in terms of the national debate over the amount of charity care provided by nonprofit hospitals.
Shinkman is charging for full copies of his work and the resulting white paper, but between Jewett’s coverage and the brief version Shinkman has posted, readers should be able to get a pretty good idea of where the story is going and, perhaps more importantly, how to report on CEO pay at your local nonprofit hospitals.
For more help covering nonprofit hospitals:
- Changes to 990 forms make hospital finance investigations necessary
- Tools for covering hospitals: Financial documents
- Digging Into Hospital Finances: Recent trends and five key documents
- Reporting on the business of health care
- Health Journalism 2008: Ripping the cover off hospital finances
Free online training:
Course teaches how to report on hospital finance
This free innovative simulation, “On the Beat: Covering Hospitals,” guides you through the sources and resources you need to tackle the beat.
You’ll tap into the same tools that you’ll use on the job, and you’ll have a virtual mentor to walk you through the maze of reports, statistics and sources. One story line teaches you about how to report on hospital finances.
Start today to hone your critical-thinking skills and gain the beat-specific knowledge needed to cover the hospitals in your community.
This online training module combines the reporting expertise of AHCJ with NewsU’s innovative e-learning experience and is made possible through a grant from the John S. and James L. Knight Foundation.
Cannabis carpetbaggers crisscross California
The Redding Record Searchlight’s Ryan Sabalow paints a classic tale of the principled old guard taking a stand against exploitative, profit-hungry carpetbaggers, one that just happens to take place in the wild west of northern California’s medical marijuana clinics. Since last year’s federal directive effectively allowed the state’s clinics to operate with impunity, a number of traveling physicians have come up from the south to open clinics in this northern outdoor recreation hub which more than 100,000 residents call home.
At $150 for each brief exam (no tricky medical procedures involved), the granting of medical marijuana recommendations is low-overhead work that holds the promise of substantial profit. A physician would need to see just 30 patients a day to gross more than $1 million a year, Sabalow writes. One local Redding doctor (the only one who specializes in pot, really) has found that the newcomers seem to care more about money than medicine.
[Dr. Terrence Malee] gave the example of a cage fighter who came in to his office trying to intimidate him into getting a recommendation that allowed him to have 7 ounces of marijuana in a week, when most patients are only recommended 2.
“I said, ‘Look, bud, the last time you went to the doctor and asked him for 1,000 Vicodin, did he give it to you? No. Well, I’m not going to give you 7 ounces either,” Malee said, laughing.
In a companion piece, Sabalow looks beyond California’s borders, thanks in part to the responses of other AHCJ members via our electronic discussion list. In particular, he looks at Montana, where traveling “cannabis caravans” have swelled the ranks of medicinal marijuana users in every corner of the state and Colorado, where five doctors accounted for over half of the state’s medical marijuana recommendations.
The Record Searchlight’s editorial board followed up with an piece that questions the wisdom of making medicinal marijuana so easy to obtain.
But it’s hard not to see a stretching of the state’s groundbreaking 1996 Compassionate Use Act beyond all recognition when patients arrive not thanks to a referral from their family doctor, but after hearing a 30-second ad on the local rock station.
For more on Colorado’s effort to reign in physicians who recommend medical marijuana, see Eric Whitney’s piece for Colorado Public Radio.
Guide focuses on diversity in services for the aging
This is a guest post by independent journalist Eileen Beal, that she wrote at my invitation.
Don’t let the title deter you from ordering or downloading a copy of “A Toolkit for Serving Diverse Communities.”
The easy-to-read guide, by the Administration on Aging (AoA), does two things: it outlines the challenges agencies and organizations providing community services face as the elderly population grows and becomes more diverse and it gives you excellent backgrounding on the Aging Services Network.
This network headed by AoA (a division of the HHS) includes:
- 56 State Units (departments) on Aging (the “state” thing is a misnomer, since this arm of the network includes U.S. territories, Puerto Rico, and the District of Columbia)
- 655 Area Agencies on Aging (AAA), which are funded through AoA and State Units; coordinate services and programs in their planning and service “area;” and are often the major funder for the agencies and organizations that provide services (such as meals-on-wheels, adult day care programs, the meals and exercise programs at senior centers, etc.)
- 238 tribal and native Hawaiian organizations (representing 302 groups), which do the same thing as AAAs
- more than 28,000 service providers/organizations that actually do the hands-on delivery of services and programs mentioned above (For more information, see item 1 below.)
The guide is in two parts. Part I gives you a good understanding of how social service agencies are organized and the staff/organizational culture, client, and funding challenges agencies and programs are facing. Part II is appendices. All are interesting, but you’ll get the most bang for your reading buck from:
- Appendices A and E explain how programs are planned, designed and implemented
- Appendix D has excellent “what would you do” scenarios that will help you frame questions when you are doing interviews
- Appendix E has good lists of factors influencing culture and ethnicity
- Appendix G provides an excellent list of on-line resources current data and diverse populations
To order a copy of the guide, call Evelyn at 202-619-0724 or you can download it.
Related resources
- National Association of State Units on Aging
- National Council on Aging (publications) and National Council on Aging (policy)
Project offers guide on access to autopsy records
The Marion Brechner Citizen Access Project at the University of Florida College of Communications has posted an online guide to access to autopsy records, which are not open records in about half the states and the District of Columbia, according to Ana-Klara Anderson, J.D., Ph.D.
Where the records are public, they are mired in exemptions that limit public access. Anderson, writing for Quill, the magazine of the Society of Professional Journalists, points out that autopsy records are important for reporting on public health and safety issues as well as crime and other issues.
Anderson, a former researcher for the Marion Brechner Citizen Access Project and a member of the SPJ Freedom of Information Committee, provides more details about exemptions and case law on the subject.
CDC says monitoring system finds no ill from spill
Filed under: Government, Health data, Hot Health Headline, Public health, Tools
The CDC has two major monitoring programs active in the Gulf of Mexico during the spill: The National Poison Data System and Biosense.
The National Poison Data System tracks calls to American poison centers. As of July 12, it had tracked 1,221 calls regarding the spill, 722 of which regarded exposure to spill-related toxins such as oil, dispersant or food contaminants. The other 499 calls came from folks seeking information about the health effects of the spill. The majority of the calls have come from the gulf states, but some originated from as far away as California, Michigan and Massachusetts.
Biosense is a public health tool that tracks real-time changes in a population’s health status. Among other things, it tracks more than 80 health facilities on the Gulf Coast and provides states affected by the spill with daily updates. According to the latest available data, it has “found no trends in the number of illnesses and injuries that would require further public health investigation.”
In addition to focusing resources of these two national programs, the CDC has collected state public health monitoring resources from Louisiana, Mississippi, Alabama and Florida.
Rafael Olmeda of the South Florida Sun-Sentinel points out that the CDC has posted “Gulf Oil Spill Information for Pregnant Women,” which generally advises everyone to stay away from oil spill affected areas.
Related
- Tip sheet: reporting on the intersection of health, environment
- Mental health impact of the BP spill multiplies
- Resources for reporting on health and the oil spill
- CDC Emergency Response and Preparedness
- A recent Dart Centre Europe panel looked at covering the human consequences of environmental disaster.
- Grief in the Gulf: Tanya Paperny writes about the challenge of reporting a slow-motion disaster.
- Dart Center resources for covering the Deepwater Horizon Spill
Raw, warm vegetables breed illness in salsa, guac
Filed under: Government, Hot Health Headline, Public health, Studies
New research implicates guacamole or salsa in 3.9 percent of restaurant-related outbreaks of foodborne illness between 1998 and 2008, more than double the rates of previous measurement periods. Both sauces often combine raw ingredients – tomatoes, peppers and cilantro – that have each been blamed for past outbreaks, the CDC release said.
Photo by anitasarkeesian via FlickrImproper storage and temperature were blamed for 30 percent of the outbreaks, and another 20 percent were caused by worker-related contamination. The outbreaks are common enough that the government even gives them their own acronym (SGA!), an honor that’s admittedly not particularly rare in the world of federal bureaucracy.
CDC began conducting surveillance for foodborne disease outbreaks began in 1973, yet no salsa- or guacamole-associated (SGA) outbreaks were reported before 1984. Restaurants and delis were the settings for 84 percent of the 136 SGA outbreaks. SGA outbreaks accounted for 1.5 percent of all food establishment outbreaks from 1984 to 1997. This figure more than doubled to 3.9 percent during the ten-year period from 1998 to 2008.
According to the release, the primary weapon against such outbreaks is simply the awareness that vegetables are a threat.
“Possible reasons salsa and guacamole can pose a risk for foodborne illness is that they may not be refrigerated appropriately and are often made in large batches so even a small amount of contamination can affect many customers,” (Magdalena Kendall, Oak Ridge Institute for Science and Education researcher) says. “Awareness that salsa and guacamole can transmit foodborne illness, particularly in restaurants, is key to preventing future outbreaks.”
Rural Texas hospitals seek lifeline from state
The Texas Tribune’s Elizabeth Titus reports that rural hospitals in the scores of Texas counties without tax bases strong enough to support a full, modern facility are struggling to find a sustainable model. The latest effort is a push to allocate $50 million on the state level to renovate or replace as many as 42 rural hospitals.
The ultimate goal is to keep the hospitals in line with state and federal safety codes, which must be met in order to receive Medicare and Medicaid reimbursements. Urban lawmakers are skeptical, and there are questions as to whether the one-time fee would really help in the long term, as codes and technology are continually evolving. “For example, a state or federal mandate that all hospitals have sprinkler systems could bust their budgets,” Titus wrote.
For a stupendous primer on covering rural health issues, AHCJ members can check out presentations from Rural Health Journalism 2010. Washington University Professor Timothy D. McBride’s guide to understanding rural health disparities in context should be particularly useful to reporters looking for stories like Titus’.
Cancer, journalism and skewed patient expectations
Once again, it appears that a reporter has found the cure for cancer. And that cure is the out-of-context anecdote. Gary Schwitzer spotted the latest offense, a CBS story on a pancreatic cancer vaccine, and Jessie Gruman of Prepared Patient Forum connected the dots to explain how such reporting contributes to the skewed patient view of cancer treatment success rates.
Citizen journalists assist with health insurance story
Journalists should take advantage of the wisdom of their readers, according to a post on Cover Business Better, the blog of the Donald W. Reynolds National Center for Business Journalism.
Bernie Kohn details how Danielle Ivory of the Huffington Post Investigative Fund used citizen journalism to research a story about how many health insurance claims are denied and why. Her research, including “a blizzard of FOIA requests,” had yielded little, so she posted an item online asking for leads on documents or cases of unfair denials.
As Kohn reports, the effort resulted in more than 600 e-mails to Ivory and helped her track down a case that had become notorious among Kaiser Permanente’s claims department. She used that information and her new contacts to track down the story.
Why insurers care about the medical-loss ratio
The Wall Street Journal’s Avery Johnson explains the significance of the “medical-loss ratio,” a single metric within the reform bill that holds great significance for the insurance industry.
The ratio, known to wonks as the MLR, signifies the percentage of premiums insurers use for medical costs versus the amount that goes to paying administrative overhead. For individual and small-business plans, it’s set at 85 percent medical to 15 percent administrative. For larger businesses, the magic medical number is 80. Those who don’t meet the threshold would be forced to pay rebates to customers.
At present, the key issue seems to be subsidiaries. Major insurers have hundreds of them each, and while the insurer could meet the requirements if all subsidiaries were averaged together, they won’t be able to hit the numbers at every single subsidiary. Current draft documents, Johnson reports, seem to imply that each subsidiary would be judged separately, a practice which insurers say might force them to stop providing insurance in certain high-risk areas.
Applying uniform numbers to the segmented, fragmented insurance industry could prove tricky. Johnson looked at the numbers.
UnitedHealth, for instance, has about 392 subsidiaries, according to Goldman Sachs health-care analyst Matthew Borsch. Its average MLR for individual policies is 69%, dragged down by a 63% ratio at its dominant Golden Rule subsidiary, according to a report by Goldman Sachs that examined state insurance filings. The Minnetonka, Minn., insurer could owe about $280 million in rebates in 2012, Mr. Borsch estimates, based on his reading of the methodology in the health care law.
The rules will be set by the National Association of Insurance Commissioners, a coalition of state insurance regulators. They’re hoping to have recommendations ready for HHS by the end of this month.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
