MORGANTOWN – Department of Health Facilities Secretary Michael Caruso gave legislators an update last week on the latest effort to come up with some kind of plan for the state’s seven hospitals.
Caruso was appointed to lead the newly created DHF in May 2023 and updated members of the Legislative Oversight Commission on Health and Human Resources Accountability on the long-term sustainability report the department has been working on for 10 months.
“We’ve come a long way,” he said.
They’re looking at a plan for each of the seven hospitals, he said, with four possible strategies in mind for each.
One is standalone restructuring: keeping the facility open while addressing its issues. Two is engaging in management agreements with other health systems.
Three is divestiture – selling them off. And four is affirmation with other health systems.
And each plan must address four components, he said: taking care of the people of West Virginia; preserving jobs; the facility structures; and using state dollars appropriately.
The seven facilities are: Hopemont Hospital in Terra Alta, a long-term geriatric psychiatric hospital; Jackie Withrow Hospital in Beckley, a long-term nursing home; John Manchin Sr. Health Care Center in Fairmont, offering services to the indigent; Lakin Hospital near Point Pleasant, a long-term nursing hospital; Mildred Mitchell-Bateman Hospital in Huntington, a psychiatric hospital; Welch Community Hospital in McDowell County, an acute care hospital; and William R. Sharpe Jr. Hospital in Weston, an acute care psychiatric hospital.
The state has a long history of trying to figure out what to do with them. Articles dating back to 2016 in The Dominion Post archives report on failed legislative bills to close them, sell them or hire someone to come up with a plan for them.
They pose various challenges: aging facilities and a shortage of nurses requiring the recruitment of much more expensive contract nurses among them.
Caruso had some good news on the nursing problem. DHF’s spending on contract staffing was $12 million less than projected. At Welch, only 8% of the nursing staff is contracted; at Manchin, it’s 24%. But it ranges up to 70% for psychiatric services.
With a new wage classification system created in 2023 in HB 2006, which reorganized the former Department of Healh and Human Resources, he said, they’ve been able to hire 80 new employees in four months; they’ve converted 40 contract nurses to state employees. The nursing vacancy rate has been reduced from 43% to 32%.
To achieve some efficiency, he told the members that they’re looking at contracting with a company to handle the hiring of contract nurses.
And it’s not well-known, he said, that of the state’s four long-term care facilities, three are rated with four stars out of five. One is a three-star. Hopemont’s four stars may go down because of the recent death of a resident who’d been kept in scalding water, but that problem has been corrected.
Whatever steps they take for the seven facilities, he said, “I don’t think you will ever get to break even point from a fiscal standpoint.” For instance, there’s no federal reimbursement for psychiatric care and all states have to eat that cost.
They are working on accountability measures, Caruso said. The facilities don’t have industry standard financial statements. With the proper statements. everything can be explained easily, including labor costs as a percentage of net expenses.
“We think we can do a better job of reporting to you,” he said. The Joint Commission – an independent nonprofit that accredits and certifies more than 21,000 health care organizations and programs in the United States – and the federal Centers for Medicare and Medicaid Services have data on all hospitals and would allow DHF to benchmark its facilities according to 40 indicators and compare their performance to other Joint Commission accredited facilities.
Caruso fielded some questions from the members. Delegate Michael Hite, R-Berkeley, asked where DHF is at regarding possible divestiture.
Caruso told him it’s under under evaluation. They’re preparing the information so they have a good handle to discuss it, but the facilities have no audited financial statements at this point. They’ve identified potential partners but haven’t initiated steps to approach them.
Red tape poses a problem for various matters, he said. It takes 22 weeks to put out an RFP for outsourcing contract staff or asking the Joint Commission for a mock survey. The Joint Commission has a valuable resource – a consulting arm that helps hospitals run better. “I do not think we run our hospitals as efficient [as they could be].
Delegate Amy Summers, R-Taylor, asked Caruso if DHF could generate or save enough money through whatever measures they adopt to allow the state to manage the two psych hospitals.
Caruso said yes: If they divest other facilities that savings could be reallocated to the to psychiatric centers. He also recommended collaboration with WVU or Marshall, which both have first-rate psychiatric programs.
Email: dbeard@dominionpost.com
