Carolinas HealthCare charity care questioned in Fort Mill hospital trial

dworthington@heraldonline.comApril 23, 2013 

— Carolinas HealthCare Systems’ charity care in Mecklenburg County has been raised as an issue in the trial over who gets to build a hospital in Fort Mill.

Attorneys for Piedmont Medical Center argued Tuesday that problems between Mecklenburg County and Carolinas HealthCare are relevant to the certificate-of-need application for the Fort Mill hospital being reviewed by the S.C. Administrative Law Court.

Carolinas HealthCare estimates its charity care at the Fort Mill hospital will be 6.3 percent of its gross patient revenue, more than twice what Piedmont has estimated for its Fort Mill hospital.

Attorneys for Carolinas HeathCare sought to exclude such questions, many of them based on a series of articles printed last year in The Charlotte Observer. The attorney argued the newspaper articles represented “hearsay” information.

Judge Phillip Lenski tried to give attorneys for both hospitals latitude and reminded the witness, Dell Murphy, Carolinas HealthCare’s senior vice president for planning and development, to limit his answers to his first-hand knowledge.

Murphy is responsible for Carolinas HealthCare’s application for the Fort Mill hospital. He was the first witness for Carolinas HealthCare. Piedmont presented its case last week. The trial may finish with testimony next week.

The S.C. Department of Health and Environmental Control first awarded the certificate to Piedmont in May 2006 before the decision was appealed by CHS and Novant. DHEC then awarded the certificate to Carolinas HealthCare in September 2011. Piedmont and Novant appealed that decision to the S.C. Administrative Law Court. Novant has since dropped its bid.

Daniel Westbrook, an attorney representing Piedmont, asked Murphy to comment on the problems that led the Mecklenburg County Board of Commissioners to end a $60 million annual payment to Carolinas Healthcare for charity care, a psychiatric hospital and public health services.

Westbrook tried to base his questions on a series of articles published in The Charlotte Observer and public records of court cases. The series, by reporters from The Charlotte Observer and The (Raleigh, N.C.) News & Observer, detailed how North Carolina’s nonprofit hospitals were making large profits and were contributing to the high cost of health care. The series was a finalist for a Pulitzer Prize in local reporting and recently won a Sigma Delta Chi award for investigative reporting.

Westbrook was limited to asking Murphy if he knew about the series.

Murphy said he was aware of the series, but “for the court, I don’t agree with what was published. ... There was a lot of information we gave The Charlotte Observer that didn’t get published.”

Murphy said the money Carolinas HealthCare makes is needed build new facilities and sustain its mission of comprehensive health care.

Westbrook also asked Murphy about an article about Carolinas HealthCare suing patients for payments.

Murphy testified that the patients in question were less than 1 percent of the system’s total patients, and represented those with the ability to pay but who had not paid. He said the court actions were a “process to get a dialogue started to get them to pay their bills.”

Murphy also sought to refute some of the testimony made by Piedmont witnesses. He said Carolinas HealthCare payor mix has seen a rise in Medicaid patients, too. He attributed the rise to tight economic times. Piedmont witnesses testified the hospital and some specialists in York County are seeing more patients who have less ability to pay.

Murphy also said that doctors in the Carolinas HealthCare network can refer patients to whoever they want.

“We don’t take the hard line,” on referrals, he said.

Piedmont witnesses said Carolinas HealthCare referral practices were reducing their number of patients, their revenue and in some cases affecting their medical skills because a certain number of cases are needed to maintain proficiency.

Murphy said doctors in the Carolinas HealthCare network in York County referred 60 percent of their patients to other CHS doctors.

Don Worthington •  803-329-4066

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