Our Hospital
 

It is so sad that the Villages Hospital has continued to fall by the CMS ratings. In 2017 it was rated at a 3, now it is rated at a disappointing 1.

I noticed that as well when I was checking out hospitals within the two communities in which I spend time. I checked out TV's hospitals as it was easy to do.

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I have had one emergency that brought me to The Villages hospital. I was seen very quick, treated and released promptly. Was I lucky or are they normally good at what they do?

You can basically blame Medicare for that. Medicare is known to pay far less than any health insurance. Quality begets quality. Offer greater pay, you'll attract greater faculty and staff. If the best you can do is a 90% Medicare payout, then you'll get the bottom 10% of the quality care in return.

You were lucky. Federal agency (MedicareJ has rated our hospital as substandard not only in several areas but overall. POA is having the CEO explain at the next meeting on the 20th.

Husband had outpatient surgery last week at Munroe/Florida/Advent Hospital in Ocala. Can't say enough good about it.

I pray that I never have to go to TV hospital. Being near Leesburg and I-75 I would hope to go to Leesburg or Ocala depending on the circumstances, not ever having to go would be the best route.

The four star hospital I use in Newport Beach accepts Medicare, no problem. Hoag (health network - Wikipedia)

That doesn’t explain why hospitals in urban depressed areas that often don’t get reimbursement for “charity care” receive four and five star ratings.

One of the items that received a low rating was patients perception of received care. Had nothing to do with insurance. Other items such as surgical complications and infection rates are included and not based on insurance payouts. Time waiting in ER was far greater than national average.
There are other areas of the country with large senior populations such as Sun City that support highly rated hospitals.
I suggest using Google and using the CMS (Medicare-Medicare) website to compare TVRH with nearby hospitals and examine specific criteria used and how the hospital rated.
Blaming “Medicare” without examining the facts does nothing to elevate the standard of care in our community. We deserve better.

Really wish Dbussone was still here to comment on this. :(

I would like to know how any full service hospital could survive if they didn't accept Medicare. And, Medicare pays out a lot more than people pay into it. That is why Medicare is broke and the Government has a 22 trillion dollar debt. So, should we force people to pay more money into Medicare, or borrow more money and go deeper into debt?

I think that we should demand accountability from the CEOs. The buck stops there. Whether it is lack of nursing and ancillary personnel, inadequate training, operational policies, lack of quality reviews, or a host of other negative conditions, there needs to be a thorough investigation and immediate mitigation of the deficits of the hospital. We might be interested in the monetary payouts to the administrators.
The citizens of this community have supported this hospital with financial donations and volunteering their time.
We depend on this hospital for our well being and in some ways it has failed us.
I hope that the CEO can provide some insight rather than excuses at the POA meeting on the 20th. at Laurel Manors. I believe he had either been a no show or cancelled his appearance at another meeting but promised his attendance this time.

Are you suggesting the hospitals have differing levels of caretakers dependent upon what insurance carrier the patient has???

That hospitals or medical care staff providers capability/quality wise based on the the patients insurance?

Do they separate us at the door? Medicare to the left and all others to the right. Bozo providers to the left....5 star providers to the right?

All the above are rhetorical....no answer required.

Food for thought....maybe.

GOLFING EAGLE, Along with dbussone helped me decide on my insurance and the hospital to use.

I would never ever never go against anyone's personal perceived experience with anything to do with Health Care as I'm not qualified. I believe the people who have had a bad experience actually did to a point.

I had an Operation at a Hospital in NJ which was rated poorly but everyone from work and neighbors all had nothing but good things to say.

My experience was PERFECT, the man in the next bed's experience did not match mine as his expectations were unreasonable. You can't verbally abuse the Staff and expected to be treated well its human nature. He even got P.Oed that I was getting better treatment than him. Please and Thank You and Common Courtesy go a long way.

Our only experience with The Villages Hospital was from helping a gentleman that we are friends within The Villages. One time from the Emergency Room to a room in record time, like a Nascar Pit Stop. The next time I was there almost 10 hours before he got a room. What are you going to do they were busy and others had problems that needed immediate attention. Our friend was calm and I started to get worked up so I do know what people are telling us about in their posts.

I'm going to bet mine and my wife's life on the advice of my Primary Doctor, dbussone, and GE from a few years back. The last two men had no dog in the fight and were good enough to give me their opinion which I trusted then & now.

People responding to me are missing the point.

This hospital caters *primarily* to medicare patients. It means this hospital has less money to pay its employees. It means this hospital is less likely to attract top-notch doctors, who typically don't rely *primarily* on medicare to pay their higher salaries, because medicare WILL NOT pay that much. The higher quality doctors will work in environments where they can recoup the loss from low-paying medicare, by having more patients who don't rely on medicare, than they have patients who do.

If you have MOSTLY medicare financing the existence of a hospital, you will have less revenue because medicare does not pay the salaries that attract better quality doctors and staff and faculty.

Most hospitals accept medicare patients, but ALSO have mostly patients who aren't on medicare, whose normal health insurance pays out more. This results in better equipment, better facilities, more staff, higher quality doctors, a better doctor : patient ratio, a better nurse : patient ratio, a higher quality of care score.

The Villages Hospital is dealing PRIMARILY with substandard revenue. You can't expect good service from substandard revenue.

Nowhere did I mention, hint, or even suggest that other hospitals don't accept medicare and are therefore better. Nowhere did I suggest, hint, or imply that hospitals that do accept medicare are substandard.

Again - I was very specific. THIS hospital - that relies PRIMARILY (not exclusively, not equally to any other, but primarily) on medicare to foot the bill - will - because it's medicare primarily footing the bill - attract faculty, staff, physicians, who are willing to accept much lower pay than hospitals that do not rely *primarily* on medicare to foot the bill.

It's basic economics. If you want to prove me wrong, donate $28 million to TVH to improve their staffing and quality of care issues. You'll see a better caliber of staff seeking to work there, and you'll see a higher quality of care.

Doctors (and other medical providers) can "opt out" of Medicare altogether and be free to charge whatever they want for their services. But, it is interesting to me, that less than one percent of doctors have decided to do so.

Where can I read the facts to support these claims??

The fault with this "opinion" is the top notch, best in their field specialists that operate in these so called medicare primarily hospitals are no less because of the hospitals where they practice.
Hence the premise is flawed.

Same place I found them. Google.
From THE VILLAGES REGIONAL HOSPITAL COMMUNITY HEALTH STATUS ASSESSMENT - https://wellflorida.org/wp-content/u...5-2016-pdf.pdf
I also found some of the data at the American Hospital Directory, gleaned a few tidbits from a US News report, and a smattering of random other medical, insurance, and government websites through the search.

The Cleveland Clinic accepts Medicare and Medicaid, they do a pretty good job in all of their hospitals. That is the only system I used for 40 years and can still go back if I had to.

I wonder how a geriatric specialist makes a decent living as all of his patients are most likely on Medicare.

I agree. I don't even think that it is legal to sell private health insurance to someone over 65. So, if the geriatric specialist doesn't accept Medicare, their patients would need to pay the entire fees out of pocket.

I see from your post that the rating has fallen. I also saw an advertisement lately in the paper that the higher muckety mucks at the hospital were touting their rating going up in some category. I'm sorry that I'm speaking in general terms without the link to prove what I'm typing.

I just spent some time going thru Golfing Eagles & dbussones old posts and see how their explanation about any issue was handled much easier than any of us could ever hope to do.

With all their years in the Medical Business, their explanations were beautiful and very soothing. To have people like that who gave so much time to help people like Barney Rubble & Wilma Flintstone understand the inner workings and the thought process of the messed up Medical world and to put it into terms that everyone could understand was priceless.

Unfortunately, our Dear friend GE had to face the biggest loss a person could go thru with the death of his spouse. We kept in touch for a while and he is Golfing all over the place and just trying to get his head back on. He was married to his beloved wife for a long time. Who knows maybe one day we will be lucky enough to get him back. I truly cherish his counseling and time he and others put in on the Forum and behind the scenes to get us to Florida.

I'm going to take a guess that our other Dear friend dbussone was just fed up of the abuse that he received from some of the tough Beer Muscled Posters that criticized every post and I believe he thinks he got an unfair shake from one of the people (no actual proof) who policed the forum back then. That person has obviously been relieved of his or her duties. Please accept that as constructive criticism because I think it was the reason he took a powder. What a loss that was also.

We pretty much had the answer to all medical questions at our fingertips and life and the old ways of this Forum cost us two extra valuable and giving fantastic human lima beings and loving people who did a whole lot for people that was without any praise of fanfare.

They had contacts at the top of the food chain at our Hospital and made many Constructive Suggestions based on things they read here when regular people were struggling to digest information that they think they have read properly. These two men would operate on any post or link or report marked 2015 and would tell us what it really meant.

The way I called them when we were Goofing around on The Three Word Sentence Thread may work so I'll give it a shot and let's see if it works!

Car 54'S Would You Please Report for duty we Flintstoner's need a real interpretation of some things we've read.

Go back and scan both of these guys posts from 2017 and you'll see what I mean about their way of explaining different medical situations with total goodwill. Bless them both I hope life is treating them well. :pray:

Medicare is an important payer to hospitals. Note these statistics—that While dated, are relevant as these number are usually lagging. “The majority of patients treated by hospitals are covered by Medicare (40.9 percent of patients treated in U.S. hospitals). The average payer mix of a U.S. hospital is as follows: Medicare: 40.9 percent. Medicaid: 17.2 percent. (Becker;s, 2013). Medicare revenue is key to hospital revenues. Payment formulas and contractual agreements are complex, and thus what might look like hospital costs are not necessarily related to revenue. My point is, Medicare patient population does not mean less revenue and poor care.

Medicare is guaranteed to the hospital, but it is contractually less than non-medicare payment. Hospitals and doctors lose money from medicare. They make up for it by charging higher prices and fees to the private sector. The more medicare and less private sector, the less the hospital and doctor will make.

This is a fact. It is a known fact, it's been a fact for years and years and years. Anyone who has ever worked in hospital finance, accounts receivable, accounts payable, billing, insurance claim, or anything similar in a medical setting, can tell you this.

Hospitals typically receive medicare payments from around 40% of its patient base, as you said. But while these payments are guaranteed, they are also LESS than the actual cost of the services they're supposed to be covering.

It is the opinion of my daughter, who has worked in collecting claims for certain hospitals from health insurers for the past 19 years, that without Medicare as a payer many hospitals would have to close their doors. Medicare pays on time. The worst payer she has dealt with is Aetna.

Based on my cousins recent stay one star was too many. No response to call button, missed medication, missed meals, ...

Believe me the CEO is the problem and he will never prepare going to a meeting alone. He'll always take his VP'S and related management with him and throw them under the bus. For the money this guy makes it's amazing that the organization has not looked into his overall performance.

I am reading recently about proposed cuts to Medicare and to Social Security and also Medicaid. Of course, the fraud needs to be cleaned up but this would go beyond that.

Please pay attention. Read and listen — widely and wisely — to stay informed on these proposed cuts that could affect you and yours directly.

I hope this does not get pulled because somebody thinks I am being partisan. I am just saying to be aware. This is about us.

Cassandra Boomer

I have read about these proposed changes and just like all seniors I am concerned, but after having read the proposed changes, it appears that there will be concentration on those posing as disabled and other people who are abusing the system.

I wrote on the other thread re: T.V. hospital and will here as well. Did any of you read Dear Heloise in today's (3/18) Sun? A person wrote in telling of their experience in an "ATLANTA" hospital.

I personally have always had good care at TVRH, even when they were slammed a year ago after hurricane Irma as well as the flu epidemic. I was there 3X during those months for dire health issues and surgery.

I sincerely hope you are right Gracie. And I truly mean that. But I remain concerned.

I think the boomers, especially the younger boomers, and those even younger than that, really need to be paying close attention and remembering that they do have their own critical thinking skills to apply. But (sigh) I fear Pogo might have been right.

It is a big picture and I believe the answers are in the middle.

How the system really works
 

I've been a healthcare consultant for 25 years or more and am still actively working. I'm almost afraid to post on here because when I do, people mostly tell me I don't know what I'm talking about. All I can tell you is I've done work for a large number of Fortune 500 companies so believe I have a pretty good grasp of how health care works (or doesn't...). If you google rural hospitals, you'll find many are closing because they only receive funds from Medicare and Medicaid which reimburses hospitals at far lower levels than private insurance for the under age 65 population. As an example, across the country, the Blues pay hospitals about 325% of Medicare on average. So that tells you why having people under 65 with commercial insurance (not govt.) provides more revenue to a hospital and does help attract better talent, money, and as a side impact, raise the quality of care simply because these facilities have more financial resources. Every time a politician tells you they are going to control the cost of healthcare by not increasing payments to Medicare providers, these are price controls. It's why the cost of healthcare rises so much on the other side of the coin, meaning the private side where they are subsidizing the govt. paid insurance. None of these comments are meant to indicate what's right, what's wrong, or what the fix is....only to help you understand how it works.....I'm sure many on here who won't believe what I say.......thanks...

I didn't understand your post and I tried. Who are "the blues"?? And, do you think this hospital, TVRH fits into the typical "rural hospital" you speak of or one with a lot of people backed by company insurance? Please clarify for me. I think you saying that our government entitlement of Medicare will cost us more because it is costing the country more?

I just want to understand what the number here mean. Aren't rural hospitals small by definition, something 25 beds or so? I don't think that Villages Hospital or the others in this area are rural hospitals, are they?

My guess is Blue Cross, Blue Shield.

Currently, Medicare pays out about $11,000 per year in benefits per eligible patient. This is about one-third more than the amount the average person pays into the Medicare system. So, Medicare is losing money and it is unsustainable. We need to either reduce the benefits or increase the cost to taxpayers. Or, just wait for the whole thing to collapse.

What I think is being said is that hospitals that have a large majority of patients on Medicare/Medicaid for the most part get less money than those who have more patients with private insurance. Private insurance tends to pay more. That leads to higher pay, better staff, etc.

From my experience the problem is the emergency room. There is simply not enough staff at times. I don't know what can be done about that. Regarding the waits that is to be expected especially without a life threatening emergency. Have spent hours at ER with Dad long waits, sometimes in waiting room. However, he was being evaluated and treated. A long wait Inman ER seems standard to me anywhere in the country.

I can't speak from experience with the hospital but according to a good MD friend of mine located here, it's extremely difficult to attract younger medical professionals to this area. The population is so much older and the overall lifestyle, recreational, restaurant, entertainment options aren't very appealing to younger people/families. Hospitals/med practices can't compete in the $$ area either compared to more urban areas and being within 25 miles of an urban area is a must for many. Unless there's a personal reason for one to move to the TV area, it probably isn't on anyone's top 10 list. This all starts to take it's toll on a hospital as older docs/nurses etc retire and they can't attract top talent.

I really find it hard to believe that Blue Cross pays more than 3 times as much for a procedure than Medicare. I have had the Blue Cross Federal employees plan for more than 40 years, and now that I am over 65, my Blue Cross preferred providers are limited to the Medicare approved amount even though I do not have Medicare Part B. This is the law. But, I have not had any trouble being treated by preferred providers, and I have not seen a tremendous drop in the reimbursement amounts that they receive.