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Thursday, April 2, 1998

Company withdraws to lease Ward Hospital

Cites $500,000 collections shortfall, dissension officials

From The Monahans News
MONAHANS, April 2, 1998 - The only health care firm that
made a legitimate offer to lease and save Ward Memorial
Hospital has withdrawn its offer, reports Ward County Judge
Sam G. Massey.

Massey said the confirmation of withdrawal by Community
Health Care Systems Inc. of Brentwood, Tenn., came in a late
Tuesday afternoon telephone call from Bob Hardison, a top
executive of the for-profit health care agency.

Hardison cited a $500,000 shortfall in the county hospital's
collection accounts and continued community conflict, the
county judge said. Hardison told Massey the dissension
involved both local physicians and the electorate.

An election forced by a petition signed by Ward County
voters is scheduled Saturday, May 2. The only county-wide
election on a municipal and school district ballot, the
proposition to be decided was whether or not to lease the
financially staggering hospital.

"I got a telephone call," Massey said. "Hardison said, 'No
way!.' He cited a $500,000 deficit in collections since the
last time they looked at the books. They noted resistance
from doctors and others. They didn't go into detail. They
said they don't want to come to Monahans. Their offer was
the only legitimate offer from a company that was well
funded. It's over."

In spite of continued problems with the hospital Massey
promises that he and the county commissioners will do
everything in their power to keep "a first class,
state-of-the-art ambulance service and an emergency care."

As to what is going to happen at troubled Ward Memorial
Hospital, that Massey said, will be decided by the
hospital's board of managers appointed by county
commissioners. The future of the hospital became the problem
of the hospital trustees when a for-profit health care firm
withdrew an offer to lease and manage the institution.

"We're through," says Massey of the Commissioners Court.
"Community Health Care Systems Inc. was the only acceptable
offer. The hospital board will decide how to proceed. They
will prepare a real budget and they'll live within that
budget. As budget officer of the county, I'll make sure that
they do."

Massey says forcing the hospital to live within a budget
almost certainly will mean "drastic cutbacks" in workers and
salaries because the county no longer has the money to
continue bailing the hospital out of its continuing
debt-filled morass -without a tax increase.

Texas law requires the May 2 vote must be held on whether
or not Ward Memorial Hospital can be leased to a third
party, according to Ward County Clerk Pat V. Finley.

"Had the commissioners called the election it could have
been cancelled when lease ceased to be an option," she said.
"But because the election was initiated by petition it must
be held although it means nothing."

Finley estimates the county-wide election will cost about
$4,000 but that does not allow for all the factors she has
not had a chance to consider.

"It is going to be pretty expensive," notes Finley, "to
decide an issue that no longer exists."

Lawsuit fights home health payment cuts

From Staff and Wire Reports
PECOS, April 2, 1998 - A federal lawsuit contends that more
than half of the state's home health care agencies will go
bankrupt if the federal Medicare agency is allowed to
proceed with payment cuts to the agencies.

The class action lawsuit was filed Wednesday in U.S.
District Court in Dallas by the Texas Association for Home
Care and Rockwall Home Health Inc.

The lawsuit seeks an injunction to prevent the U.S.
Department of Health and Human Services from implementing
retroactive new payment limits which the plaintiffs say
don't cover the cost of caring for home health patients.

According to the home care association, the average home
health patient cost about $8,200 in 1996. It says more than
75 percent of home care agencies in Texas would be
reimbursed only $2,600 to $3,400 per patient.

"That means agencies are supposed to deliver the same care
for only 30 percent to 40 percent of the cost," said Sara
Speights, a spokeswoman for the home care association that
represents more than 1,200 licensed home care agencies in

"If these new limits are allowed to stand, then home health
as we know it will disappear as a Medicare service for most
elderly," she said.

Advocates for the elderly and disabled complain that new
limits on Medicare payments for home care have led providers
to deny services to the sickest beneficiaries. The changes
to home health benefits came in last year's balanced budget
deal approved by Congress.

Pecos home health companies respond

Locally, Tojia Criss, RN, director of Reeves County
Hospital's home health department, said that the Medicare
cuts won't affect that agency as much as the other two home
health agencies in Pecos. "As far as Reeves County Hospital
home health is concerned, it isn't going to affect us much
because we haven't had our initial Medicare survey yet,"
Criss said.

Criss believes that the hospital's agency won't be as
affected by the cuts because it is going into home health
care already knowing about the limited payments and being
ready to operate on a tight nursing staff. She said that she
came here from El Paso, where about 15 home health agencies
have already gone out of business because of the cuts.

Criss said that the payment cuts are the result of the
Interim Payment System (IPS), that is based on a cost per
beneficiary limit. "They are taking their 1994 cost report
and paying 70 percent of that amount," Criss said. "It's
going to hurt home care in general, especially any agency
that wasn't in business in 1994. It means that agencies will
have to provide the same care in less visits. For example,
if you're used to providing a patient with 100 visits,
you're going to have to provide the same care in 70 visits

"It's going to hurt the rural areas a lot -we're going to
have to be very creative."

Criss explained that rural areas will be hit especially hard
because they don't have access to some services such as
mobile lab units that major metropolitan areas have that
could provide some services which home care patients are no
longer eligible for, such as venipuncture, unless linked
with another necessary service.

Leo Hung of American Home Health said that "based on the
1997 balanced budget act, they (Texas Department of Human
Services) said there has been a lot of abuse in the home
health industry, so they cut the home health reimbursement.
They set a cap, and that cap is much lower than what we
usually get."

American Home Health has contributed to the Texas
Association for Home Care Legal Fund and will be represented
in the class action suit. Agencies are being represented by
the legal fund for a variety of concerns.

Home health agencies that had low per-beneficiary limits for
fiscal year 1994, those with no base year in fiscal year
1994, agencies with heavy current case loads of
long-term-care patients or patients with high acuity needs,
agencies that have a "case mix" unlike that which they
served in 1993 and those that have a fiscal years for
purposes of the IPS starting before Jan. 1998 are being
represented by the legal fund.

Hung said that patient care everywhere will be affected by
staff cuts and by limits on the benefits the patients can
receive. He said that many elderly people have become afraid
to use home health care because they feel they need to save
what benefits they still have in case they become much more
ill and need the service more in the future. He said that
will likely cause more of those people to wind up in the

"We are lucky here at American Home Health because we
started in 1989. It will hurt the new agencies more, because
they will be assigned a median rate, which is much lower
than what we are getting."

Landa Rediger, Administrator of Pecos Home Health, said that
"many letters have been sent by individual members of
Congress as well as whole congressional delegations, an
enormous outpouring of concern from Congress and
constituents, home care providers and the many beneficiaries
they serve, directed at HCFA (Health Care Financing
Administration) about the impact of the venipuncture
prohibition and the new Interim Payment System."

Rediger continued, "Many factors have played a roll in
increasing the use of home care. Demographics show that the
number of elderly and disabled is increasing. Hospital stays
are becoming shorter, driven by cost controls. Nursing home
use is declining. More patients and physicians are aware of
home care. Technological advances are permitting more
services to be delivered at home. Judicial rulings have made
home care more broadly and readily available. Finally, for
most people, home is the preferred setting for health care
and supportive needs."

Early voting in runoffs begins Saturday

Staff Writer
PECOS, April 2, 1998 - Early voting for the runoff elections
will begin Saturday, April 4, at the Reeves County

The courthouse will be open from 9 a.m. until 5 p.m., for
those who would like to vote early, according to Reeves
County Clerk Dianne O. Florez.

The Reeves County Precinct 4 Commissioner race will be in
the runoff elections, with Bernardo "Chaquen" Martinez and
Gilberto "Hivi" Rayos.

In the Justice of the Peace Precinct 3 race, incumbent Joel
Madrid is being challenged by Rosendo Carrasco.

Joseph T. Sullivan and Charlie Urbina Jones are also in the
runoff elections in the Congressional U.S. Rep. District 23

Last date to request an application to vote by mail is April
7 with the actual voting date scheduled for April 14.

Early voting will continue until Thursday, April 9, at the
courthouse. "Early voters can vote here anytime from 8 a.m.
until 5 p.m.," said Florez.

The courthouse will be closed on Friday, in observance of
Good Friday.

Anybody needing an application to vote by mail, can call
445-5467 and request one, according to Florez.


Dionisia Nunez

Dionisia Nunez, 84, of Lubbock, died Wednesday, April 1,
1998 at St. Mary's Hospital in Lubbock.

A rosary is scheduled for 7 p.m., Thursday at Ellis Funeral
Home Chapel in Midland.

Mass will be held Friday, April 3, with burial in Resthaven
Memorial Park in Midland.

Nunez was born in Candelaria, and moved to Lubbock in 1993
from Pecos. She was a homemaker and a Catholic.

Nunez was preceded in death by her husband, Anastacio Nunez.

Survivors include: two daughters, Mary Pause of Monroe, Ga.,
and Terri Mires of Lubbock; two sons, Ray Nunez of Odessa
and Danny Juarez of Souix Falls, S. D.; two brothers,
Francisco Chavez of Artesia, N.M. and Ricardo Chavez of
Midland; one sister, Juanita Ortiz of Big Spring; six
grandchildren; and eight great-grandchildren.

Jose Segovia

Jose Segovia, 53, of Pecos, died Tuesday, March 31, 1998, at
Reeves County Hospital.

A rosary will be held at 7:30 p.m., Thursday at Martinez
Funeral Home Chapel.

Mass is scheduled for 2 p.m., at Santa Rosa Catholic Church
with burial in Greenwood Cemetery.

Segovia was born Aug. 7, 1943, in Pecos. He was a lifetime
Pecos resident employed in ranching and farming and was a

Segovia was preceded in death by his parents, Macedonio
Segovia and Filomena Gomez.

Survivors include: his wife, Bertha Segovia of Pecos; two
sons, Ricardo Segovia of Woodland, Calif. and Jeffery
Segovia of Odessa; two daughters, Stephanie and Isabel
Segovia of Pecos; four brothers, Dulces and Marcos Segovia
of Odessa, George Segovia of Jal, N.M. and Joe Sosa of
Odessa; four sisters, Florence Dominguez of Odessa, Jesusita
Lopez of Big Spring, Julia Brionez of Kermit and Abby
Montoya of San Angelo; and nine grandchildren.

Martinez Funeral Home is in charge of arrangements.


PECOS, April 2, 1998 - High Wednesday, 85, low this morning,
53. It will be a sunny, pleasant day across all of Texas on
Friday. Skies will be clearing tonight across West Texas
following a windy day with the possibility of some showers
and thunderstorms in the Panhandle. It will be sunny on
Friday. Lows tonight will be in the chilly 30s and 40s in
West Texas, highs Friday will be in the 60s in the Panhandle
and in the 70s and 80s elsewhere in West Texas.

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Pecos Enterprise
Mac McKinnon, Publisher
Division of Buckner News Alliance, Inc.

324 S. Cedar St., Pecos, TX 79772
Phone 915-445-5475, FAX 915-445-4321

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Copyright 1998 by Pecos Enterprise