Decatur Co Hospital will close April 14 - Governor issues Stay-At-Home Orders.

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News From Your Commissioner

News From Your Commissioner

News From Your CommissionerNews From Your Commissioner

MESSAGE TO CONSTITUENTS

Regarding Hospital Closure

Thursday, April 2, 2020


To My Constituents,

By now most of you have heard that our local hospital, Decatur County General, will be closing its doors at the end of business on April 14th. This could not come at a worse time for the people of our county, yet we have no choice at this point. 


I’m sure that many of you have kept up with the continuing saga of the facility and know the underlying situation, but for those that have not here is a comprehensive look at this situation: (forgive me for the length, but it is necessary to fully understand the situation).


THE BACKGROUND

The hospital has been in a financial downfall for more than a two decades, however it was not widely known until it became a critical issue. Since that time several valid attempts were made to correct the problems and bring the facility into a profitable status. In fact, it is my understanding that the hospital was within $600,000 of being able to break even when politics took over and made bad decisions that only worsened the financial stability year after year. 


Several factors led to the crisis. The three most important were: 1) the lack of practicing doctors, 2) the failing insurance system, and 3) the rigid mandates and policies dictated from federal and state government. 


The business model of the traditional community hospital has become obsolete.  Doctors no longer come back to their hometowns to practice. The necessary malpractice insurance is so expensive (thanks to an out-of-control legal system), that doctors must generate significant amounts of income to simply stay in business. 


Insurance reimbursements have become so complicated that it is often impossible to predict revenues. Small hospitals submit claims and hold their breath until they see what costs will actually be paid. Larger hospitals operate on such massive volumes that each individual claim does not have the same impact. The many issues with insurance reimbursements have created a system that is ripe for corruption; every level seems to have opportunity for exploitation.  Loopholes and clouded reimbursement policy have led to an influx of scams that have left small hospitals destitute. Decatur County General has seen this firsthand


Our small community hospital is expected to adhere to every regulation that is expected from larger facilities such as Vanderbilt or Baptist hospitals. (For example: we must have a certain number of employees on hand at any given time, whether we have 10 patients or none; we are required to maintain certain technologies locally rather than be able to transfer those cases to larger facilities.) Because there has been no major effort in government to differentiate these regulations, the cost of operations is unproportionate to revenues for small hospitals. Meeting regulations may cost us 50-70% of our revenues, while it only costs a large facility 10-20%. 


The common denominator in all three of these factors is money. We do not have enough money to operate our hospital. A MINIMUM cost for operations at Decatur County General is just over $300,000 per month. PER MONTH.  


The revenue from the additional wheel tax generated approximately $600,000 per year.  When the wheel tax was instituted, the $600,000 could address shortfalls. However, that was only 1 part of a comprehensive plan that never saw fruition. Rather than continue with a plan to become part of a larger system, the Commission at that time chose a cheaper – but unproven - alternative. 


It is difficult to fully understand the mechanisms of economic planning. This commissioner certainly does not as it is not my area of expertise. However, success is gained by understanding that you cannot know everything, and you must seek guidance from those who know the particular pieces with which you are dealing. This is where we as a County have failed. We have refused to listen to expert advice and made decisions based on our limited understandings. 


The most critical point of our failures is that we continue with this same mindset. We look for the easiest, cheapest way out; never realizing that its cheap price is due to its inability to be successful.  We have gone down this road 4 times and it has only increased our debt from $600,000 to $6 Million. 


This is unacceptable and must be addressed. 


THE REASON

The collapse of our hospital can only be attributed to one group of people – us, the citizens of this county. We were not paying attention and allowed bad decisions to be made without any uprising from the public. We have failed to demand accountability from those in leadership positions; and we have failed to recognize our responsibilities of civic duty – our service to our community. 


We have not stood up and been a participant in our city and county governance; leaving these positions to be filled with folks who have not had significant business and financial experience. However, you must applaud those people who have tried to make a difference and volunteered to run for offices; it is indeed a thankless job. We cannot simply point fingers at those who have made mistakes, when we have not been willing to stand in their shoes. 


A perfect example of this scenario is the story of the talents in the Bible: God expected more from those to whom more was given. That story is applicable to us in our modern age as well. Those who have skills must – for the sake of the financial future of their own community – MUST stand up and lead at some point in their lives. We are each a part of the community and do not live in isolation. No matter how far out in the county you may reside, you rely on services provided by the collective of the people – the county (or city, or town) to which you belong. 


GOING FORWARD

Our county is at a critical point. Not only is our hospital unable to continue, our county operations, in general, will be right behind if we do not act now. 


The hospital closure is not the end of healthcare in our county. While the public hospital is incapable of continuing operations, its closure allows for private companies to open facilities. Decatur County General’s continued operations has been an obstruction for any other private group to act. This may seem irrational, but it is based in financial analysis and government regulation. 


While there is movement on the state level to rethink the hospital and emergency healthcare regulations, Tennessee has not yet changed its laws. A hospital can only open in an area based on population and distance to the next emergency facility. (This is another reason why our census is so important.)  If we were any closer to Lexington, Camden or Savannah, we could not legally operate a hospital. (I believe the limit is 30 miles, so our proximity to Lexington is already a sticky issue. We have been lucky that DCGH was chartered prior to these regulations).


Additionally, a corporation looks at its potential profitability in any area before it decides to invest in opening in that area. With DCGH open, the potential profitability was too small for any larger hospital group to even consider investing in our county. The closure will now open this opportunity. 


It is also important to note that large reputable hospital companies do not want to invest in or purchase our old, outdated facility. The cost of refurbishing the current facility is not worth the investment when building a newer facility would be better use of their funds. Plus, these large companies (especially those that are publicly traded) must maintain a specific identity – a brand. When a patient enters one of their facilities, it must look and function to enhance their brand (thus their stock value)


We may be without a hospital for a time while other opportunities are being sought, but this closure is not the end of healthcare for our area. We likely will need to invest more in our EMT services to pick up the burden of additional emergency transports. 


The timing of this disaster at the same time as the worst medical pandemic in more than 100 years is simply unimaginable; but we have no option but to deal with it. I encourage you to call your Commissioners and the Mayor to relay your opinion. 


What Decatur County needs now is attention from our public. We need you take an interest in your governance and demand answers. With the damning report from the investigators of the Comptroller’s office, (click here) we need to make changes. Please read the report from the Comptroller. Only with your input, can we – as your elected officials – know what you want and expect for the future of Decatur County. 


Faithfully,

April Watkins Barrett

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LOCAL UPDATES

Decatur County Government

Decatur County Government

Decatur County Government

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County offices are closed to public.  Please call the office if you need assistance.


All courts are closed until further notice.

Decatur County Schools

Decatur County Government

Decatur County Government

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Decatur Co. Schools will be closed through the month of April.

City of Parsons

Decatur County Government

TN Dept of Health

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All City Parks are closed until further notice.  


Check Facebook for closures of Church Services, City Offices, Parks and other facilities.


TN Dept of Health

TN Dept of Health

TN Dept of Health

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Governor's Office

TN Dept of Health

Governor's Office

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CDC

TN Dept of Health

Governor's Office

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Covid 19

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SITUATION SUMMARY

Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a new coronavirus that was first identified during an investigation into an outbreak in Wuhan, China. Additional cases have been identified in a growing number of other international locations, including the United States. 

Tennessee's Response

As we continue to learn more, Tennessee's response will continue to evolve. Stay vigilant in reading and sharing information from reliable sources. Click below for up-to-date information on COVID-19 in Tennessee.

Symptoms

Patients with COVID-19 have had mild to severe respiratory illness with symptoms of:

  • Fever
  • Cough
  • Shortness of breath

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COVID-19 GUIDELINES

WHAT TO EXPECT IF YOU WERE POSSIBLY EXPOSED TO COVID-19 (Coronavirus)

From TN Department of Health

WHAT CAN I DO?

If you have been exposed to someone with COVID-19, follow the steps below to monitor your health and avoid spreading the disease to others: 


HOW DO I KNOW IF I WAS EXPOSED?

You generally need to be in close contact with a sick person to get infected. Close contact includes: 

  • Living in the same household as a sick person with COVID-19 
  • Caring for a sick person with COVID-19.
  • Being within 6 feet of a sick person with COVID-19 for about 10 minutes or longer.
  • Being in direct contact with secretions from a sick person with COVID-19 (e.g., being coughed on, kissing, sharing utensils, etc.) 

COMMUNICATE WITH PUBLIC HEALTH

  • You may receive a call from public health if you have been in close contact with someone with COVID-19. They will explain quarantine guidance and answer any questions you have. 
  • If you have any additional questions, contact your local health department. 

QUARANTINE YOURSELF

  • You should stay home for 14 days after your last contact with the person with COVID-19. If your contact is a household member, you may need to stay home for longer. 
  • Do not go to work or school, and avoid public places for 14 days. 
  • If possible, get others such as friends or family, to drop off food or other necessities. 

MONITOR YOUR HEALTH

  •  Watch for fever, cough and shortness of breath during the 14 days after the last day you were in close contact with the person with COVID-19. 
  • If you develop these symptoms within 14 days of last contact with a person with COVID-19, you may have COVID-19. 
  • If your symptoms are mild, stay home and monitor your health. If you need medical assessment, call the health clinic or hospital before you arrive and tell the provider that you are a contact to a person who was diagnosed with COVID-19.

PRACTICE HEALTHY HABITS

  • Cover your cough or sneeze into your elbow or a tissue. 
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub. 
  • Clean and disinfect objects and surfaces regularly, including your phone. 

Learn More • Online: www.tn.gov/health/cedep/ncov or www.cdc.gov/coronavirus/2019-ncov