OSU med residency- code blue

[brunoflipper]

i said two years ago when ardent bought out hillcrest that this would never last... the state/fed financial package for the hospital was bull**** and osu was skimming way too much off the top... so now, it is done... ardent is through subsidizing the osu residency programs... no other hospital in town will touch these programs with a ten foot pole...

the med school will be fine, except it won't have a hospital, but other than that it'll be aces (just like ou tulsa- med school sans hospital)... but, the residency programs are doomed...

someone should call mr pickens and ask him to buy trmc from ardent en toto... problem is, the state has never shown their willing to give enough money to fund a public hospital and they won't start now... so even if it is purchased for osu, the recurring costs would never get funded... the state should have given us a real public hospital a long time ago...

hess makes it sound like they can work this out, no freaking way.... truth is, this is only going to change if osu coughs up the cash... cant blame ardent, there a private company providing an unreimbursed public service- i wouldnt do it either...

somebody get the keys... start the bus...


"Hospital's program in jeopardy

By CURTIS KILLMAN World Staff Writer
9/22/2007

Ardent announces it is ending the agreement that provides medical resident training at the OSU Medical Center.


Ardent Health Services, citing a contract breach, said Friday it was terminating an agreement that provides for the medical resident training program at the Oklahoma State University Medical Center in Tulsa.

Ardent officials say the agreement breach, which stems from a funding dispute, forced them to initiate the contract termination process, which takes up to two years to complete.

The move comes 16 months after hospital and university officials signed a 50-year agreement designed to put the teaching program on stable financial ground.

"There are significant challenges with any teaching hospital, but we must have a true partnership to make this work and to date, that has not materialized," said Earl Denning, president and CEO for Ardent Health Services - Oklahoma Division. Ardent owns the former Tulsa Regional Medical Center.

An OSU official said he was disappointed Ardent has opted to terminate the contract, and expressed concerns about the future of the program, especially as the university prepares to recruit new
physicians for fall 2008.

"While this current circumstance obviously means the program is at some risk, we remain committed to seeking a long-term solution for our residency program," said James Hess, chief operating officer and vice president for Health Care Administration for OSU Medical Center in Tulsa.

The hospital, 744 W. Ninth St., has 132 residents from the OSU College of Osteopathic Medicine.

The medical resident program has been credited with turning out many doctors over the years, with many working in rural and underserved areas of the state. The contract termination could hurt the university's ability to attract physicians to the residency program, Hess said.

"I'm certain it will have an impact on the recruiting effort," he said. "It's difficult to say what impact at this point."

About 35 to 36 resident physicians come to the program each year, Hess said.

At issue are two sources of funding tied to the hospital, one for federally matched funds appropriated by the Oklahoma Health Care Authority and another $20 million appropriated by the state Legislature.

Ardent officials claim the company is entitled to receive all of about $6.5 million in federally matched funds allocated to OSU by the Oklahoma Health Care Authority.

"It's difficult to have a sense of partnership when $6.5 million is diverted from our hospital's control -- a hospital that is crucial to the underserved, as well as physician training," Denning said.

But OSU officials dispute Ardent's claim to all of the OHCA funds and instead point to an offer to split the funds with the hospital as it has in the past.

Ardent in June sued the Oklahoma Health Care Authority in federal court over the allocation of the funds.

The OHCA funding dispute in turn triggered a request by Ardent that it be given a portion of the $20 million appropriated by the Legislature.

The OSU Medical Authority, which oversees use of the legislative funds, has allocated $10.6 million of the $20 million for a variety of capital items.

"We were counting on that $6.5 million," Denning said. "And all of a sudden it's gone, and so we're saying, 'Wait a minute; if you are going to take that money then I want some of the $10.6 million in underwriting some of the expenses that I am paying out of my pocket for your teaching program.' "

Said Hess, regarding the request: "The university has felt that the Legislature and governor's office in approving the legislation, we believe it was their intent that the money be used for capital improvements at the facility, not for operations. Ardent would desire the use of the funds otherwise."

Denning said it was "shame that this has all happened," referring to the funding dispute.

"I understand and appreciate the role of the teaching program," he said. "But we are paying out of our own pockets $13 million a year to support this program."

"Now we're in the hole $19.5 million, and we can't continue down that road, and we won't continue down that road," Denning said.

A spokeswoman for the Oklahoma Health Care Authority defended the agency's decision to give all of the $6.5 million in funds from the Indirect Medical Education program to OSU. The program is similar to one with the University of Oklahoma College of Medicine and "within the federal and state policies," agency spokeswoman Jo Kilgore said.

"Payments for the IME program are made under an approved federal / state Medicaid plan," a statement from Kilgore said. "The plan authorizes the agency to make payments to each university as part of the joint venture between the operator of the hospital and the medical school."

Both Hess and Denning said they will continue to explore their options.

"There is some time available to seek solutions, and we'll be in the process of exploring those with our legislative partners," Hess said.

"An instability in the teaching program in the residency training program could have long-term implications in the availability of physicians in rural and underserved Oklahoma," Hess said.

A state senator who last month intervened in the dispute to try to work out a deal between the two entities said he was concerned about the termination of the agreement.

"I am very disappointed that the folks at the College of Medicine and Ardent aren't doing a better job of working well together," said Sen. Mike Mazzei, R-Tulsa.

"If they don't resolve their differences, the ramifications for both organizations aren't good," Mazzei said. "I'm mostly concerned for the medical residents and students who are once again faced with uncertainties after something pretty historic was done to help secure the medical school's training facilities future."



Oklahoma State University Medical Center: A teaching hospital


Oklahoma State University Medical Center, formerly Tulsa Regional Medical Center, has served as the teaching hospital for OSU's College of Osteopathic Medicine for more than 30 years. Here is a recent timeline of events involving the hospital:

May 11, 2004: Ardent Health Services of Nashville, Tenn., purchases Hillcrest Healthcare System, including TRMC, 744 W. Ninth St.

July 2005: Nine members are named to a joint commission led by Republican Rep. Chris Benge and Democratic Sen. Tom Adelson, both of Tulsa, to study the TRMC-OSU issue. The commission issues a report in December and eventually hires consultants to examine the situation.

April 2006: After evaluating several options, Merrill Lynch analysts release a report recommending a 50-year Academic Affiliation Agreement between the OSU College of Osteopathic Medicine and TRMC.

May 5, 2006: Officials from the OSU College of Osteopathic Medicine and TRMC sign the Academic Affiliation Agreement.

June 7, 2006: Gov. Brad Henry signs the Oklahoma State University Medical Authority Act (Senate Bill 1771), creating the Oklahoma State University Medical Center Public Trust and Authority, and appropriating $40 million to fund improvements at Tulsa Regional Medical Center over five years.

Sept. 26, 2006: Henry convenes the first meeting of the OSU Medical Authority.

Nov. 2, 2006: Tulsa Regional Medical Center becomes Oklahoma State University Medical Center.

Jan. 25, 2007: OSU Medical Authority approves $10.6 million in phase I capital improvement projects for the OSU Medical Center. Projects, scheduled for completion by July 2008, include enhancements and/or expansions to residency program space, Labor & Delivery / neonatal ICU, and operating rooms, and the emergency department.

June : Ardent sues the Oklahoma Health Care Authority in federal court over the allocation of federal funding for medical education.

July 12: Ardent tells the OSU College of Osteopathic Medicine it wants $6.5 million the medical school has received from the state to go toward offsetting costs associated with the residency program.

Aug. 13: Ardent notifies the College of Osteopathic Medicine of the termination of the Academic Affiliation Agreement, but later withdraws the termination letter, providing an additional 30 days to reach a solution.

Sept. 14: OSU's governing board votes to have Oklahoma Attorney General Drew Edmondson represent OSU in the contract dispute.

Sept. 21: Ardent announces it is terminating the Academic Affiliation Agreement."

[swake]

So this is OSU and the state's fault?

It's really hard to tell from the outside. It certainly seems to be the state's lack of funding that's at fault, but in knowing a couple of people that work at Hillcrest, Ardent is not a great company.

There's has to be a way to make this work, doesn't there?

[sgrizzle]

Didn't OSU try to buy the hospital originally and only went into this ardent thing reluctantly?

[brunoflipper]

quote:Originally posted by swake

So this is OSU and the state's fault?

It's really hard to tell from the outside. It certainly seems to be the state's lack of funding that's at fault, but in knowing a couple of people that work at Hillcrest, Ardent is not a great company.

There's has to be a way to make this work, doesn't there?

yes.... osu got enough money to fund their teaching program but decided to use it to expand the med school and get some capital improvements... they got those two increases last year when they poor mouthed about how they were going to lose their program because ardent was going to kick them out... but osu decided to keep more of the cash than they had initially let on to ardent... now, they (osu) are shocked that the private company that owns the hospital is a little torqued to be out 19 mill for a residency teaching program...

and yes, the state has never funded a public hospital for tulsa and this was a half-assed attempt... osu went into this because arrangement because ardent was willing to accept the cash in return for letting them stay at trmc... osu has never had the resources to buy trmc and the state has never indicated theyd help them get them...

ardent is like any healthcare company... no better or worse than any of the local players in t-town...

in short, the boys in the capitol are leaving tulsa hanging, osu got greedy with the money they begged for and ardent is sick of being screwed...

the only resolution is to buy off ardent temporarily or buy the whole damn thing off their hands (which is what they want anyway)...

[jne]

"osu got enough money to fund their teaching program but decided to use it to expand the med school and get some capital improvements"
Expand the Residency program you mean?
Capital improvement - whats the hospital worth to OSU if they don't have the facilities necessary to train residents?
I'm hearing that Ardent has a similar arrangement  with OU.  The reason the legislature stepped in is because the school is needed to supply new physicians for the state, particularly in rural areas.  That still has to be the priority.  It may get worse before it gets better.

[brunoflipper]

quote:Originally posted by jne

"osu got enough money to fund their teaching program but decided to use it to expand the med school and get some capital improvements"
Expand the Residency program you mean?
Capital improvement - whats the hospital worth to OSU if they don't have the facilities necessary to train residents?
I'm hearing that Ardent has a similar arrangement  with OU.  The reason the legislature stepped in is because the school is needed to supply new physicians for the state, particularly in rural areas.  That still has to be the priority.  It may get worse before it gets better.

no, i meant med school... the residencies are operated by departments of the osu medical school and the money was funneled into the departments within medical school... the capital improvements went to the departments themselves, for equipment, for med school facilities and some into the hospital... they did not offset ardent's costs/losses, which was ardent's point from the beginning...

the only interaction ardent has with ou is at hillcrest, thats a completely different arrangement... trmc is a money pit and has been turned into the de facto public hospital... ardent wants no part of it... "whats the hospital worth to OSU if they don't have the facilities necessary to train residents?" zero, but the better question is "what are the residency programs worth without a hospital to train in?" zero, and the programs go tits up... no other hospital in town will have them nor does ou want any direct competition for residents at the other hospitals (i.e. st. francis, st. johns or hillcrest) where ou has their medicine, psych, ob, peds, fp and surgery programs... all of the ou residencies in tulsa fill with a lot of osu DO grads... the one thing the ou programs have had over the osu programs is access to the other private hospitals... and the last thing ou wants now is to have to compete on site with osu for residents... ou will stand in the way of any of those programs trying to move into any of the other local hospitals...

the only answer is for osu to cough up the cash  (which is already spent and they dont have) or the state to buy the damn thing and give it to osu outright... will either of those happen? one of them had better or osu/trmc is screwed...

[Chicken Little]

I part of the TRMC/Ardent deal was that part/all of indigent population was going to be "diverted" away from Hillcrest, making it more profitable.

So, what now, Bruno?  Why won't the legislature create a public hospital here?  Now would be time.  The State will have several hundred million left over this year.  How much would it cost to create and dower a public hospital?

[jne]

quote:Originally posted by brunoflipper

quote:Originally posted by jne

"osu got enough money to fund their teaching program but decided to use it to expand the med school and get some capital improvements"
Expand the Residency program you mean?
Capital improvement - whats the hospital worth to OSU if they don't have the facilities necessary to train residents?
I'm hearing that Ardent has a similar arrangement  with OU.  The reason the legislature stepped in is because the school is needed to supply new physicians for the state, particularly in rural areas.  That still has to be the priority.  It may get worse before it gets better.

no, i meant med school... the residencies are operated by departments of the osu medical school and the money was funneled into the departments within medical school... the capital improvements went to the departments themselves, for equipment, for med school facilities and some into the hospital... they did not offset ardent's costs/losses, which was ardent's point from the beginning...

the only interaction ardent has with ou is at hillcrest, thats a completely different arrangement... trmc is a money pit and has been turned into the de facto public hospital... ardent wants no part of it... "whats the hospital worth to OSU if they don't have the facilities necessary to train residents?" zero, but the better question is "what are the residency programs worth without a hospital to train in?" zero, and the programs go tits up... no other hospital in town will have them nor does ou want any direct competition for residents at the other hospitals (i.e. st. francis, st. johns or hillcrest) where ou has their medicine, psych, ob, peds, fp and surgery programs... all of the ou residencies in tulsa fill with a lot of osu DO grads... the one thing the ou programs have had over the osu programs is access to the other private hospitals... and the last thing ou wants now is to have to compete on site with osu for residents... ou will stand in the way of any of those programs trying to move into any of the other local hospitals...

the only answer is for osu to cough up the cash  (which is already spent and they dont have) or the state to buy the damn thing and give it to osu outright... will either of those happen? one of them had better or osu/trmc is screwed...

I think the medical school departments ARE the hospital departments.

[brunoflipper]

quote:Originally posted by jne

quote:Originally posted by brunoflipper

quote:Originally posted by jne

"osu got enough money to fund their teaching program but decided to use it to expand the med school and get some capital improvements"
Expand the Residency program you mean?
Capital improvement - whats the hospital worth to OSU if they don't have the facilities necessary to train residents?
I'm hearing that Ardent has a similar arrangement  with OU.  The reason the legislature stepped in is because the school is needed to supply new physicians for the state, particularly in rural areas.  That still has to be the priority.  It may get worse before it gets better.

no, i meant med school... the residencies are operated by departments of the osu medical school and the money was funneled into the departments within medical school... the capital improvements went to the departments themselves, for equipment, for med school facilities and some into the hospital... they did not offset ardent's costs/losses, which was ardent's point from the beginning...

the only interaction ardent has with ou is at hillcrest, thats a completely different arrangement... trmc is a money pit and has been turned into the de facto public hospital... ardent wants no part of it... "whats the hospital worth to OSU if they don't have the facilities necessary to train residents?" zero, but the better question is "what are the residency programs worth without a hospital to train in?" zero, and the programs go tits up... no other hospital in town will have them nor does ou want any direct competition for residents at the other hospitals (i.e. st. francis, st. johns or hillcrest) where ou has their medicine, psych, ob, peds, fp and surgery programs... all of the ou residencies in tulsa fill with a lot of osu DO grads... the one thing the ou programs have had over the osu programs is access to the other private hospitals... and the last thing ou wants now is to have to compete on site with osu for residents... ou will stand in the way of any of those programs trying to move into any of the other local hospitals...

the only answer is for osu to cough up the cash  (which is already spent and they dont have) or the state to buy the damn thing and give it to osu outright... will either of those happen? one of them had better or osu/trmc is screwed...

I think the medical school departments ARE the hospital departments.

not necessarily, you can get credentialed and have privileges at the hospital  (thus being a member of particular section/department at trmc itself) and have nothing to do with the residents or medical school...

[jne]

Editor of the Oklahoman on OSU Med

http://link.brightcove.com/services/link/bcpid1111406010/bclid1111621425/bctid1203072006

[swake]

Ardent proposes a deal where they donate the OSU Medical Center to the OSU Medical Authority and then agree to run the hospital as a teaching hospital for ten years.

http://www.tulsaworld.com/news/article.aspx?articleID=20080105_1_A1_ISZEW81327

[sgrizzle]

Starts out good. Kinda wish ardent would leave the hospital to OSU altogether.

[FOTD]

Just part of the many reasons health care in America is sick.

I was wondering if the land is worth more than the building and if the city might buy the hospital, level it, merge it into
that already weird parking garage for the Areema.

Hopefully the Mayo Clinic, MD Anderson, Cleveland Clinic, National Jewish etc. will jump into the mess, play the white knight and save the day. Right.

[TUalum0982]

quote:Originally posted by brunoflipper

i said two years ago when ardent bought out hillcrest that this would never last... the state/fed financial package for the hospital was bull**** and osu was skimming way too much off the top... so now, it is done... ardent is through subsidizing the osu residency programs... no other hospital in town will touch these programs with a ten foot pole...

the med school will be fine, except it won't have a hospital, but other than that it'll be aces (just like ou tulsa- med school sans hospital)... but, the residency programs are doomed...

someone should call mr pickens and ask him to buy trmc from ardent en toto... problem is, the state has never shown their willing to give enough money to fund a public hospital and they won't start now... so even if it is purchased for osu, the recurring costs would never get funded... the state should have given us a real public hospital a long time ago...

hess makes it sound like they can work this out, no freaking way.... truth is, this is only going to change if osu coughs up the cash... cant blame ardent, there a private company providing an unreimbursed public service- i wouldnt do it either...

somebody get the keys... start the bus...


"Hospital's program in jeopardy

By CURTIS KILLMAN World Staff Writer
9/22/2007

Ardent announces it is ending the agreement that provides medical resident training at the OSU Medical Center.


Ardent Health Services, citing a contract breach, said Friday it was terminating an agreement that provides for the medical resident training program at the Oklahoma State University Medical Center in Tulsa.

Ardent officials say the agreement breach, which stems from a funding dispute, forced them to initiate the contract termination process, which takes up to two years to complete.

The move comes 16 months after hospital and university officials signed a 50-year agreement designed to put the teaching program on stable financial ground.

"There are significant challenges with any teaching hospital, but we must have a true partnership to make this work and to date, that has not materialized," said Earl Denning, president and CEO for Ardent Health Services - Oklahoma Division. Ardent owns the former Tulsa Regional Medical Center.

An OSU official said he was disappointed Ardent has opted to terminate the contract, and expressed concerns about the future of the program, especially as the university prepares to recruit new
physicians for fall 2008.

"While this current circumstance obviously means the program is at some risk, we remain committed to seeking a long-term solution for our residency program," said James Hess, chief operating officer and vice president for Health Care Administration for OSU Medical Center in Tulsa.

The hospital, 744 W. Ninth St., has 132 residents from the OSU College of Osteopathic Medicine.

The medical resident program has been credited with turning out many doctors over the years, with many working in rural and underserved areas of the state. The contract termination could hurt the university's ability to attract physicians to the residency program, Hess said.

"I'm certain it will have an impact on the recruiting effort," he said. "It's difficult to say what impact at this point."

About 35 to 36 resident physicians come to the program each year, Hess said.

At issue are two sources of funding tied to the hospital, one for federally matched funds appropriated by the Oklahoma Health Care Authority and another $20 million appropriated by the state Legislature.

Ardent officials claim the company is entitled to receive all of about $6.5 million in federally matched funds allocated to OSU by the Oklahoma Health Care Authority.

"It's difficult to have a sense of partnership when $6.5 million is diverted from our hospital's control -- a hospital that is crucial to the underserved, as well as physician training," Denning said.

But OSU officials dispute Ardent's claim to all of the OHCA funds and instead point to an offer to split the funds with the hospital as it has in the past.

Ardent in June sued the Oklahoma Health Care Authority in federal court over the allocation of the funds.

The OHCA funding dispute in turn triggered a request by Ardent that it be given a portion of the $20 million appropriated by the Legislature.

The OSU Medical Authority, which oversees use of the legislative funds, has allocated $10.6 million of the $20 million for a variety of capital items.

"We were counting on that $6.5 million," Denning said. "And all of a sudden it's gone, and so we're saying, 'Wait a minute; if you are going to take that money then I want some of the $10.6 million in underwriting some of the expenses that I am paying out of my pocket for your teaching program.' "

Said Hess, regarding the request: "The university has felt that the Legislature and governor's office in approving the legislation, we believe it was their intent that the money be used for capital improvements at the facility, not for operations. Ardent would desire the use of the funds otherwise."

Denning said it was "shame that this has all happened," referring to the funding dispute.

"I understand and appreciate the role of the teaching program," he said. "But we are paying out of our own pockets $13 million a year to support this program."

"Now we're in the hole $19.5 million, and we can't continue down that road, and we won't continue down that road," Denning said.

A spokeswoman for the Oklahoma Health Care Authority defended the agency's decision to give all of the $6.5 million in funds from the Indirect Medical Education program to OSU. The program is similar to one with the University of Oklahoma College of Medicine and "within the federal and state policies," agency spokeswoman Jo Kilgore said.

"Payments for the IME program are made under an approved federal / state Medicaid plan," a statement from Kilgore said. "The plan authorizes the agency to make payments to each university as part of the joint venture between the operator of the hospital and the medical school."

Both Hess and Denning said they will continue to explore their options.

"There is some time available to seek solutions, and we'll be in the process of exploring those with our legislative partners," Hess said.

"An instability in the teaching program in the residency training program could have long-term implications in the availability of physicians in rural and underserved Oklahoma," Hess said.

A state senator who last month intervened in the dispute to try to work out a deal between the two entities said he was concerned about the termination of the agreement.

"I am very disappointed that the folks at the College of Medicine and Ardent aren't doing a better job of working well together," said Sen. Mike Mazzei, R-Tulsa.

"If they don't resolve their differences, the ramifications for both organizations aren't good," Mazzei said. "I'm mostly concerned for the medical residents and students who are once again faced with uncertainties after something pretty historic was done to help secure the medical school's training facilities future."



Oklahoma State University Medical Center: A teaching hospital


Oklahoma State University Medical Center, formerly Tulsa Regional Medical Center, has served as the teaching hospital for OSU's College of Osteopathic Medicine for more than 30 years. Here is a recent timeline of events involving the hospital:

May 11, 2004: Ardent Health Services of Nashville, Tenn., purchases Hillcrest Healthcare System, including TRMC, 744 W. Ninth St.

July 2005: Nine members are named to a joint commission led by Republican Rep. Chris Benge and Democratic Sen. Tom Adelson, both of Tulsa, to study the TRMC-OSU issue. The commission issues a report in December and eventually hires consultants to examine the situation.

April 2006: After evaluating several options, Merrill Lynch analysts release a report recommending a 50-year Academic Affiliation Agreement between the OSU College of Osteopathic Medicine and TRMC.

May 5, 2006: Officials from the OSU College of Osteopathic Medicine and TRMC sign the Academic Affiliation Agreement.

June 7, 2006: Gov. Brad Henry signs the Oklahoma State University Medical Authority Act (Senate Bill 1771), creating the Oklahoma State University Medical Center Public Trust and Authority, and appropriating $40 million to fund improvements at Tulsa Regional Medical Center over five years.

Sept. 26, 2006: Henry convenes the first meeting of the OSU Medical Authority.

Nov. 2, 2006: Tulsa Regional Medical Center becomes Oklahoma State University Medical Center.

Jan. 25, 2007: OSU Medical Authority approves $10.6 million in phase I capital improvement projects for the OSU Medical Center. Projects, scheduled for completion by July 2008, include enhancements and/or expansions to residency program space, Labor & Delivery / neonatal ICU, and operating rooms, and the emergency department.

June : Ardent sues the Oklahoma Health Care Authority in federal court over the allocation of federal funding for medical education.

July 12: Ardent tells the OSU College of Osteopathic Medicine it wants $6.5 million the medical school has received from the state to go toward offsetting costs associated with the residency program.

Aug. 13: Ardent notifies the College of Osteopathic Medicine of the termination of the Academic Affiliation Agreement, but later withdraws the termination letter, providing an additional 30 days to reach a solution.

Sept. 14: OSU's governing board votes to have Oklahoma Attorney General Drew Edmondson represent OSU in the contract dispute.

Sept. 21: Ardent announces it is terminating the Academic Affiliation Agreement."

guess we now know why Ardent's President and CEO David Vandewater was flying in almost weekly on a private plane to Tulsa from Nashville!.......

[FOTD]

Let's not forget they were trying to work with Aggies and not Meddies....

jester