Hospital CEO: Indiana home health not a priority

WATSEKA — Iroquois Memorial Hospital’s new chief executive officer said he does not consider the expansion of home-health services into two rural counties in western Indiana a priority, even though two of the hospital’s doctors broached the need last summer to provide the service across the state line.

Chuck Bohlmann, who started as CEO of the Watseka hospital in late December, said last month that he would like to “re-examine” the idea, but on Friday he said, “from what I’ve been told, Jasper County Hospital (in Rensselaer, Ind.) already provides home-health services” to the area in question.

“At first blush, is there a need to compete like that? I don’t think so,” Bohlmann said. “It’s not about a market-share grab. If the service is being provided, that’s great.”

The hospital was planning to look into filling a need to provide home-health services in neighboring Newton and Benton counties in Indiana after the Ford-Iroquois Public Health Department dropped its own plan to do so in late January.

Ford-Iroquois Public Health Administrator Doug Corbett said he was asked last June to consider expanding the health department’s home-health program into the two Indiana counties. The idea was presented to Corbett by two doctors employed by Iroquois Memorial Hospital — Dr. Phillip Zumwalt and Dr. Gonzalo Florido, who also serve part time as medical directors for the Ford-Iroquois and Newton County health departments, respectively.

The two doctors told Corbett there was a need for providing home-health services in Benton and Newton counties, Corbett said. Corbett said he had hoped the fee-based program could not only address that need but generate revenue to help fill a $138,000 budget gap for this fiscal year, with the average home-health patient bringing in $1,800.

The Ford-Iroquois Board of Health subsequently approved the proposal and applied for a license to operate a home-health branch in Kentland, Ind. The health department cited in its license proposal a “lack of medical services available locally.”

Meanwhile, Corbett never mentioned Jasper County Hospital during subsequent meetings to explain the plan to the public. During an Iroquois County Board meeting in January, Corbett incorrectly stated that the closest home-health provider to Benton and Newton counties was based in Bloomington, Ind.

The Paxton Record later obtained, through a Freedom of Information Act request, the health department’s proposal to license a home-health branch in Kentland, Ind. The proposal and its attached “windshield survey” mention Jasper County Hospital as “the only home health agency in the Newton County phone book.”

Health department spokesman Julie Clark said in a subsequent email that the agency’s home-health coordinator, Mary Cahoe, had researched the need for more home-health services in Indiana and was told that Jasper County Hospital “would welcome our services due to the distance that they must travel to provide services outside of Jasper County.”

But the Jasper County Hospital home-health program’s coordinator, Dianne Hollerman, said in an email to the Paxton Record that she “cannot imagine anyone of authority telling that we do not have the ability to cover the Newton and Jasper area for Home Health Care and Hospice.”

Hollerman also said she did not speak with anyone representing the Ford-Iroquois Public Health Department — and neither did anyone else of authority. Hollerman also noted that the hospital’s home-health program has staff members living throughout Jasper and Newton counties, and “when we get a referral, we’re out there in 24 hours in at least 90 percent of our cases.

“I can’t imagine Newton County would need more,” she said.

Last week, Clark was unable to provide the name, title or department of the person with whom Cahoe spoke.

“We do not know the name of the person Mary talked to,” Clark said in an email.

Of the 154 patients currently in Jasper County Hospital’s home-health program, almost one-third — 42 — live in Newton County. There were currently no patients in Benton County, but Hollerman said she is sure other home-health agencies, like those in Lafayette, serve Benton County, too.

According to information obtained from the Indiana State Department of Health, there are 54 home-health agencies licensed in Indiana to serve Newton County and 30 to serve Benton. However, none of the 345 licensed agencies in Indiana have facilities located in either county.

Corbett decided to drop the Indiana home-health program in late January, after the Iroquois County Board’s attorney raised concern about the legality of providing services outside the health department’s jurisdiction of Ford and Iroquois counties.

Corbett said he was hoping to grow the program in Indiana over time, hopefully starting with five, 10 or 15 patients in the program’s first few months. He said the health department’s home-health program serving Ford and Iroquois counties has “just under 200 patients a year.”

“Even if you took 20 percent of that (total) to start out for a given year (in Indiana), that’s pretty low-balling it, I would think,” Corbett said.

Florido had agreed to serve as medical director for the Indiana home-health program prior to it being nixed, Corbett said. Florido already runs a medical clinic in Kentland Ind., operated by Iroquois Memorial Hospital, that is located two blocks away from where the health department rented an office for $400 per month for the now-dropped Indiana home-health program.

Florido, in his part-time position overseeing the operation of the Newton County Health Department, never brought up to his own board of health the need for improved home-health services in his county, according to the health board’s chairman,  Ray Chambers.

Florido did, however, inform the board about the Ford-Iroquois Public Health Department’s plan to provide the service after the decision was made last July, Chambers said.

With small staffs and budgets, the public health departments in Benton and Newton counties do not have the resources to provide home-health services for homebound patients, according to Chambers and Benton County Public Health Administrator Sally Slavens.

Most Indiana counties do not provide home health — only one county health department is the owning entity of a home-health agency, according to the Indiana State Department of Health.

Slavens said her county, which had a population of 8,854 as of the 2010 Census, would welcome more home-health services, but she was not certain whether there is any unmet need.

Meanwhile, Kim Durham, the only full-time registered nurse employed by the Newton County Health Department, said she does not know of “any immediate, pressing need” in her county, which has a population of 14,244.

“Could I see a need? Maybe. It’s possible, considering we don’t have a lot of health care here,” Durham said.  “We obviously don’t have a lot of health care infrastructure in Newton County – only a few providers, no hospitals.”

Meanwhile, neither Florido nor Zumwalt approached the Iroquois Memorial Hospital board last summer to discuss the possibility of the hospital pursuing an expansion of its home-health services, according to the board’s chairman, Dennis Wittenborn. Both physicians serve as officers for the hospital’s medical staff, with Zumwalt serving as vice chief of staff and Florido as secretary/treasurer.

Wittenborn said the status of the hospital’s home-health program is “absolutely OK.”

Bohlmann said Iroquois Memorial had looked into the possibility of expanding its home-health program into Indiana several years ago but decided against the idea because of low “patient volume” in that area of the state.

Bohlmann said Friday there is nothing preventing the hospital from re-examining the need to provide the service, but at this point he does not feel it is a priority, especially now that the hospital has applied to become a “critical access hospital.”

Florido and Zumwalt could not be reached for comment over the past several weeks.

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