Hoboken University Medical Center is in tough financial straits, as are most area hospitals who have to deal with insurance reimbursements and other issues. Now, HUMC CEO Spiros Hatiras is concerned that patients who normally would be brought to his hospital are being unfairly diverted by ambulance to Jersey City Medical Center.
Christopher Rinn, JCMC’s Emergency Medical Services director, said last week that the charges are completely untrue.
“We do not poach or steal patients,” Rinn said, “and the accusation sickens me.”
“There are big bucks at stake for the hospitals.” – Tom Molta
Jersey City is covered by LibertyHealth through a separate contract, according to Rinn.
Bayonne handles its own 911 calls.
For every medical 911 call from North Bergen, Union City, Weehawken, West New York, or Hoboken, Liberty Health’s emergency medical dispatchers decide if medical assistance is necessary and help the caller with any immediate care that can be given. Rinn said the call screeners are certified medical technicians who take roughly 25,000 emergency calls per year.
Then, the dispatchers can call either a basic life support (BLS) ambulance to respond, or for more serious calls, an advanced life support (ALS) ambulance.
When necessary, BLS service is provided locally by each town’s ambulance service, but ALS service is provided by the regional trauma center, which in Hudson County is JCMC. Their ambulances are owned by LibertyHealth.
‘Swoop and scoop’
Last week, Hatiras called the process a “swoop and scoop” and said that the call screening contract allows for preferential treatment, giving more patients to JCMC.
Data presented by JCMC officials contradicted what Hatiras is claiming – but Hatiras said he believes there are more numbers out there to back up his claim, and that JCMC hasn’t released them yet.
Hatiras is asserting that LibertyHealth is unfairly diverting some people from Hoboken, Union City, and other towns to Jersey City Medical Center even if they could be handled at HUMC, Christ Hospital in Jersey City, or Palisade Medical Center in North Bergen.
He said having the call screening contract is giving LibertyHealth an unfair advantage, and he takes offense that the county has not publically advertised for this contract in the past.
Freeholder Anthony Romano, who represents Hoboken and part of Jersey City, scheduled a Public Safety Committee meeting last week to hear both sides, but the conversation seemed to sprawl out of control, according to several attending members. The meeting was not open to the public.
Afterward, Romano said the county will advertise for the call screening contract next year, but is convinced that there are no other possible providers in Hudson County capable of handling the large volume of calls.
Haritas said his hospital is not looking for the contract, but other providers besides LibertyHealth might like a chance to compete.
Rinn said that even if the county takes bids on the service, no one else in the county will be able to provide the same “economy of scale.”
At the freeholder meeting this past Tuesday, Hoboken University Medical Center officials pushed to have the freeholders serve as an ambulance oversight authority.
Rinn said the 911 call screener has no input into the destination of an ambulance. He said the call screening contract with the county isn’t related to actions Hatiras is claiming are happening at the ground level, in the ambulances.
“We’re not an enforcement arm [for ambulances],” Romano said in a later interview. “We don’t come up with the protocol.”
Better coordination between hospital officials, municipalities, and public safety entities might help the problem, he said, and follow-up on the situation will be ongoing.
Call the ambulance
For questionable calls, dispatchers sometime call in both ALS and BLS units, according to Tom Molta, coordinator of the Hoboken Volunteer Ambulance Corps. The decision on which unit takes the patient is made by the advanced life support team, or LibertyHealth EMS.
The decision of which hospital the patient goes to is based first on their condition, then on their preference, but Hatiras said some patients are complaining that they have been taken to JCMC against their wishes.
Rinn said 80 percent of the calls that LibertyHealth ambulances pick up from Hoboken residents go to HUMC.
“We take patients where they want to go,” he said, unless their condition dictates otherwise.
But Haritas countered that gray areas pop up. He said that JCMC isn’t providing data to show where their patients from other northern Hudson County towns are going, and why.
For instance, he said, HUMC is a designated stroke center, but a Union City patient showing signs of arm numbness may go past HUMC on their way to JCMC, if ambulance workers aren’t informed that HUMC is the nearest stroke center.
Rinn responded, “If [Hatiras is] concerned about EMS transfer, why doesn’t he start his own ambulance corp?”
Molta said LibertyHealth emergency response teams do a great job and provide an important service to Hoboken citizens. But he conceded that JCMC has an advantage based on their situation.
“They’re getting the call before everybody else,” he said. “They have some kind of advantage.”
The Hoboken Volunteer Ambulance Corps is funded by donations. The city contributes a stipend and covers insurance for the operation, Molta said.
His corps responds to 3,500 to 4,000 calls per year, he said. They sometimes respond to out-of-town calls when needed.
“We don’t charge for our service,” he said, “but there are big bucks at stake for the hospitals.”
Timothy J. Carroll may be reached at firstname.lastname@example.org.