The information posted this week served to underline the financial disparities in health care across the board.
Over the past decade, seven Georgia hospitals were so poor they had to close. In Claxton, Evans Memorial Hospital CEO Nikki NeSmith made $154,000 in salary and benefits, less than any of the top 10 officials at the bigger Georgia hospitals. For instance, the general counsel at Meadows Health in Vidalia was paid $254,000, and Piedmont Healthcare’s chief philanthropy officer, Sidney Kirschner, was paid $1.2 million in 2017.
Besides being CEO, NeSmith also serves as Evans’ chief nursing officer.
State Rep. Matt Hatchett, R-Dublin, one of the legislators who pushed for the disclosures, said he is glad hospitals are releasing the information.
“Some of it’s been informative,” he said. “Some of it’s just information that people need to know.”
The disclosures came out of a years-long legislative fight over Cancer Treatment Centers of America, a private hospital company that wanted to expand its Georgia business faster. Nonprofit hospitals fought CTCA, saying the company would cherry-pick the state’s more lucrative, well-insured patients and leave nonprofits with the bulk of the state’s uninsured and expensive patients.
Hatchett and other conservative legislators tired of their opposition, noting that some nonprofit hospitals have high-value assets and pay hefty salaries.
The frustrated lawmakers sided with CTCA, and they also decided to require the nonprofit disclosures. Now the hospitals must list on their websites information including their top 10 administrative positions’ salaries and fringe benefits; the land they own; their debts; their net assets and fund balances; their joint ventures or partnerships and the value of those; their charity care policies; and several documents with financial and operational summaries that they normally file with varying state or federal agencies.
Monty Veazey, the president of the Georgia Alliance of Community Hospitals, said much of it was already available, just in scattered places.
“We haven’t, surprisingly, had anyone to push back” from hospitals, Veazey said.
Health care costs have soared generally, and hospitals are one of the key drivers of that. A study in the journal Health Affairs found that inpatient hospital prices for patients rose 42% from 2007 to 2014. The same service at a hospital, such as a lab test or a scan, can bring the hospital much more money than the exact same service done somewhere else.
Previous reporting by The Atlanta Journal-Constitution has found that CEOs’ contracts often reward them for financial success more than health quality. That reporting, in 2014, found Northside was a high payer then, too.
Georgia hospital representatives say their salaries are in line with the work they do and comparable to what’s offered elsewhere. They note that hospitals are complex organizations that can employ thousands of employees.
As for rising costs to patients, hospitals point out that their disclosures also note millions of dollars in charity care for patients that is never repaid.
Hatchett suggested that might not be enough.
“There are hospitals in this state that are suffering financially big-time, and their communities need to know that,” he said, explaining the reason for the disclosures.
“There are other hospitals on the other hand that are making lots of money that communities need to know that, too,” he added. “Some of the hospitals in our state are accumulating lots of funds and assets, and in my thinking I would like to see maybe some of those funds reduced. And reduce the cost of everyone’s health care accordingly. … They don’t have owners, they don’t have stockholders, they’re the community’s assets. Why do they need large amounts?”
The hospitals say they reinvest money they earn into providing health care.
Veazey said for-profit hospitals should also be forced to post similar information since the government pays them to provide health care through Medicare and Medicaid.
“I think that’s something they should do because they receive state dollars just like we do,” Veazey said. “They (the Legislature) were punitive on us and let the for-profits slide.”
Cancer Treatment Centers of America, the main for-profit hospital company in the legislative fight this year, used heavy lobbying over several years to win the right to expand. Little is known publicly about its executive salaries.
Citing uncertainty with the rules over what to disclose, Evans Memorial did not post all 10 required top salaries, just the two that were over $100,000. Some hospitals’ documents were either not posted or difficult to find, although the law required that the material be linked “in a prominent location on the main page of its website.”
A man who identified himself as the chief operating officer of Bleckley Memorial Hospital said only its information technology worker, who was out on a family emergency when a reporter called, knew where the documents were linked. Asked whether he could help the reporter find the link on his homepage, the COO declined and hung up.