Who Knew HHC Owned A Chain Of Nursing Homes

It's called the Health & Hospital Corporation of Marion County, but it operates nursing homes throughout the State of Indiana. Huh? That's right. I discovered that HHC owns and operates dozens of nursing homes in places like Anderson, Brownsburg, Evansville, Lafayette, Mooresville, Wesfield, Noblesville, Ft. Wayne, South Bend, Valparaiso, Bedford and Franklin. At the same time HHC went on buying spree of at least 23 nursing homes, it recently closed Lockefield Villages, a nursing home it built in the 1990s adjacent to Wishard Hospital, one of about ten it operates within the county. The Star's Dan Lee explained the closing just months ago:

Wishard Health Services is closing Lockefield Village Health and Rehabilitation Center, a restructuring and cost-cutting move that will displace the 178 residents of the Downtown long-term care facility.

Dr. Lisa Harris, chief executive of Wishard Health, said the move will allow Wishard Health to focus on the growing need for acute and primary care services. Wishard, operated by Marion County Health and Hospital Corp., is a nonprofit hospital and health system that cares for many of the region's poor and indigent.

"Closing Lockefield Village, while a difficult decision, will allow us to focus resources on our core mission," Harris said this week in a Wishard memo.

Lockefield Village, which opened in 1996 at 980 Indiana Ave., has stopped admitting new patients and plans to cease operations by May 13. The facility's residents include stroke and Alzheimer's patients and others who require skilled nursing care.

Wishard said it is working with American Senior Communities, an Indianapolis-based nursing home provider, to help place Lockefield Village residents in other locations.

Dr. Harris' claim that it was closed to focus on the growing need for "acute and primary care services" rings hollow when it has extended its nursing home acquisition to every corner of the state. Lee's story indicated that HHC had no plans for the vacated Lockefield Village, even though we now know just months later that HHC planned all along to swap property with IU to build its new Wishard Hospital facility at a cost of at least a quarter of a billion dollars. Although HHC's CEO Matt Gutwein has boasted about the productivity and quality of care at Wishard, Lee's report notes that Lockefield Village scored just 1 out 5 possible star on its Medicare rating. Virtually all of the residents at Lockefield Village were Medicaid/Medicare patients. [Go to the State of Indiana's interactive map to locate the various nursing homes owned by HHC]

In a short period of time, HHC has been converted from a Marion County-only provider of indigent care and enforcer of the county's health and building codes into a statewide provider of health care services. Did I miss some public discussion where it was decided that HHC should broaden its services statewide? It is hard for me to appreciate how its mission is furthered by owning a nursing home in Bedford or Ft. Wayne. It's difficult to gather any real information about how these decisions were made by the HHC's Board of Trustees because the Board's minutes have such abbreviated statements about issues it discusses. An October, 2002 minute entry exemplifies the brevity of these discussions:

Mr. Elwell began the meeting by discussing the possibility of HHC purchasing certain assets and acquiring certain leases for nursing homes in the State of Indiana. Leah Mannweiler, from Krieg DeVault, outlined for the Board the reimbursement issues involved in such a transaction. Discussion followed.

Mr. Elwell outlined the plan for the first acquisition and explained HHC hoped to acquire more nursing facilities through December 2003. The Board asked about potential liabilities associated with these transactions and asked about an exit strategy. Discussion followed. Mr. Elwell noted that this meeting was to explain the general idea behind the transactions and informed the Board that they would receive more detailed information at the next Board meeting on October 15, 2002.

The Board gave approval for Mr. Elwell and staff to further pursue the purchase and acquisition of certain nursing facilities and asked him to report back to the Board, with more detailed plans, at the October 15th Board meeting. Discussed followed.

At the following meeting in November, 2002, there is this brief enty concerning approval of nursing home purchase agreements:

Ms. Hebenstreit next presented, "Resolution No. 11-2002, "Purchase of Assets and Acquisition of Leases." Mr. Gutwein asked if there was a motion to approve the Resolution. Mrs. O'Laughlin made the motion to approve. Dr. Bock seconded the motion. Mr. Gutwein asked if there was any discussion on the motion. There was none, therefore Resolution No. 11-2002 was unanimously approved.

If you hadn't read the minutes from the meeting the month before, you would have no idea that the "Purchase of Assets and Acquisitions of Leases" involved nursing homes. I see nothing in the record that discussions were held with the City's Mayor, City Councilors or County Commissioners to seek their input before going on a buying spree of nursing homes outside Marion County. Where were the public hearings? There is simply no transparency in the actions of HHC's Board of Trustees. Hidden from public view, it has been converted into a statewide corporate health care giant. Why does it need these nursing homes? Is it bilking Medicare/Medicaid dollars from these nursing homes to finance its big corporate hospital center in Indianapolis? Who knows.

This is just one of the many issues I plan to raise in the coming months as voters of Marion County are asked to approve construction of this new hospital to replace Wishard Hospital. Something doesn't add up when HHC officials tell the public it can borrow all of this money and not raise a dime in taxes to pay for it. A big hat tip to the Advance Indiana reader who brought this matter to my attention. Keep the tips rolling in, and I'll be happy to share with everyone else.