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Frequently Asked Questions

3/16/2011

What is the DCH Health System?
The DCH Health System is a government subdivision that operates a community-owned healthcare system. The system consists of DCH Regional Medical Center, Northport Medical Center, Fayette Medical Center and Pickens County Medical Center. These facilities are owned by the public, and the system is operated on behalf of the public by the DCH Health System Board of Directors. DCH Health System is similar in its structure and operation to other local authorities, such as the Park and Recreation Authority (PARA). The official name of the DCH Health System is the DCH Healthcare Authority. While we do business as the DCH Health System, the DCH Healthcare Authority name is still used for official business, such as a bond issue.
How are board members appointed and what are their terms?
The DCH Health System is operated by a nine-member board. Two members are appointed by the Tuscaloosa City Council, two by the Tuscaloosa County Commission, one by the Northport City Council, two by the medical staffs of DCH Regional Medical Center and Northport Medical Center and two by the board itself. Terms are for six years.

What is the Healthcare Authority Act and what does it do?
The Alabama Legislature passed the Healthcare Authority Act in 1982 to ensure a sound system of community-owned hospitals. About 35 community-owned, not-for-profit hospitals operate under the Healthcare Authority Act. Public hospitals and health systems that incorporate under the act are allowed exemptions from certain laws that pertain to other public organizations so that they can compete with for-profit hospitals.

What is a public hospital?
Public hospitals like the hospitals in the DCH Health System, are owned by citizens of the community. Public hospitals are usually operated by a board appointed by local governing bodies. Private hospitals are owned by groups or individuals who own stock in the hospital. Some other hospitals are owned by church groups or charities.

What do you mean when you say that DCH is a not-for-profit hospital?
The term "not-for-profit" is somewhat misleading, because all hospitals must make a profit in order to stay in operation. The difference is that not-for-profit hospitals reinvest their reserve, or the amount of revenue left over after expenses have been paid, back into health care services. For-profit hospitals use some of it to pay dividends to thier stockholders. Also, for-profit hospitals do not usually consider caring for indigent patients as part of their mission.

How do cutbacks in Medicare and Medicaid funding affect local hospitals?
The federal government funds health care for the elderly through Medicare and state and federal governments fund care for the indigent through Medicaid. Cutbacks in the Medicare and Medicaid programs make those types of patients less attractive for some hospitals, which may encourage them to try to limit the number of elderly and indigent patients they treat.

Because of our mission of service, DCH hospitals accept all types of patients. Cutbacks in Medicare and Medicaid payments can mean that we receive less money for treating Medicare and Medicaid patients than it costs us to provide the care. That means more unreimbursed "free" care must be added to our overhead, which drives up the cost of health care for everyone.

Click here for more information about Medicare and Medicare Advantage.

How does DCH know its hospitals provide quality care?
The staffing levels at DCH hospitals are more than adequate to provide quality care. The number of employees and the type of employees per patient at DCH hospitals are comparable to other hospitals in the Southeast.

Our hospitals are accredited by the Joint Commission on Accreditation of Healthcare Organizations, the nation's largest accrediting body. DCH Regional Medical Center, Northport Medical Center, Fayette Medical Center, the Sam Phelps Outpatient Center and DCH Home Health Care were all reviewed by the Joint Commission in October 2010. All received high marks.

We know we offer quality care because our patients tell us so. We mail surveys to thousands of our former patients asking them to rate the care they received, and we do well in comparison to other hospitals.

There is also another check and balance to assure quality: Your family doctor. There are more than 250 physicians who practice at DCH hospitals. These men and women have trained and practiced at some of the most prestigious hospitals in this country, so they know quality when they see it. Physicians are in our hospitals day in and day out as they care for their patients. These professionals have a stake in ensuring that the hospitals they practice in provide quality care, and they continually let us know what we can do to improve care to their patients.

We have also received awards from independent agencies recognizing the quality of our services. Recent awards and recognition include Top 100 Hospitals for orthopedics and recognition in Money magazine for peripheral vascular intervention procedures and treatment of chronic obstructive pulmonary disease. DCH Health System facilities have also been recognized and accredited by numerous organizations, including the Alabama State Nursing Association, Pharmacy Practice News, American Diabetes Association, American College of Radiology, American Academy of Sleep Medicine, the Arthritis Foundation and many others. For more information on recognition, awards and accreditations for quality, click here.

Does DCH provide educational opportunities for people interested in the health care field?
The DCH Health System provides clinical training sites for students in many health care fields. Much time and effort are put forth by our health care professionals to ensure that these students are well-trainted in the fields they have chosen.

Since 1976, DCH Regional Medical Center has helped the College of Community Health Sciences at the University of Alabama graduate more than 260 residents in the Family Practice Residency Program. Many of those physicians are now practicing medicine in West Alabama and in several other areas in Alabama and the Southeast.

In addition to medical students, DCH helps train more than 1,500 students each year for careers in:

  • Radiology.
  • Nursing.
  • Medical lab specialties.
  • Physical therapy.
  • Occupational therapy.
  • Pharmacy.
  • Respiratory therapy.
  • Nutrition services.
  • Emergency medical technician.
We also offer internships for students in nonclinical areas, such as patient accounts, marketing, communication and human resources. For more information about training opportunities, click here.

How is free care financed in Tuscaloosa County?
DCH Regional Medical Center receives 10 percent of the 2-cent county sales tax to help provide care for residents of Tuscaloosa County who have no money or insurance. The Regional Medical Center usually receives between $4 million and $5 million in sales tax to provide health care for the poor. For every dollar ($1) received, DCH hospitals provide more than $9 in community benefit. For more information, click here.

Why does DCH need the sales tax money?
Although the sales tax money does not nearly cover the cost of free care, the tax support is very important to DCH's financial well-being. Because our major sources of reimbursement -- the federal government and Blue Cross -- pay us based on a set rate rather than billed charges, it would be very difficult for us to make up for the sales tax revenue if it were no longer provided.

Why do DCH hospitals need to make a reserve?
Like any business, DCH needs to bring in more than it spends in order to replace equipment, purchase new technology, build new facilities and renovate existing facilities to accommodate new services. Funds are also set aside to cover unexpected needs and to meet credit ratings that allow us to borrow money for major projects at reasonable rates.

What is DCH doing to contain healthcare costs? What can private citizens do?
DCH contains healthcare costs through a variety of means. DCH enjoys hefty discounts on equipment and supplies by buying supplies in concert with other hospitals. Managed care programs promote efficient, cost effective care for certain conditions and discharge planning provides for more efficient use of inpatient beds. DCH currently offers a broad range of outpatient services, which are less costly than inpatient care, and we have expanded our home health care agency.

Private citizens can help contain health costs by using healthcare resources appropriately - by using healthcare only when necessary and by using the appropriate type of healthcare. Consumers can also look for outpatient alternatives when it's appropriate and they can take advantage of preferred provider arrangements offered through their employer.

What does the DCH in DCH Regional Medical Center stand for?
Druid City Hospital opened in 1923. In the late 1970s, the hospital was known as Druid City Hospital Regional Medical Center to reflect the facility’s role as a hospital not just for the Druid City (the City of Tuscaloosa’s nickname) but for all of West Alabama. In 1984, we took the name DCH Regional Medical Center because it was shorter and because the name Druid City Hospital still made it sound as if the hospital served only the City of Tuscaloosa. We retained the abbreviation DCH because it had a long tradition and was recognized in the community.

Why is the City of Tuscaloosa called the Druid City?
In the late 1800s, the city fathers of Tuscaloosa planted oak trees along downtown streets. Just as the City of Birmingham was known as the Magic City because of its amazing growth, the City of Tuscaloosa became known as the Oak City, or, in recognition of the ancient British tribe that worshipped oaks, the Druid City. (You may know the Druids are the folks who are believed to have built Stonehenge in England.) You can see reference to Tuscaloosa as the Druid City in a number of places. The patch for the City of Tuscaloosa Police Department includes a reference to the Druid City. One of the former high schools was named Druid High School, and the Tuscaloosa telephone book lists several businesses that include Druid in the name.

When the city opened its first clinic in 1919, it was natural that they would name it Druid City Clinic after the city’s nickname. When the city built its first hospital in 1923, it made sense to name it Druid City Hospital to honor the city’s nickname and the city’s first clinic.

Why do you advertise?
Healthcare is a complex industry and the public has a right to know what services are available in the community and how to use those services. Advertising is one way DCH educates the public about the services available here in West Alabama and to build consumer loyalty. DCH also has a responsibility to educate the public about how to stay healthy, and some advertising/promotional dollars are spent to accomplish this goal.

Hospital-Acquired Infections
It's a medical fact that infections exist in all hospitals. Medical literature indicates that hospitals of similar size have considerably higher rates than does the Regional Medical Center.

Why are you renovating parts of your hospitals and buying new equipment?
The DCH Health System must manage all of its resources to remain strong in this era of change. DCH must attract patients and provide quality healthcare. DCH must also attract and retain the physicians and employees who deliver these services. This will require balancing financial resources directed toward facilities and equipment, health services and human resources.

What is the status of DCH's retirement plan?
DCH's pension plan is safe and secure. DCH completely funds the pension plan. The pension funds are held in trust at AmSouth Bank, Regions Bank and Northern Trust. These funds are overseen by an independent pension committee and may not be used by the DCH Health System to fund any of its operations.

In addition to the pension plan, DCH introduced a plan in 1996 that allows employees to set aside money on a pretax basis. DCH will match employee contributions. The plan is similar to a 401(k) plan.

What does DCH do to support the community?
DCH is a major contributor to the region when it comes to health. DCH provides the community many free health services, such as health screenings and serves as a health education resource as well. Click here for our 2008 Community Benefit Report. DCH is also active in the community in a variety of other ways. DCH is an active member of the Chamber of Commerce. The Medical Center and Northport Medical Center support Adopt-A-School, and Northport Medical Center sponsors the hospital exhibit at the Children's Hands On Museum. DCH employees are involved in many area civic groups and charities, especially health-related charities, including American Heart Association, March of Dimes, American Cancer Society and the Arthritis Foundation. DCH employees are among the strongest supporters of Tuscaloosa County's United Way campaign. Click here for our latest Community Benefit Report.

Does DCH treat AIDS patients?
As a regional referral medical center, DCH treats almost all major and minor illnesses.

Who owns the Medical Tower?
DCH owns the Medical Tower and leases the space to physicians at a market price.

Does DCH own Fayette Medical Center?
In 1984, when most small rural hospitals were closing or selling to large hospital chains, the Fayette County Hospital Board chose to enter into a long-term lease with the DCH Health System. The Board renewed the lease for another 20 years in 1996. This arrangement allowed the Fayette Hospital Board to bring greater stability to their hospital while retaining local ownership. The DCH Health System and the Fayette County Hospital Board share the profits generated by the hospital, which has been very successful since it became a part of DCH.

Why did the DCH Health System buy Northport Medical Center?
The DCH Health System purchased Northport Medical Center (then AMI West Alabama Hospital) in 1992.

The Board purchased the hospital for the following reasons: To limit duplication of high-cost equipment and other resources; To allow the reserves from Northport Hospital-DCH to be invested in local healthcare services rather than going to out-of-state stockholders; To allow both hospitals to share the burden of caring for charity patients; To ensure that West Alabamians have access to more specialized health services provided by a healthy local healthcare system. With a united, community-owned system, Tuscaloosa is better able to compete with Birmingham hospitals and managed care plans, which are becoming more aggressive in this market.

Why do patients have to wait so long in the Emergency Department?
Patients are treated according to the severity of their illness or injury. That means a patient with a relatively minor problem may have to wait for treatment while the staff handles patients with more serious problems. Despite being one of the busiest Emergency Departments in Alabama, the quality and comprehensiveness of the Regional Medical Center's Emergency Department services continue to be highly regarded by our patients. The Regional Medical Center has implemented a Minor Emergency area. This area specializes in treating minor health problems with a goal of receiving, treating and discharging appropriate patients in 90 minutes or less.

Why is healthcare so expensive?
Whole books have been written on this subject, but let's boil it down to a few basic issues: Healthcare requires highly specialized facilities, equipment and personnel, and these resources are expensive While consumers are comfortable with discount outlets for goods, consumers have consistently demonstrated that they expect the best, most comprehensive care for themselves and their families.

Are patients denied treatment at DCH because they can't pay for health care services?
Although DCH is not required by law to provide indigent care, it is part of our mission of service to the community to provide necessary medical treatment for residents of Tuscaloosa County regardless of their ability to pay. DCH also accepts patients from other counties in the region if the care they need is not available from their county hospital.

What are DRGs and what affect have they had on the healthcare system?
First, some history. Medicare, the federal program that funds medical care for the elderly and disabled, once paid hospitals and physicians based on the amount of care given to Medicare patients. In an attempt to reduce costs, Medicare officials in the early 1980s decided to pay for care on what they called a prospective payment system. This means the government was going to pay for care based on a price they set in advance. They did this by categorizing diseases into more than 450 diagnosis related groups, or DRGs. They then set a price they would pay for treating patients who fit into each DRG. If a hospital was able to provide the care for less than the rate, they could keep the difference. If it cost them more than the DRG rate to treat that patient, the hospital lost money.

Many of the rates are simply too low, which means that hospitals lose money whenever they treat Medicare patients who fall into those DRGs that have low rates.

Blue Cross, the state's largest health insurance provider, also pays hospitals and doctors a set rate for the care of patients covered by their plan. Because Medicare, Medicaid and Blue Cross patients account for the vast majority of our hospitals' business, we are paid a set rate for most of our patients, regardless of what the bill says.

Is DCH a smoke-free facility?
Yes. Smoking is prohibited at DCH facilities, except in a few designated areas outside the buildings.

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