?^m ? \
I (trn g
I PROGRESS SENTINEL
ly VOL. XXXXV11N0. 10 USPS 162-860 KENANSVILLE. NC 28349 MARCH 10. 1983 16 PAGES THIS WEEK 10 CENTS PLUS TAX -
j,.
Duplin Hospital
Seeks Fiscal Cure
? When a rural county hos
pital's low-income patients
turn the hospital itself into a
financial patient, voters and
tax-payers face major deci
sions.
When the hospital is
$700,000 behind in paying its
bills, as Duplin General in
Re'nansville has been in
| recent months, taxpayers
must decide how close the
,9 g&P is between income and
t expenses.
Should they use county
taxes, or raise fees to the
patients who can pay. or turn
the hospital over to a private
for-profit firm?
Under the last option, the
firm probably would need a
county subsidy for patients
who can't pay their full bills.
The problems facing
? Duplin General, an 80-bed
facility serving one of the
state's most rural counties,
are typical of rural medical
facilities, according to hospi
tal and county officials.
The hospital is losing
money because federal
Medicare and Medicaid pro
grams only pay about 70
percent of the hospital's
charges. Patients under
^ these programs make up
W two-thirds of its care, exactly
opposite what county offi
cials say should be.
W.J. Costin, chairman of
the Duplin County Commis
sioners, said the patient pay
ment mix should be about 30
percent Medicare and Medi
caid and about 70 percent
private insurance or payment
schedules.
_ Duplin General now is in a
9 serious bind because it has
deviated from that formula.
"The government cheats
on the payment of bills,"
said Dr. Corbett L. Quinn, of
Magnolia, a longtime prac
titioner in Duplin County. He
appears to have strong
support from hospital and
local government officials
when he charges "the
government lies when it says
it funds Medicaid and Medi
care."
"Quinn suggested levying
a county tax, labeled as a
hospital operating tax.
Duplin County voters autho
rized a property tax of up to 8
cents per $100 for hospital
operation when they
approved the hospital in a
1952 referendum.
Costin said the county
needs the hospital and won't
allow it to close. The hos
pital's Board of Trustees will
meet at 7 p.m. Thursday to
discuss its financial prob
lems.
"We've got to find some
thing out by June 1," when
the county plans its budget,
Costin said. "They're (trus
tees) $700,000 behind in
paying bills, although this
varies month by month.
They're having cash flow
problems."
"We're getting hit at both
ends," Costin said. "Besides
having to make up the dif
ference between billings and
what we get, we have to send
$308,700 to Raleigh this year
as the county's share of the
Medicaid program cost."
In the past five months,
the hospital billed Medicare
patients $106,188 ? as much
as allowed by current rules
? and billed Medicare for
the $982,117 balance of those
patients' fees, hospital ad
ministrator Richard Harrell
said. Of (hat balance, Medi
care paid only $695,974,
leaving the hospital with un
paid and uncollectable bills
totaling $286,143.
Current government
jargon calls that loss* 'jjon-.
tract adjustments."
Hospitals are barred by
law from billing Medicare
and Medicaid patients for the
difference between charges
and actual government pay
ments. Some of the federally
applied squeeze is designed
to hold down hospital costs.
Hospital officials, how
ever, maintain their costs far
exceed what they can recover
under these programs.
Hospital Board Chairman
Ray Sanderson said Medi
care and Medicaid reim
bursements are about equal
to the cost of a patient's care,
but do not account for the
patient's share of the hos
pital's total operating costs.
When all hospital costs are
included, Harrell said, the
actual cost of Medicare pa
tients was $263.51 per day,
of which patients paid $25.71
and Medicare $168.52, leav
ing $69.28 unpaid and un
collectable.
During the past hospital
fiscal year ? Oct. 1, 1981 to
Sept. 30, 1982 ? 50 percent
of Duplin General's patients
were on Medicare, a pro
gram for the elderly; 9
percent on Medicaid, de
signed to aid the poor; 12
percent under a mental
health program using a simi
lar reimbursement formula;
and 29 percent on insurance
or out-of-pockef payments.
Eight percent of the hos
pital's billings ended up as
bad debts. Harrell said.
Sanderson cited a recent
"worst case scenario" in
which Medicaid paid $252
and Blue Cross $18 towards a
patient's $670 bill, leaving a
-less of $382. \
.In a memorandum to
county commissioners.
Quinn predicted. "It will cost
in the neighborhood of $1
million initially and about
$500,000 annual mainte
nance (in public money) as
long as the present formulas
for state and federal parti
cipation remain in effect."
Quinn said his estimate of
$1 million needed initially is
an estimate of costs of im
mediate replacement for old
equipment.
County Manager Ralph
Cottle said county commis
sioners appropriated $1,931
million for the hospital in the
last five years, an average of
$380,000 per year, mostly for
investment in the building
and equipment. Cottle said
this amounts to about 6 cents
per $100 in the county's
property tax rate.
Commissioner D. J.
Fussell said, "Duplin Gen
eral is not going to close.
Closing it isn't even in my
vocabulary."
Fussell suggested hiring a
consultant on hospital finan
cial affairs to advise the
commissioners and hospital
trustees on possible solu
tions. He and other commis
sioners have said they may
have to alter their priorities
to maintain the hospital, but
they don't favor the last
resort: raising county taxes.
Duplin County Schools
Detail Maintenance Bill
9
Maintenance of Duplin
County's $46 million worth of
school buildings will cost
about $5.3 million in the next
five years if the school board
and county commissioners
are willing to pay the full
price tag.
An extensive school facili
ties review has been pre
pared for the county Boaid of
d| Education. It evaluates
school structures, sites and
educational quality.
The Duplin system in
cludes 18 schools, the ad
ministrative center and two
maintenance buildings. The
oldest buildings were built in
the 1920s and the newest in
1979.
The most expensive items
listed in the maintenance
? estimates are roof repairs,
$804,900; sewer renovation
and construction, $662,600;
storm windows for energy
conservation. $481,600;
boilers in the older buildings,
$357,700; drainage tile,
$355,300; and parking lot
work, $336,100.
Other items prominent on
the list were fieldhouse and
bathroom work, $273,800;
floor covering, $217,800;
bleachers for athletic events,
$142,500; removal of barriers
to the handicapped,
$141,400; tractors for
grounds work, $108,000; and
ballfield fences, $100,000.
Reroofing at the new
Kenansville Elementary ,
School is being done at the ,
expense of the architect and
roofing contractor and is
costing the school system ,
nothing. I
Cost estimates for indi- (
vidual schools vary widely, ,
from $663,400 for James
Kenan Hiah School east of
*
Warsaw, one of the oldest
high schools in the county, to
$32,200 for Kenansville Ele- (,
mentary. the newest school.
James Kenan's needs
spread across most of the
line items ? $180,000 for the
sewer system; $75,000 for
roofs, $72,000 for parking
lot, $65,000 for fieldhouse
and bathrooms, $45,000 for
bleachers, $40,000 for drain
age. $29,000 for ball fences,
$26,000 for storm windows,
$24,000 for wall lockers,
$22,000 for rewiring. $ 12,000
For band room - gymnasium
renovation, $10,800 for ceil
ing -fans, and $10,000 for
gym floors.
Needs totaling $606,400
vere listed for East Duplin
High School near Beulaville,
he county's largest school
vith 776 students.
Major items on the East
Duplin list were $80,000 for
storm windows, $78,000 for a
heating system boiler,
$75,000 for roof work.
$65,000 for fieldhouse and
bathrooms, $55,000 for
bleachers, and $38,000 for
handicap barriers.
The study estimated
$511,100 worth of needs for
Wallac-Rose Hill High
School, the oldest part of
which was built in 1955.
Major needs are roofs,
$147,300; fieldhouse and
bathrooms, $83,800; storm
windows, $46,900; and re
wiring $43,400.
Needs for Chanty Middle
School east of Rose Hill were
estimated at $406,700 with
gymnasium-bandroom reno
vation to replace a frame
building estimated at
$50,000.
Enrollment is 366 students
in grades seven and eight.
1982 Duplin Sheriff's Department Reports
Half Stolen Property Recovered
Duplin citizens who were
victims of theft in 1981 had a
50 percent chance of having
their property returned,
Duplin County Deputy Glenn
Jernigan said. And. the re
covered property almost
never returns valued as
much as before the theft.
The Duplin County
sheriff's deparetment
received reports of $213,393
worth of property stolen
during 1981. The sheriffs'
department recovered
$117,059.99 in stolen goods
during the same year, Jer
nigan said. Figures for 1982
will not be available until
mid-year, due to the con
tinuing investigation of some
ol the crimes. The sheriff's
department averaged about
five investigations of theft a
week during 1981. The
average value of the 1981
thefts was $881.79. And. 139
of the investigations were
solved that year.
"Money is one of the
hardest things to recover."
Deputy Jernigan at the
Duplin Sheriff s Department
said. "It is easily spent
without being traced. But, an
automobile is easy to trace
because of the title and serial
number of each car which is
registered with the Depart
ment of Motor Vehicles."
Household items or personal
property are difficult to
^id -htify without a serial
number or "ah identifying
mark.
The Duplin County Sher
Glenn Jernlgan
rif's department is currently
participating in.a statewide
program called Operation
Identification, a part of the
Crime Watch project started
by the Department of Crime
Control and Public Safety.
Operation I.D. involves the
marking of personal property
with the owner's drivers
license number, to make the
item easy to identify. When a
person marks property
within the home or place of
business, he or she qualifies
for an Operation I.D. warn
ing sticker. The stickers are
placed at each point of entry,
Jernigan said. The property
should be inventoried with a
description including the
brand name, serial number
or owner's identification
number and the purchase
price. The inventory should
be filed in two different
places such as the home and
office.
"The biggest problem
with the recovery of property
is identifying the items,"
Jernigan said. "You have to
be able to prove to a jury the
item belongs to you and that
is hard to do on items with no
serial number or identifi
cation number. And. we
suggest a person mark all
property with identification
numbers because many
items have serial numbers
stuck on and after a few
months or years the number
will become loose and fall
off." Jernigan suggests the
use of an electrical writing
tool to permanently embed
owner identification numbers
in property. Items such as
jewelry and silverware
cannot be marked, and Jer
nigan suggested the items be
inventoried and photo
graphed for indentification
purposes.
"If we are unable to prove
that it is stolen, the suspect
gets the property back,"
Jernigan said. "But, even
when property is recovered,
it's doubtful the victim gets
the full value back. Most of
the time the property has
been damaged in some way
and many sentimental items
cannot be replaced or re
paired." In ases where
stolen propert> is returned
and the stlspe. ^onvic"vt
judges will impose a resti
tution for the amount of
damage to the items. Resti
tution is only imposed upon
those released on probation
or paroled or allowed work
release. However, Jernigan
added, the convicted thief
can be sued in civil court for
damages.
"It's hard to know how
much good the program
(Operation I.D.) does
because we don't know the
number of times a criminal
has walked up to a door and
seen the warning sticker and
left," Jernigan said. "And,
the breaking, entering and
larceny cases are some of the
hardest crimes to solve be- ?
cause you don't know for
whom you are looking. The
suspect can be male or
female and of any race ?
there are no eyewitnesses to
help. But. we think Opera
tion l.D. is working because
we have had a report of a
breaking, entering and
larceny at a business when
all the equipment was
marked with identification
numbers but a kerosene
heater. And, the kerosene
heater was the only item
stolen."
Homeowners' policies can
help victims of theft replace
the stolen property if the
items are never recovered,
Mrs. Hilda Booth of Booth
Insurance in Kenansville.
explained. Victims of theft,
insured by a homeowners'
policy, can file a claim for
the missing items as soon as
the property is reported
missing to the Sheriff's De
partment. A homeowner's
policy covers most of the
general merchandise within
a home and most policies are
$100 deductible. A home
owner's policy d >es have
limits on payments for stolen
items such "-as silverware,
jewelry and money.
"For the owner's protec
tion." Booth said, "we often
tell then to h.sve an inven
tory of to.ir pe-sona!
property, especially silver
ware, jewelry and other more
valuable items. And, a
photograph of the items is
helpful. Items not covered
under the general home
owner's policy can be in
sured by a floater to the
policy, specifically identify
ing the items." Booth said.
"The Duplin County
average of solved thefts was
better than the national
average in 19B1." Jernigan
said. "But we won't be
satisfied until all the cases
are solved."
Board Of Education
To Plan Budget
The Duplin County Board
of Education began putting
its 1983-84 budget together
in a special meeting March 8
in the school headquarters
building in Kenansville. It
also continued a review that
began Tuesday night of long
range facilities plan.
The board will conduct
regular business at 7:30 p.m.
March 15 and continue
budget deliberations. That
meeting also will be held in
the school headquarters
building.
Craig Phillips, N.C. super
intendent of public instruc
tion. will tour county school
facilities March 16, starting
with an 8 a.m. breakfast
at North Duplin Elementary
School near Calypso. He will
visit the Warsaw,
Kenansville and East Duplin
schools and be the guest at a
reception about 3:30 p.m. at
the Wallace-Rose Hill High
School.
Phillips will take part in a
regional school superinten
dents' meeting at 7:30 at
school system headquarters.
The board plans to
approve its budget proposal
in a special meeting at 7:30
p.m. March 29. It will pre
sent its budget proposal to
the county board of com
missioners April 5.
The board was informed
by Herb McKim of Ballard,
McKim and Sawyer, Wil
mington architects, that re
placement of the Kenansville
Elementary School roof will
start this week. The work will
be done at no cost to the
school system because of the
failure of the roof on the
two-year-old building.
Warsaw Waste
System Finished
Construction of waste
water treatment facilities for
the town of Warsaw, repre
senting a cost of almost S2
million, has been completed
by Miller Building Corp. of
Wilmington, general
contractor.
The tertiary filterihg sys
tem includes a complete
laboratory of 1.200 square
feet and three pumphouses.
Tests for quality control and
purity are made in the lab.
The three-phase,610,OOO
gallon capacity filtering sys
tem includes oxidation
ditches, clarifiers and final
filtering.
The plant was designed by
McDavid Associates Inc. of
Farmvitle. engineers.
THE DERNED DOME LEAKS OR THE
CUSSED CUPOLA HAS A HOLE IN IT -
Whatever you might want to call it, that
thing on top of the Courthouse allows water
to dribble into the courtroom and it disrupts
court. Fact is, it took nine garbage cans to
catch the leaking water Monday in the main
courtroom. As the rains came down, court
had to be moved into the new courtroom.
Stacy Smith and his maintenance cr*^
rallied to the rescue. Seems some of the
timbers in the old cupola rotted, and when
there is rotted cupola lumber, it's caput. The
tapered tin top tore, too. Caput county
courthouse cupola caused catastrophet .
Well. I do declare!...
?