Fairview Closes Tamarack Clinic

Given that Medicare provides inadequate reimbursement for the customized wheelchair seating systems, Fairview Health Service, on July 1, 2004, told the staff of Tamarack Clinic, which provides customized seating, that the clinic would close at the end of July.

These seating systems are a critical component for adequate health care for the persons served by the Tamarack Clinic, most of whom are adults with spinal cord injuries or multiple sclerosis. Without proper seating systems, pressure sores can develop within hours. The skin dies, and creates a breeding ground for infection. These wounds can travel to the bone and without immediate attention can become life-threatening. An experienced wound nurse said the loss of Tamarack’s services would be “devastating” for its patients.

Tamarack’s seating systems help to heal and to prevent pressure sores. These seating systems also enable persons with very involved physical disabilities to work and to be out and about in our community.

Fairview stated that its action was “necessitated by changes in Medicare reimbursement.” Fairview’s actions cannot be justified on that basis. Fairview says it was losing $15,000 to $20,000 per month on the clinicBup to $240,000 per year. However, in 2003, Fairview Health Services had net revenue over expenses of $60 million. Fairview’s administration said that’s not very much, considering that Fairview had total expenses in 2003 of $1.6 billion. By the same token, $240,000 isn’t very much compared to profit of $60 million. Nor is it very much compared to the cost of hospital care and treatment for the pressure sores these seating systems prevent.

Medicare’s policies need to be changed. They unwisely and unfairly focus on keeping people at home and away from work. Demonstrators asked Fairview to hold off on closing the clinic and to join with advocacy groups to challenge Medicare. Fairview would not do that, even on a short term basis.

Fairview was gifted the Tamarack Clinic from a private entrepreneur who lacked the resources to operate it because of the lack of Medicare reimbursement payment policies. The hope was that as a part of a larger healthcare business, this clinic could survive. Now Fairview justifies its actions by claiming that Gillette Specialty Healthcare (a nonprofit organization that historically has served children and that has a total budget only a little larger than Fairview’s profits) and another small, private wheelchair company will be able to serve the people Tamarack did. If Fairview cannot, how can they?

Perhaps Fairview should not be expected to provide a needed service at a loss on an extended basis, even in a $1.6 billion dollar operation, but Fairview is not just any other business accountable to stockholders. It is a nonprofit corporation established with the stated mission “to improve the health of the communities we serve.” Yet Fairview terminated this service without advance notice to its patients and without any assurance that alternative services would in fact be available. As a health care provider, its bottom line should have been to do no harm.