Illegal immigrants burden UMC

Tethered to the dialysis machine behind her reclining chair by two tubes attached to a catheter in her chest, Marta Berrera wearily stares at nothing in particular as blood flows out of, and then back into, her body.

Every four or five days, she shows up at University Medical Center’s emergency room, her failing kidneys requiring that her waste be filtered and excess fluid be removed through artificial means.

"I am so thankful to this hospital for doing this for someone who is not a citizen," she said Thursday, an interpreter translating her Spanish as she choked back tears. "Without this help, I would die and my four children would be without a mother."

Wrapped up in Berrera’s expression of gratitude is a dilemma that confounds the health care professionals at the only publicly supported hospital in Las Vegas.

"Our people are really torn," said Brian Brannman, UMC’s chief operating officer. "We want to take care of people who are ill. We’re proud that we can save lives. But our employees are also worried about the survival of UMC. They know that the appetite of taxpayers for helping undocumented immigrants is limited."

Since April, UMC has been spending about $2 million per month providing emergency dialysis services to 80 illegal immigrants, Brannman said.

He projects that these services at UMC could run more than $24 million in the current fiscal year.

In each of the five prior years, the hospital provided the same emergency services to half as many illegal immigrants for a little more than $1 million per month.

Brannman said the hospital receives no reimbursement from federal, state or local sources to provide this life-saving treatment for people who have entered the country illegally.

But under federal law, any patient who shows up at an emergency department requesting an examination or treatment for a medical condition must be given an appropriate medical screening to determine whether there is an emergency. If there is, treatment must be provided.

"When we’re projecting a budget deficit of $70 million for fiscal year 2010, you can see that $24 million in dialysis treatment that’s not reimbursed is an awfully big chunk," Brannman said.

UMC health care professionals say discussion of how to reform the nation’s health care system must include how to shore up taxpayer-supported hospitals, strained to the breaking point by following the law to care for those who are breaking it.

Health care costs for illegal immigrants, a hot-button issue in the current debate, vary widely because of the difficulty in obtaining accurate information on illegal immigrants. But all estimates run into the billions of dollars.

UMC staffers contend more efforts also must be made to persuade foreign nationals to head home for care.

And, they say, unless there is meaningful immigration reform, taxpayers can expect to pay more to wait longer for their own emergency services.

"There’s no question that these illegals who come for dialysis treatment at emergency rooms back everything up," said Dr. Dale Carrison, UMC’s head of emergency services, adding that most require treatment two or three times a week. "And there’s also no question that they need help. But this isn’t how emergency rooms were meant to be used."

MEDICARE COVERS U.S. CITIZENS

Carrison said the four dialysis chairs on the fifth floor of UMC were designed for hospital patients who suddenly become ill, and not for those in need of chronic care.

U.S. citizens with end stage renal disease automatically qualify for Medicare to cover dialysis costs.

Illegal immigrants are not eligible for Medicare, however.

As a result, patients who have neither insurance nor Medicare to pay for dialysis are almost exclusively illegal immigrants, a distinction that allows hospital officials to estimate costs for their care.

"What they figured out is that if they come to emergency rooms, we’ll dialyze them if they’re in bad enough shape," Carrison said of illegal immigrants.

Using emergency rooms this way is costly and dangerous, he said, adding that a full screening with lab tests is done each time an individual comes to the emergency room.

"Unless it’s a real emergency, we don’t do dialysis on them, so their body is in bad shape," Carrison said.

Brannman said it isn’t unusual for an illegal immigrant to wait for eight hours for treatment, only to be told their condition isn’t bad enough for treatment that day.

"Then they’ll come back a day or two later really sick," he said.

Carrison said dialysis patients covered by Medicare have their own doctors who are aware of their conditions, so expensive tests need not be done repeatedly.

According to Brannman, the cost at UMC can run from $11,000 to $18,000 per visit for an emergency dialysis patient.

The high costs reflect these tests and that the patients’ health might have worsened to the point that they need more than just dialysis to stabilize their condition.

The June issue of the American Journal of Kidney Diseases reported on a Texas study that found that the cost of dialysis care was 3.7 times greater when done through the emergency room than through the usual doctor-guided treatment program at a dialysis center.

"The federal government kicked the can down the road on the immigration issue and gave the bill to us," Brannman said. "This is a federal policy failure that is driving huge health care costs to our citizens."

The monthly cost for emergency dialysis for illegal immigrants has nearly doubled since April. This can be attributed not only to the loss of jobs, but also to the ending of a long-term contract with an outside dialysis provider to cover about 20 chronic dialysis cases for illegal immigrants at about $2 million a year, Brannman said.

The contract was terminated because of a budget shortfall, and the $2 million was shifted to other services, including upgrading the hospital’s neonatal unit.

But it now appears the decision backfired, as the 20 chronic care patients became more expensive emergency care patients.

"We had to make some hard choices, and we didn’t think the county should be renewing a contract to help a small number of undocumented, anyway," Brannman said. "We didn’t think we should be in the business of making contracts for illegal immigrants. And you also have to remember these undocumented people don’t have to just come to UMC for emergency dialysis care. Remember under federal law, any emergency department has to take them."

Attempts Friday to find out what other hospitals in the Las Vegas Valley handle emergency dialysis for illegal immigrants were unsuccessful.

Carrison said he has found illegal immigrants discharged from other hospitals who were told to come to UMC for their emergency dialysis care.

Brannman said a UMC social worker told him that one of the illegal immigrants reported that at another hospital he was threatened with being turned over to immigration authorities if he didn’t go to UMC for treatment.

Repeated attempts to get Medicaid payments from the state to pay for emergency dialysis for illegal immigrants have been unsuccessful, Brannman said.

Yet Ben Kieckhefer, a spokesman for the state Department of Health and Human Services, said Friday the state will pay for "true emergencies."

"It appears that it comes down to what the definition of an emergency is," Brannman said. "Our doctors obviously believe that these people would die without dialysis."

GRATEFUL FOR CARE

Brannman said he has also asked for help from Mexican authorities.

Mariano Leuma Gas, the consul for Mexico in Las Vegas, said he has been working with UMC to try to send some illegal immigrants back to their home country for care.

Brannman said Gas has helped UMC on other health care issues, finding funding to send Mexican patients from Las Vegas to Mexican hospitals. But he said they have been unsuccessful in persuading dialysis patients to go home for care.

"You have to remember that I can’t make them go back, but families often want them to," Gas said. "The problem is the economy is so bad in Mexico now, too, and there often is a long wait for dialysis. But I think we can work out this problem. We need to talk more."

All three individuals in the UMC dialysis section interviewed Thursday admitted they were without insurance and in the country illegally.

The 34-year-old Barrera, who came to the United States 16 years ago, said she has been receiving dialysis treatment through UMC since December 2007.

Her condition worsened so dramatically recently that she had to spend a costly eight days in the hospital.

Another patient in the dialysis room Thursday, 47-year-old Felipe De Arcos Rodriguez, said he once had to be hospitalized for two months when he waited too long to get dialysis.

The cost of care over that period would be at least in the tens of thousands of dollars, with the final cost dependent on the lifesaving measures that had to be undertaken.

Rodriguez said he has been receiving dialysis for six years and seven months. His arms are full of bumps where tubes were inserted for the procedures and scar tissues formed.

Because he is not an American citizen, he is not eligible for a transplant.

"I’ve been in a coma four times and UMC saved me," the Mexican immigrant said. "I am very grateful to UMC. It is a great place. I try to pay the hospital $50 a month."

Emergency dialysis patient Ricardo Valladares, who came to the United States from El Salvador, said the fact that UMC gives treatment to non-citizens shows that the hospital has a big heart.

"They are special people," he said.

Berrera prays that UMC will never stop giving dialysis help to everybody.

"My husband is in jail now," she said, stressing that other family members were watching her children while she was in the hospital.

"I need to keep fighting to get better. With God and UMC, I will. And then I will be able to help my children."

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

ad-high_impact_4
News
Protesters Line Streets for President Trump's Arrival in Las Vegas
Hundreds lined the streets in front of Suncoast to protest President Donald Trump's arrival in Las Vegas. (Madelyn Reese/ Las Vegas Review-Journal)
Thunder Mountain monument stands as a tribute to Native American culture
Caretaker Fred Lewis talks about Thunder Mountain monument in central Nevada, made from concrete and found items. The five-acre site is a tribute to Native Peoples of the West. (K.M. Cannon/Las Vegas Review-Journal)
New CCSD superintendent Jesus F. Jara aims for 1st in the nation
On his third day as Clark County School District superintendent, Jesus F. Jara talks about his vision for the future during a visit to Del Sol Academy of the Performing Arts on Thursday, June 21, 2018, in Las Vegas. (Marcus Villagran/Las Vegas Review-Journal) @brokejournalist
Ceremony Recognizes Refugee Students, Graduates
Rosy Mibulano, a graduate of Las Vegas High School who came to America from the Congo in 2015, was recognized in a ceremony for refugee students in Clark County. Like many other students relocated to Las Vegas from countries around the world, Rosy had a challenging high school experience, from learning English to adjusting to American customs and taking care of her family. On top of that, she wants to go to school to become a nurse so she can take care of her mother, who suffers from diabetes. The annual Refugee Recognition Ceremony celebrates the enormous lengths these young adults go through to create a new life for themselves. (Madelyn Reese/Las Vegas Review-Journal)
Paul McCartney is worth over $1 billion
Sir Paul McCartney is one of the most celebrated and accomplished musicians in history. He just turned 76 on June 18. McCartney grew to international fame with the Beatles and went on to become a wildly successful solo musician. Paul McCartney’s net worth is estimated at $1.2 billion, according to Celebrity Net Worth. In 2017, McCartney landed the No. 13 spot on Forbes’ list of the world’s highest-paid musicians, earning $54 million for the year. On Thursday, June 20, McCartney will release a double A-side single featuring two new songs, "I Don't Know" and "Come On to Me." McCartney has yet to announce a title of his new album or when it will be released. Th album is expected to be released before he headlines the Austin City Limits Music fest in October.
Water leak at Mandalay Bay convention center
The convention center area of Mandalay Bay in Las Vegas experienced major flooding Tuesday afternoon. Credit: Melinda Cook
Hollywood Memorabilia Up For Grabs at Las Vegas Auction
Elvis Presley's car, Marilyn Monroe's bras, Han Solo's blaster, and Jerry Lewis's "Nutty Professor" suit are just some of the items that are up for auction at Julien's Auctions at Planet Hollywood June 22 and 23. The auction's viewing room at Planet Hollywood is open to the public 11 a.m. to 6 p.m. daily through Saturday at Planet Hollywood. (Madelyn Reese/Las Vegas Review-Journal)
Indoor farming in Southern Nevada
Experts discuss Nevada's indoor farming industry. (Bailey Schulz/Las Vegas Review-Journal)
Former Fontainebleau could have become a Waldorf Astoria
Months after developer Steve Witkoff bought the Fontainebleau last summer, he unveiled plans to turn the mothballed hotel into a Marriott-managed resort called The Drew. But if Richard “Boz” Bosworth’s plans didn’t fall through, the north Las Vegas Strip tower could have become a Waldorf Astoria with several floors of timeshare units. (Eli Segall/Las Vegas Review-Journal)
New Springs Preserve Exhibit Shows Off "Nature's Ninjas"
"Nature's Ninjas" arrives at the Springs Preserve, in an exhibit and live show featuring critters that come with natural defenses, from armadillos to snakes, poison dart frogs to scorpions and tarantulas (Madelyn Reese/Las Vegas Review-Journal)
CrossRoads of Southern Nevada psychiatric urgent care to open in Las Vegas
Jeff Iverson, who operates the nonprofit sober living facility Freedom House, is opening a private addiction treatment center that will operate a detoxification center and transitional living for substance users trying to recover. (K.M. Cannon/Las Vegas Review-Journal)
Metro Capt. Jaime Prosser gives update of officer-involved shooting
Metro Capt. Jaime Prosser provides an update about an officer-involved shooting at Radwick Drive and Owens Avenue in the northeast Las Vegas on Thursday. A robbery suspect was shot and killed. (Bizuayehu Tesfaye/Las Vegas Review-Journal) @bizutesfaye
Wayne Newton surprises burglars
Wayne Newton and his wife, Kathleen, arrived at their southeast Las Vegas home shortly before midnight on Wednesday to find two burglars inside their house. The burglars fled and were seen heading north through the property. Las Vegas police quickly set up a perimeter and launched an extensive search of the area, but the suspects were able to escape. It was unclear if the burglars got away with anything of value. Several items, under the watchful eyes of the police, were seen on the ground near the home's main driveway. Neither Newton, nor his wife, were injured. The Newtons were not available for comment.
Police Officers Turn Off Body Cameras
In four separate body camera videos from the Route 91 Harvest festival shooting released Wednesday, officers in a strike team are instructed to turn their body cameras off and comply with the request.
Debra Saunders reports from Singapore
Las Vegas Review-Journal White House correspondent talks about the historic summit between President Donald Trump and North Korea's leader Kim Jong Un.
How long will North Korea's denuclearization take?
In Singapore, Las Vegas Review-Journal White House correspondent Debra Saunders asks President Donald Trump how long North Korea's denuclearization will take. White House video.
LVCVA purchase of gift cards hidden
A former LVCVA executive hid the purchase of $90,000 in Southwest Airlines gift cards in records at the agency. Brig Lawson, the senior director of business partnerships, said the money was for promotional events and did not disclose that it was for gift cards. Lawson also instructed Southwest employees to submit invoices without mentioning the purchases were for the cards. More than $50,000 of the cards cannot be accounted for. The convention authority is publicly funded . Lawson recently resigned.
Kim Jong Un visits Marina Bay Sands in Singapore
North Korean leader Kim Jong Un and his entourage visited the Marina Bay Sands in Singapore briefly Monday night, local time. (Video by Philip Chope)
Coca-Cola Bottle Purse Has 9,888 Diamonds
Designer Kathrine Baumann and jeweler Aaron Shum set the Guinness World Record for most diamonds (9,888) set on a handbag. The Coca Cola bottle-shaped purse was on display at the Coca Cola Store on the Strip. (Madelyn Reese/Las Vegas Review-Journal)
Sentosa Island a pleasure resort with a pirate past
The site of Tuesday's U.S.-North Korea summit is known for theme parks and resorts. But before that, it was known as a pirate island. (Debra Saunders/Las Vegas Review-Journal)
Judge Sandra Pomrenze's comment about girl's hair
Nevada Races Full of Women From Both Sides
It's already been a historic election season for women in politics. Record numbers of women are running for political office all over the country - including Nevada. (Madelyn Reese/ Las Vegas Review-Journal) @MadelynGReese
East Las Vegas home damaged by fire
Clark County Fire Department crews responded to a house fire in east Las Vegas Thursday morning. (Bizuayehu Tesfaye/Las Vegas Review-Journal) @bizutesfaye
911 call: Mom tries to get to son shot at Route 91
A woman stuck on the interstate during the Route 91 Harvest festival shooting on Oct. 1, 2017, in Las Vegas, tries to get to her son. 911 call released by Las Vegas police.
Las Vegas 911 caller reports people shot on Oct. 1
A 911 caller on Oct. 1, 2017, reports several people shot at the Route 91 Harvest festival in Las Vegas.
911 call from woman under stage in Las Vegas shooting
A 911 call from a woman underneath the stage at the Route 91 Harvest festival during the Oct. 1, 2017, Las Vegas shooting.
LVCVA facing scandal over gift cards
LVCVA is facing a growing scandal over airline gift cards. LVCVA bought $90,000 in Southwest Airline gift cards between 2012 and 2017. Now auditors can’t account for more than $50,000 of the cards. CEO Rossi Ralenkotter and his family used $16,207 in gift cards on 56 trips. Brig Lawson, the senior director of business partnerships, was responsible for buying and distributing the cards. He recently resigned.
Siblings separated in the foster care system get a day together
St. Jude's Ranch for Children and Cowabunga Bay Cares program partnered to bring 75 siblings together for the day to play on the water slides and in the pools at the Henderson water park. (K.M. Cannon/Las Vegas Review-Journal)
People flee the Route 91 Harvest festival on Oct. 1, 2017
Las Vegas police released footage from a camera on Mandalay Bay of the Route 91 Harvest festival on Oct. 1, 2017
Aaliyah Inghram awarded medal of courage
Aaliyah Inghram, a 10-year-old girl who was shot while protecting her 18-month-old brother and 4-year-old cousin during a shooting on May 8, awarded medal of courage. Bizuayehu Tesfaye/Las Vegas Review-Journal @bizutesfaye
TOP NEWS
News Headlines
ad-infeed_1
ads_infeed_2
Local Spotlight
Home Front Page Footer Listing
Circular
You May Like

You May Like