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BMH officials say COVID-19 patients are not lucrative for the hospital

Officials offer a definitive “no” to questions about whether Blount Memorial Hospital has made money off of COVID-19 patients — a query about hospitals that repeatedly has resurfaced throughout the pandemic, most notably by former President Donald Trump.

“The hospital has not profited off of caring for individuals hospitalized with COVID-19,” BMH Chief Financial Officer Jonathan Smith emailed The Daily Times. “In fact, we’ve lost money in caring for these patients, as the care required for a COVID patient is intense and costly.”

Chief Medical Officer Dr. Harold Naramore said during the Jan. 26 BMH board of directors meeting that he’s frequently heard people say hospitals are admitting coronavirus patients to profit. This, he said, is not true.

Echoing Smith’s statement, Naramore said taking care of COVID-19 patients is a “money-losing proposition for hospitals.”

“That being said, the hospital exists to care for our community and support the health of this community,” he said. “We’ve been honored to be able to help ease the suffering and aid in the recovery of hundreds of COVID-19 patients.”

Hospitalization for any illness is notoriously costly, but COVID-19 racks up hospital bills in unique ways. Costs mount when hospitals factor in personal protective equipment, additional staff and the length of inpatient stays, Naramore said.

“... (W)hen you look at all of that as a whole, it’s a lot,” he said, adding that there’s more included in the daily management of COVID-19 in comparison to other illnesses.

Among the most expensive parts of being hospitalized with COVID-19 are the medications and treatment therapies, which can cost thousands.

One of the leading treatments for the coronavirus in hospitalized patients is remdesivir, an antiviral medication that decreases virus multiplication in the body. Patients usually receive six intravenous doses, Naramore said.

“It’s an effective medication, but it’s not a magic bullet that cures COVID,” he said.

Remdesivir became a well-known COVID-19 treatment after Trump received the drug during his coronavirus hospitalization in October.

Blount Memorial began using the medication to treat COVID-19 inpatients in May. Since then, Smith said the hospital has administered 2,006 remdesivir doses to roughly 334 patients as of Friday, Jan. 29.

Shortly after remdesivir received its U.S. Food and Drug Administration emergency-use approval, the manufacturer, Gilead Science Inc., donated 607,000 vials to American hospitals. Worldwide, Gilead donated 1.5 million vials of the antiviral drug.

The U.S. Department of Human Health Services (HHS) announced May 9 that Tennessee hospitals would get seven cases of remdesivir from the donation.

Receiving some of the allotted doses, Blount Memorial was able to give the drug to coronavirus inpatients for free until July 7, Smith said.

“... (W)e’ve worked to ensure that any resource that’s out there to support the care of COVID patients is readily available to our patients here in Blount County,” Naramore said.

After July, the hospital had to purchase the drug, which Gilead announced in June would cost roughly $3,200 per patient.

Remdesivir is covered to some degree by private and government insurers. People without insurance receive financial assistance for the drug through the Coronavirus Aid, Relief and Economic Security (CARES) Act, according to the HHS.

Altogether, Smith said the hospital has spent $1,261,000 on remdesivir.

The $1.26 million spent on the treatment has surpassed any federal and state assistance the hospital has received for treating COVID-19 patients — including the CARES Act, which requires Medicare to provide a 20% incentive payment on top of the normal payment for taking care of coronavirus patients.

Smith said as of Friday, Jan. 29, Blount Memorial had gotten $707,955.25 in COVID-19 incentive payments from Medicare.

“The 20% premium doesn’t begin to address the costs of remdesivir, the longer lengths of stay, the additional staff required to care for hospitalized COVID patients, the additional personal protective equipment needed, and the additional medications and therapies that these individuals require,” Naramore said. “They’re sick, and to care for these individuals, it’s costly.”

To make up for these costs, Blount Memorial has applied for a Federal Emergency Management Agency (FEMA) grant.

“Due to the pandemic and the associated disaster declaration, eligible entities are able to apply for reimbursement for qualified expenses with a reimbursement up to 75%,” Smith said.

FEMA also could reimburse the hospital for some of the costs associated with administering COVID-19 vaccines, Naramore said.

Blount Memorial, which gave vaccines to all employees and volunteers and is currently vaccinating people ages 75 and older with a primary care physician belonging to Blount Memorial Physician’s Group, has weekly vaccination costs of around $20,000, Naramore said, estimating a $125,000 total vaccination costs to the hospital.

As of Feb. 4, the hospital had administered 8,212 COVID-19 vaccines, BMH Director of Marketing Jennie Bounds said.

Vaccine costs include staff and supplies needed to give the shots. All doses and some supplies are free since the vaccine is still under emergency-use authorization. There is no charge to patients for receiving a vaccine.

“At the end of the day, we feel that providing this service is one that benefits our community — and while the cost is significant to us, it’s still something we want to do to help improve the health and well-being of Blount Countians,” Naramore said. “That’s our mission, and it’s why we exist.”

State attorney general sues Food City over opioid sales

A lawsuit filed Thursday by the Tennessee attorney general accuses grocery chain Food City, and three Knoxville locations in particular, of helping fuel the opioid epidemic.

Tennessee AG Herbert H. Slatery III filed the lawsuit in Knox County Circuit Court against Food City Supermarkets LLC and parent company K-V-A-T Food Stores Inc.

It was brought forth “to protect the public, to abate and remedy Defendants’ participation in an unlawful controlled substance selling scheme, and to preserve the integrity of the commercial marketplace,” the official complaint states.

The complaint, which totals 208 pages, accuses the defendants of “aiding and abetting the unlawful sale of narcotics and controlled substances including 30 milligram immediate release oxycodone,” citing Knoxville stores on Kingston Pike, Morrell Road and Hardin Valley Road.

According to the lawsuit, Food City allegedly sold opioids with more morphine milligram equivalents at the Kingston Pike location than all pharmacies across 81 counties, while also pressuring employees to increase opioid sales and fill suspicious prescriptions, retaining employees at lucrative stores despite violations and illegally and secretly transferring opioids across its pharmacies.

Food City strongly denied the accusations.

Other allegations in the lawsuit include that the company sold more than 206 million prescription opioids, with almost 25% of those sales occurring at the Kingston Pike location; sold more than 42.5 million Oxy 30 pills, with 44% sold at the Kingston Pike location; and ignored or watered-down reports of suspicious prescribers and continued selling opioids despite those medical professionals being arrested, raided, disciplined or indicted.

The lawsuit also states the company routinely sold large quantities of “high risk” prescription combinations, particularly a combo of an opioid, a benzodiazepine and a muscle relaxer dubbed “The Holy Trinity;” sold Oxy 30 and other prescription opioids to drug-trafficking criminals; and bought more Oxy 30 from wholesale drug company AmerisourceBergen between October 2011 and January 2012 than any of its other customers.

“Food City made a lot of money from filling opioid prescriptions. In itself that’s not a problem. The problem is how they did it,” said in a press release. “The company knew its customers were addicted. It knew the pill mills writing the prescriptions were some of the worst actors at any level of the opioid crisis.

“But Food City did virtually nothing that would disturb that income stream. It stoked the market with the most diverted and abused opioids, pushed its pharmacists to sell more and more, and ignored the most alarming evidence — overdoses and illegal sales taking place right outside the pharmacy door.”

The lawsuit also accuses Food City of enabling a hot spot for criminals by discounting opioids with a prescription savings card program, making its pharmacies hoard opioids and other controlled substances and soliciting secondary suppliers when its main supplier reduced thresholds at its highest-volume pharmacies.

The lawsuit alleges Food City continued selling opioids despite overdoses in its stores and parking lots, pushed back against reports of compliance issues and sold opioids to people from numerous foreign countries.

Accusations are ‘grossly incorrect,’ says Food City

Food City and its parent company strongly deny the allegations.

“K-VA-T vehemently disagrees with the allegations contained in the lawsuit and will vigorously defend itself through the litigation process,” the company said in a statement provided to The Daily Times.

“The lawsuit’s allegations are grossly incorrect and unfair regarding Food City’s approach to serving its pharmacy customers. K-VA-T recognized during the relevant time period that a few of its pharmacies dispensed a high volume of pain management prescriptions.

“Therefore, the company contracted with independent auditors and experts in pharmacy best practices to assure that its dispensing practices were compliant with all state and federal regulations.”

The company said it “has regularly been subject to oversight and inspection by state and federal regulators, including the Tennessee Board of Pharmacy.”

Its pharmacies filled prescriptions written by state-licensed physicians and health care professionals who were registered with the U.S. Drug Enforcement Administration, the company said.

“The methods, practices and physician perspectives on pain management have changed dramatically over the past decade or more, and it is unfortunate that this course of action was pursued more than a decade after most of the allegations cited by the Attorney General’s office allegedly occurred,” the company said in the statement.

“The Attorney General unfortunately has joined the nationwide bandwagon led by the plaintiff’s bar in bringing meritless attacks against pharmacies, having failed to make measurable progress in its efforts to hold manufacturers, distributors, and physicians accountable.”

The company said it cooperated fully with Slatery’s investigation before he filed the complaint, and that rejected attempts to resolve the matter.

“It is particularly troubling that the Attorney General chose this particular time amid the already challenging COVID-19 burdens to attack a local business that the State of Tennessee has deemed essential — a company that is an employer of thousands of Tennesseans during the worst economic environment in recent history,” the company said in the statement.

“However, K-VA-T will expend its time and resources to defend itself to correct the serious misrepresentations made by the Attorney General,” the company statement said.

The company also asserted its locally owned, customer-focused image, citing its work with community-based organizations and stating more than 12% of the company is owned by some of its associates through its Employee Stock Ownership Program.

When contacted by The Daily Times for comment, all three Food City locations in the Maryville-Alcoa area declined, telling the newspaper to contact corporate representatives.

Despite litigation, Publix still coming
  • Updated

Publix is still moving forward with plans to build a store in Blount despite being stalled by legal differences that have dragged on for more than a year.

Company Media Relations Manager Jared Glover emailed The Daily Times on Wednesday the company hasn’t abandoned its plans, first announced in July 2020.

“We can confirm that we are still moving forward with the Publix in Maryville,” Glover emailed.

Mike Cohen, a media representative for Knoxville-based developer CHM LLC, said in a text message Monday: “The developers are still moving forward with the project.”

But litigation is ongoing.

The branch of CHM responsible for managing a project that was supposed to see the old Sears building torn down and a Publix built nearby has been defending its case against Foothills Mall ownership since August 2020.

According to filings, CHM and mall owners disagreed on plans to move forward with the grocery store long before then.

The case was still open in Blount County Circuit Court at the beginning of February and its most recent filing was in September 2020.

New York City-based Time Equities Inc. currently owns the mall and, in its original lawsuit (at least 400 pages long) stated Publix was violating certain decades-old agreements attached to the land, some preventing developers from significantly altering the mall’s landscape.

Tearing down the vacant Sears, legal counsel for Time Equities argued, would do just that.

CHM countered in legal filings it couldn’t be held liable for something it intended to do but had not yet.

In a recent email to The Daily Times, Abby Drapeau with Time Equities public relations said the company wouldn’t comment while the matter was still in court.

“Time Equities cannot comment on ongoing litigation,” she emailed.

Originally, CHM said the grocery store would open by mid-2021. Even though company officials say it’s moving forward, they have not discussed a new or altered timeline.