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This taxpayer-funded hospital in Louisiana has a $25M surplus — and it only treated 64 patients



MONROE, La. – Prevost Memorial Hospital saw its surplus cash, investments and other assets hit nearly $25.5 million in the fiscal year ending last August, though the pandemic scared away many non-COVID patients for months and cut into the availability of nursing staff, hospital officials and their latest audit say.

Hospital Administrator Vince Cataldo recently told Ascension Parish officials that the 25-bed hospital in Donaldsonville saw just 64 patients in all of pandemic-affected 2020. He later clarified in an interview that number was only “inpatients” staying overnight. Total patient numbers were far higher, he added.

Still Cataldo’s comments and the western Ascension hospital’s overall financial health raised eyebrows among council members who have scrutinized its taxpayer-subsidized budget for several years and criticized what they view as its lack of investment in aging facilities. Others called for more public services in one of Ascension’s poorest, health-needy communities.

Councilman Chase Melancon asked Cataldo to consider quarterly events for the west bank that could offer preventive health care, like mammograms and pap smears. Councilman Aaron Lawler criticized the hospital’s lack of wheelchair-accessible bathrooms in patient rooms.

“That’s terribly disappointing that, in this day and age, with $30 million in assets, people will have to go into a hospital and can’t be in a wheelchair and use a bathroom with dignity in their own room,” Lawler told Cataldo. “We have talked about this for years.”

The quasi-public hospital is overseen by a Parish Council-appointed board and collects revenue from a half-cent sales tax in western Ascension. The tax generates about $1.2 million to $1.4 million a year.

In comments to the council and in a later interview, Cataldo promised that the waning pandemic and likely resolution of a land dispute this summer have the hospital on the cusp of spending some of those surplus dollars on a new medical office complex aimed at drawing new specialists and services. He expects a groundbreaking this year.

Cataldo, who has worked at Prevost since it opened in 1968, said patient rooms will be renovated, which will lower the number of beds by a quarter but provide more space and handicap-accessible bathrooms.

In recent years, the hospital has replaced a leaking roof and, more recently, annexed an existing medical office to upgrade as part of a new lease with Our Lady of the Lake Physician Group.

“We haven’t exactly been sleeping, as Mr. Lawler seems to think,” Cataldo said.

The bulk of available dollars on the hospital’s balance sheet are socked away in investments that Cataldo said are counted on for annual returns to supplement the hospital’s budget. Sales tax revenue goes almost entirely to the $100,000 set aside each month for uncompensated care.

The two council members who represent western Ascension rose to Cataldo’s defense during the council meeting last week, citing the coming improvements.

“I think, at this time, pretty much everything is in a forward motion,” Councilman Alvin “Coach” Thomas said, “and I can appreciate Mr. Lawler’s comments on some of the stuff that’s been going on, but again things are moving forward, and it will be attended to ASAP.”

Major hospital chains have continued to move into Ascension Parish in recent years. The parish government, sheriff and school officials also are talking about a new wellness center aimed at improving health care and child care access to western Ascension.

The biggest medical investments have happened on the parish’s populous, wealthier and growing east bank, including by the nonprofit corporate parent of Our Lady of the Lake Regional Medical Center, Baton Rouge General and Ochsner Health system.

But, in nearby northern Assumption Parish, Thibodaux Regional Medical Center recently started construction on a 20,000-square-foot physician clinic and wellness center planned for La. 70 Spur in Plattenville, about 12 miles from Prevost.

Prevost’s total number of patients, most of whom are outpatients, dropped during the pandemic but remained in the hundreds per month, even at their lowest point, Cataldo said. They currently average around 1,000 per month.

Nationwide, trends for rural hospitals have seen revenues shift toward outpatient services, according to the American Hospital Association.

At St. James Parish Hospital in Lutcher, which also gets taxpayer dollars, about 88% of its revenue is in outpatient services, a hospital spokeswoman said.

When asked,  spokeswoman Kassie Roussel said St. James hospital had more than 64 inpatients last year, but she attributed many to the its new five-bed “Progressive Care Unit.” The unit was conceived before the pandemic, but allowed the hospital to hold more serious COVID patients.

“Our PCU has the monitoring equipment, design and specially-trained staff to care for patients needing a higher than typical level of care,” Roussel said.

Cataldo said his hospital stopped taking COVID patients after initially receiving some because officials learned many would need specialty care that wasn’t available.

Beginning in early 2015, two former west bank parish council members began questioning the hospital’s finances and pitched a plan in 2017 to re-dedicate half of the hospital’s half-cent tax for recreation, arguing it was overfunded and could afford the loss.

The measure went to the ballot in fall of 2018 amid an extended closure of the Sunshine Bridge due to a Mississippi River barge crash.

The crash highlighted the west bank’s limit health care access, and the tax swap failed handily. The councilors who backed the initiative lost re-election in 2019.

Since the end of fiscal 2015, the hospital’s surplus cash, investments and other assets rose by 56%, up from $16.3 million to $25.5 million, audits show. The 2020 balance sheet benefited from several million in COVID stimulus dollars and investments that were cashed.