By Mark Waite

TONOPAH — Nye Regional Medical Center employees have been laid off with the closure of the Round Mountain and Beatty clinics, but the hospital isn’t closing, Dr. Vincent Scoccia, chief executive officer of Primecare Nevada said Wednesday.

“No, the hospital is not closing unless some sort of unforeseen black swan event occurs,” Dr. Scoccia said.

Rumors about Nye Regional Medical Center closing Aug. 13 have been swirling in the local community. Tonopah resident Al Robertson brought the issue up under public comment at the July 3 Nye County Commission meeting, who said 14 employees received layoff notices two weeks ago.

Beatty still has a federally-subsidized clinic operated by Nevada Health Centers Inc., Round Mountain has a clinic but only for mine workers.

Dr. Scoccia admitted Medicare payments have been withheld pending an audit. Primecare is also hurting after Round Mountain Gold pulled its lab work.

“We’ve been going out of business for 13 years. What we did have to do, we had an outreach clinic in Round Mountain, Nevada as well as Beatty, Nevada. The mine pulled its lab business from us, they gave all their lab business to Quest, which our organization is a privately-held organization, we have to pay as we go. We get no public support. In any business when you lose any income stream you have to downsize,” Scoccia said.

The employees were laid off to protect the core workers at Nye Regional Medical Center, he said.

Dr. Scoccia described the Recovery Audit Control RAC his facility is undergoing as standard practice. However he said large institutions like Renown Health Centers or University Medical Center have better resources to appeal the RAC audit findings, which statistics show are overturned 75 percent of the time.

“About a week ago they held $100,000 in Medicare money because of this RAC audit. We can appeal those but it takes time and money,” Dr. Scoccia said.

The portion of Nye Regional patients using Medicare or Medicaid is only about 25 percent, Dr. Scoccia said, but he added, “we’re running a small business. That’s a significant portion, that’s a quarter of our business.”

He faulted the system.

“Local government is broke, state government is broke, so they’re always in here looking for money they have given you,” Dr. Scoccia said. “What the government does, they have these third party auditors to come into doctor’s offices, hospitals, pharmacies to look for discrepancies. Initially it was coding errors. Now they’ve gone into medical necessity.”

“They only get paid if they find something. So of course they find something,” he said.

NRMC Chief Operations Officer Susan H. Hughes was a little less optimistic.

“It’s a 50/50 chance that the hospital will stay open,” she said. “I feel in my heart it is better than that.”

The hospital problems are rooted in larger health care issues, Hughes said: fewer patients are insured and there are changes coming down from the federal government.

Hughes said the hospital could attempt to obtain rural outreach funds which may be available for Nye Regional but have previously been untapped.

“I don’t know what will happen without outside intervention,” Hughes said.

Dr. Scoccia also claims Nye County hasn’t paid medical indigent bills since 1999.

“The Nye County Sheriff’s Department owes us over $1 million. They have not paid us in over the last six years. We may look big and have all this fancy equipment but we live paycheck to paycheck,” he said.

“You know what the county’s response is? Sue us. Why should we have to sue you? You owe us money!” the doctor said.

Commissioner Joni Eastley said she received calls from residents who claimed Dr. Scoccia told them he was being forced to announce an Aug. 13 closure date because of the bills Nye County owed him.

“I heard various stories, from $1 million to $2 million, which is patently false. We owe him no money,” Eastley said.

During a meeting with Dr. Scoccia, the doctor asked her to go into the community and solicit donations, Eastley said.

Eastley said Dr. Scoccia told her the federal government was withholding his Medicare and Medicaid payments pending what he called a perfectly legitimate audit. He also mentioned the cancellation of the lab contract.

Wendy Simmons, Nevada Health Division chief of health care quality and compliance, said her office wasn’t informed of any closure of Nye Regional Medical Center. The division would be informed of any change in ownership, she said.

Dr. Scoccia said he hopes to reopen the Beatty and Round Mountain clinics in the next 60 to 90 days.

“We’re not closing our doors, we’re fighting. We’re fighting like we have been the last 13 years,” he said.

Primecare was about to add ancillary services to the Beatty clinic operated by Nevada Health Centers, like X-ray and ultrasound equipment, as well as a lab, before the mine pulled their business, Dr. Scoccia said.

Nye County has been extending contracts with Nevada Health Centers Inc. for $17,850 to operate the Beatty clinic on a month-to-month basis.

Nevada Health Centers Chief Executive Officer Tom Chase said, “we’re talking with Nye Regional as to what their continued presence is going to be in Beatty and how it’s going to look. We’ve been having active discussions with them. When those are completed, we’ll advise both the town advisory board and the county of what we’re thinking and get input from both and from there probably propose a contract.”

Chase feels an annual contract with the county for the Beatty clinic will be ready soon.

“From our perspective I strongly believe we’re going to be operating in Beatty for quite some time. That’s my personal belief and that’s the direction in which we’ve been talking with Nye County, there’s going to be a presence for Nevada Health Centers,” Chase said.

Nevada Health Centers has a nurse practitioner in Beatty who will be stationed there a minimum of 18 months and a physician’s assistant manning the Amargosa Valley clinic, Chase said. The company operates rural clinics elsewhere in Nevada like Eureka, Carlin and West Wendover. The Amargosa Valley Town Board is mulling over a contract proposal with Nevada Health Centers, he said.

Former Nye Regional Medical Center Chief Executive Officer/Administrator Mark Latcheran claimed questionable business practices at Nye Regional Medical Center in a suit filed in federal court last September after his October, 2010 termination. U.S. District Judge James Mahan however dismissed Latcheran’s claims he was terminated in breach of his three year contract. Mahan noted Latcheran admitted he didn’t report his concerns to the authorities before his termination.

Latcheran claimed full-time nurses, physical therapy and radiology technicians were being paid as contract employees instead of hourly. He accused Scoccia of self dealing in lease agreements for the building and land. Latcheran questioned Dr. Scoccia’s decision to sign service contracts through his personal company, APEX, instead of negotiating directly. Latcheran’s suit claimed Karin Scoccia resigned in December 2009 as chief financial officer “due to some alleged unprofessional and unacceptable practices by Nye Regional and its board.”

LiCON, a small group of medical facilities in northern Nevada who formed an alliance to promote their businesses and reduce costs, terminated Nye Regional Medical Center’s membership in the group due to several risks and questionable procedures, Latcheran claims.

On April 26, 2010, Certified Public Accountants Cupit, Millian, Ogden and Williams ceased providing accounting services to Nye Regional due to an alleged loss of confidence in the management, the suit claims.

Latcheran said Dr. Scoccia hired an out-of-state friend to fly to Nevada to review the maintenance program every quarter, what Latcheran felt was unnecessary and expensive.

“Scoccia made personal loans to himself with hospital proceeds. When plaintiff asked him to return said funds, Scoccia replied that he did not have the money to repay the hospital,” the suit claims.

In response, Dr. Scoccia said, “we get sued all the time, fortunately no malpractice suits. But in business, when you soar like an eagle you get hunters.”

He was more concerned about the audit, adding he’s formed a RAC defense team.

“The RAC people will keep auditing us until we go out of business,” Dr. Scoccia said.

“We save lives here. If this hospital was shut down for some crazy reason, you couldn’t drive to Bishop or Hawthorne quick enough,” he said.

Fortunately, he said Life Guard International Inc. began air ambulance service at Tonopah Airport, back in 2009.

Bill Roberts, a writer for the Tonopah Times-Bonanza & Goldfield News contributed to this report.