Sale of dialysis unit raises concerns

Monday, June 29, 1998

Monday, June 29, 1998

Sale of dialysis unit raises concerns

PRIVATIZATION: Center patients question level of care, company's profits

By Kathryn Combs

Daily Bruin Senior Staff

Since June of 1997, administrators for the UCLA Dialysis Unit have been planning to sell. Now, after a one-year search, the UC Board of Regents approved the sale during their last meeting.

According to Marshall Salomon, director of corporate development and planning for Total Renal Care (TRC), they are slated to take over the management and operation of the UCLA Dialysis Center sometime in the next four or five weeks. TRC is the third largest provider of dialysis services in the United States.

However, employees and patients are concerned that the quality of care will decrease due to the unit's sale to a for-profit corporation. One employee expressed concern about the corporation's cost-cutting method of reusing dialyzers.

Medical center officials argue that they chose TRC because of the company's impressive track record.

"TRC has really demonstrated their commitment to our academic and research programs, and that was very important to us as an academic medical center," said Frances Ridlehoover, associate director of professional and ambulatory services with the UCLA Medical Center.

"They have a comprehensive quality management program led by renowned experts in the dialysis field, and our current medical directors will continue as the medical directors under TRC," she said. "The quality that our program has had under current directors will continue under TRC."

However, Miriam Blum, a peritoneal dialysis patient with UCLA, said, "Quality means different things to different people. This definition is probably different for someone on dialysis than for an administrator or businessman."

Blum also spoke against the sale of UCLA's dialysis unit at the last regents meeting on June 18, when the actual sale was approved.

"Total Renal Care plans to implement changes that increase their profits but that decrease our care," she asserted during her speech.

However, Salomon disagrees, asserting that both he and representatives from TRC intend to meet with the patients and are looking forward to doing so.

"UCLA is a world-renowned institution with a very well-known and prestigious research program, and we are very interested in working with them in the advanced studies of kidney failure," he said.

"We look forward to working with their staff and patients. TRC is absolutely dedicated to providing our patients with the clinical outpatient services required," he added.

Ridlehoover also said the new relationship between UCLA and TRC will not only help the UCLA Dialysis Unit financially but will also help to further research efforts at UCLA.

"The medical center has really experienced a decline in the contribution margin of the program in the last three years," she said.

"This is the amount the program can contribute to cover their expenses. Plus, the market for dialysis services has become increasingly dominated by international companies," she added, explaining that corporations such as TRC can still provide quality service while cutting costs.

However, Blum argues cost-cutting measures are often at the expense of the patient. She cited the reuse of dialysis filters as only one example of this.

"We don't have kidneys that work anyway; now we have this technique that works. Now they are saying it is OK to compromise our care by reusing filters over again and again and again in order to make more money."

Salomon said TRC is committed to the provision of quality care at low cost.

"In terms of quality of care ... we feel that we are the most respected dialysis provider, and this is because we are a quality-driven company," he said.

"The quality of care (at UCLA's Dialysis Center), if anything, will be enhanced," he added.

Salomon added that TRC does not typically face such opposition from staff and patients and said that in fact, TRC has already met with staff members and intends to meet with patients to discuss this move.

"I think it is fair to say that if you spoke to them now you would come away with a very positive feeling about the impending acquisition," he said.

However, employees with the UCLA Dialysis Unit feel differently. One employee fears that the corporation's interest in profits may compromise quality care.

Other employee concerns have been the potential for layoffs as a result of this acquisition. However, UCLA officials say TRC's offers to employees have been generous.

"TRC will make offers to current employees at their current salaries with an incentive payment in addition," Ridlehoover said.

"(TRC) has also agreed to pay their health care benefits for the next year, and we will work very hard to internally reassign employees, should they not accept this offer."

In addition, Ridlehoover asserted that labor was not the reason for the sale.

"The business driver on this deal is not labor expenses, it is the economies of scale that a nationwide company brings," she said

"A key contributor to selecting TRC for us was that they have demonstrated a solid commitment to research and our academic programs," she continued.

Blum, however would like to see the sale delayed and believes patients should be consulted first.

"Patients were completely excluded, and if anyone really believes that the medical director fully represents the patient's interests, I beg to differ," she said.

"Somebody has to stand up and say this is wrong."