The agreement providing dialysis for immigrants who were former Grady patients expires at the end of August, and it’s unclear what will happen next.
A year ago, Massachusetts-based Fresenius Medical Care agreed to treat 25 of the 38 end-stage renal disease patients – most of whom are illegal immigrants – at Grady’s expense, and treat five others as charity care cases. Emory Healthcare agreed to serve three more immigrants as charity, and Colorado-based DaVita said it would serve the other five as free care.
Grady Memorial Hospital’s agreement with Fresenius will run out at the end of the month. Both Fresenius and Grady declined to comment Monday about the contract and whether they are discussing a new one.
Grady, Atlanta’s largest safety-net hospital, paid Fresenius $750,000 for a year’s care of the 25 uninsured immigrants.
But Grady’s financial situation has deteriorated recently, and its losses this year could reach $20 million or more. The Grady system announced in June that it is cutting 120 jobs. It said the cuts were necessary because of reduced state and county funding; a weak economy with high unemployment; and increasing costs of supplies, utilities, pharmaceuticals and labor.
Meanwhile, the hospital continues to shoulder an enormous financial burden in caring for uninsured patients, including immigrants, providing more than $200 million in indigent care annually.
Grady closed its outpatient dialysis clinic in 2009, citing losses of $4 million a year. About 60 uninsured immigrants were getting care at the Grady clinic at the time of closure.
Of those patients, 13 volunteered to be transported at Grady’s expense to other states or to their home countries, and Grady agreed to pay for three months’ treatment.
Five of the 13 who left for Mexico with assistance from Grady or the Mexican government died, the New York Times reported last year. Nationally, about one in five dialysis patients die within a year of starting treatment, and about two in three die within five years, according to the Times article.
Patients need dialysis when they develop end-stage kidney failure — usually by the time they lose almost all kidney function.
Dialysis uses a man-made filter to remove wastes from the blood, restore a proper balance of electrolytes, and eliminate extra fluid from the body.
Typically, patients need regular dialysis three times a week.
Medicare covers routine dialysis, but illegal immigrants are not eligible for that federal insurance program, and neither are some newly arrived legal immigrants.
The uninsured Grady patients’ dialysis situation drew national attention when the clinic closed. Grady, after spending more than $2 million on repatriation and dialysis since shutting the clinic, reached an agreement with Fresenius in August 2010.
Both Emory and DaVita said Monday that they plan to continue the dialysis for their charity care patients.
Fresenius and DaVita are the largest private dialysis providers in Georgia and the nation.
Dorothy Leone-Glasser, head of the consumer group Advocates for Responsible Care, said Monday that she hopes the dialysis agreement can be renewed.
“There’s nowhere else for them to get dialysis treatment,’’ she said.