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Despite uncertainties, KC-area health center absorbs money-losing clinic

By Mike Sherry for KHI News Service, Nov. 27, 2013

KANSAS CITY, Mo. – Samuel U. Rodgers Health Center has taken over operations at a safety-net clinic with deep roots in the Hispanic community, a commitment that health center officials said does not come without financial risk.

As of the beginning of this month, Sam Rodgers assumed control of Cabot Westside Medical and Dental Center from Saint Luke’s Hospital. Cabot has served the city’s West Side for more than a century after its start as a four-bed ward of Saint Luke’s Hospital.

The transfer of assets from Saint Luke’s to Sam Rodgers includes the $5.5 million, 13,000-square-foot building that Cabot relocated to in late 2004.

Saint Luke’s will also underwrite some of Cabot’s operating costs for a specified period of time, said attorney Bob Beachy, who represents Sam Rodgers. Terms of the agreement are confidential, he said.

The agreement allows Saint Luke’s to nominate a person for the Sam Rodgers board, Beachy said, and it also establishes a six-person advisory board (with equal representation from both sides) to monitor activities at Cabot.

With Sam Rodgers, officials also said, Cabot patients will pay lower rates and get more services.

Dire need
“We really thought that if we did not do this that Cabot would eventually fold,” said Hilda Fuentes, Sam Rodgers chief executive.

Cabot had a 25 percent operating deficit last year on a $4 million budget, said Liz Cessor, vice president of mission and community services for Saint Luke’s Health System. She is the former chief executive of Cabot.

With the addition of the roughly 7,000 patients Cabot sees annually, Fuentes said Sam Rodgers’ volume would increase by about 30 percent.

Sam Rodgers has spent about $200,000 for information technology upgrades at Cabot, she said.

Fuentes estimated that Sam Rodgers would need philanthropic support of about $500,000 a year to balance Cabot’s budget.

That fundraising challenge will come on top of the money that Sam Rodgers already has to raise for its current annual operating budget of about $17 million, Fuentes said, about half of which comes from grants.

But, she said, she and the board believed it was part of Sam Rodgers mission to preserve a resource for a needy community. She said leaders of the health center believed there is an unmet need in that neighborhood and that Cabot has room to increase volume.

“This isn’t something that is going to be easy. This is going to be something we need to work at,” Fuentes said. “It’s a calculated risk.”

More for less
As part of Sam Rodgers, Fuentes said, Cabot patients will have access to services like imaging and lab services with a $25 copay.

Under Saint Luke’s, Cabot had to refer patients off site for such procedures, Cessor said, and the services could be costly. A chest X-ray, she said, could cost $125 on top of the copay charged by Cabot.

The clinic’s patients are primarily the working class poor who are still struggling with the effects of the recession, Cessor said. Of the clinic’s adult patients, Cessor said, four in five are uninsured.

Fuentes said Medicaid and Medicare reimburse Sam Rodgers at a rate that is more than three times higher than that of Saint Luke’s.

Sam Rodgers gets the higher rates through its status as a federally qualified health center (FQHC), which the Centers for Medicare and Medicaid Services (CMS) certify as treating an underserved area or population.

Cessor said Saint Luke’s unsuccessfully applied to make Cabot its own FQHC, hearing from CMS that the city had enough of these centers with Sam Rodgers and Swope Health Services.

Cessor said Saint Luke’s would have done whatever it took to keep Cabot open, if it could not reach an agreement with Sam Rodgers.

“We would’ve looked at other options,” she said. “I mean, you can always decrease services, decrease costs, and stay open, but that’s not what we wanted to do. Our mission is to provide care to all.”

Gloria Ortiz-Fisher has watched the developments at Cabot from various perspectives, including as a Sam Rodgers board member.

She is also executive director of a nonprofit community development corporation on the West Side, and is chairman of the Latino Civic Engagement Collaborative, a consortium that includes leaders from several organizations around the city.

Ortiz-Fisher also said her grandparents were patients at Cabot.

“I can’t even imagine the West Side without the clinic there,” Ortiz-Fisher said. “It’s an institutional part of the neighborhood.”

The Health Care Foundation of Greater Kansas City is proud to partner with the KHI News Service to provide weekly health stories about health and policy issues impacting the greater Kansas City region. Because it is committed to objective coverage, HCF exercises no editorial control over the content. The KHI News Service is an editorially independent initiative of the Kansas Health Institute.


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