Latest news with #PortStLucie
Yahoo
24-07-2025
- Health
- Yahoo
After Cleveland Clinic expanded to Florida, patients say surprise fees followed
PORT ST. LUCIE, Fla. — When the Cleveland Clinic started acquiring hospitals and medical offices in this palm tree-lined region six years ago, many Floridians were excited. The Ohio nonprofit, ranked among the top hospitals in the world, pledged to bring expert care and an infusion of cash to the state's Treasure Coast, an area north of Boca Raton brimming with 55-and-up gated communities. But in the years after the Cleveland Clinic's blue and green signs popped up outside dozens of medical offices, patients began receiving unexpected bills: an additional $95 for a consultation with a neurosurgeon. An extra $112 to see a family medicine physician. And $174 more for a neurologist appointment that previously cost only a $50 co-pay. Baffled, the patients contacted their doctors' offices and insurers and learned that the new costs were 'facility fees' — charges that hospitals have traditionally billed for inpatient stays and emergency room visits but are now increasingly charging for routine appointments in their outpatient clinics. The fees, which are often not fully covered by insurance, are meant to support the higher level of care that these doctors' offices provide, according to hospitals. For blindsided patients, that can mean paying a hospital fee — even if they never set foot in a hospital. 'My heart dropped,' said Brandy Macaluso-Owens, 43, a social worker who lives in Port St. Lucie. She received a $174 facility fee after a visit in March with a Cleveland Clinic gastroenterologist. 'I probably met with the doctor maybe as little as 15 minutes.' The Cleveland Clinic defended facility fees in an email, saying they are an 'appropriate practice' that align 'with government regulations and industry guidelines.' 'These fees help support just some of the costs of maintaining outpatient facilities so that we can continue providing high-quality, compassionate care to all patients,' the Cleveland Clinic said. The Cleveland Clinic is far from the only hospital charging facility fees, which amount to billions of dollars annually for patients across the country. The fees have become pervasive in recent years as major health systems have snapped up doctors' offices, making it harder for patients to find independent practices: More than half of all physicians nationally are now employed by hospitals or health systems, up from just a quarter in 2012. For more on facility fees, watch NBC's 'Nightly News with Tom Llamas' at 6:30 p.m. ET/5:30 p.m. CT and 'Top Story' on NBC News NOW at 7 p.m. ET. At the same time, facility fees have become more noticeable because of a rise in high-deductible health insurance plans, which leave patients paying a larger share of their medical bills before their insurance kicks in. A study last year found that the average deductible for employer-sponsored coverage had risen about 47% in a decade. These factors are affecting many patients who are already teetering financially. About half of adults in the U.S. say they would be unable to pay an unexpected $500 medical bill or would have to go into debt to pay it, according to the health policy group KFF. Facility fees can run into the hundreds of dollars, and even small amounts can quickly add up. Did your doctor's office charge you a facility fee? Here's what to know 'People are getting really high bills for simple, routine care,' said Christine Monahan, an assistant research professor at the Center on Health Insurance Reforms at Georgetown University who has studied the issue. 'They don't expect to be paying high bills for this. And it's not realistic to expect people to be able to afford this.' Opposition to outpatient facility fees is a rare area of agreement between patient advocates and insurance companies, which argue that hospitals are unnecessarily inflating the cost of care. While efforts to restrict facility fees have drawn bipartisan support at the state and federal levels, the hospital industry has pushed back, arguing that the fees are necessary to help fund core services like 24/7 emergency departments, and that insurers should cover them. These national forces are all colliding in southeast Florida, where 11 patients told NBC News that the Cleveland Clinic had charged them unexpected facility fees in the past several years. For some, the fees were a mere annoyance, a sign of the escalating cost of health care. For others, the bills were a financial burden too big to shoulder. And some are refusing to pay them. Billie Paukune Boorman, a waitress, was recently charged a $174 facility fee for her 13-year-old daughter's ear, nose and throat appointment, along with over $200 in other unanticipated charges. 'I don't have that kind of money laying around,' she said. The Cleveland Clinic declined an interview request from NBC News and declined to comment on individual cases but said in its email that patients are charged facility fees in doctors' offices that are classified as hospital outpatient departments, which must meet stricter quality and safety standards than nonaccredited physician practices. The facility fees reflect 'the significant added costs to hospitals of complying with these standards,' the Cleveland Clinic added. The Cleveland Clinic told NBC News that it has sent more than 250,000 letters to its Florida patients informing them of the fees ahead of their appointments, and said it posts signs at its offices saying that they are hospital outpatient departments. Medicare patients receive an additional notice at check-in. The letters that the Cleveland Clinic sent say patients may see 'a change from how you were billed in the past' but do not explicitly note that patients may be charged more out of pocket. Many of the patients who spoke to NBC News did not recall receiving the letters. The health system did not answer questions about how it determines the price of a facility fee but said the costs 'vary depending on the facility and the type of medical services provided.' Several patients said they did not notice any differences in their care after the fees were implemented. Last year, Irene Rauch, 66, a semiretired human resources executive, was charged a $95 facility fee for an appointment with a neurosurgeon she said she had seen for the same type of appointment three months earlier for just a $15 co-pay. The added charge was not something she had budgeted for. 'I'm grateful for the care that I've gotten at the facility,' she said. 'Does it justify this unknown fee, when you go to see the doctor for a check-up and you're in there for five minutes?' A booming population with growing health care needs Along Florida's Treasure Coast, signs of the booming — and aging — population are everywhere. Strip malls full of medical offices pepper the streets, and senior centers bustle with exercise classes and bingo games. In 2018, the leaders of the Cleveland Clinic saw the area's growing need for health care and invested in the century-old nonprofit's first major expansion outside Ohio. Renowned for cardiac surgery, among other specialties, the Cleveland Clinic emphasizes its public health mission, committing over $413 million annually to philanthropy. The health system now owns four hospitals and dozens of outpatient offices across the Treasure Coast, including family health clinics, sleep labs and a wound care center, and it has vowed to be 'part of the social fabric of the community.' The flurry of facility fees did not immediately follow the Cleveland Clinic's arrival in Florida: Most patients said they only noticed them in the last year or two. In February, Mark Huber, 60, of Hobe Sound, went to a Cleveland Clinic neurologist whom his wife, Victoria, had seen a couple of times in 2024. The couple had carefully selected the in-network doctor from their commercial insurance plan's website so they would only have a $50 co-pay. But after his appointment, Mark Huber received a bill for a $174 facility fee. 'We were just floored that this charge came and no one was apologizing,' he said. Some of the outpatient offices that the Cleveland Clinic has acquired in the region had already been charging facility fees prior to becoming part of its health system, the Cleveland Clinic said in an email to NBC News. It said it began charging fees in the last two years at additional sites to be consistent across its locations. 'We understand this frustration with any change and are transparent with all billing practices,' the Cleveland Clinic said. Patients with concerns can speak to a Cleveland Clinic financial advocate, the organization added. During a Facebook Live chat with a Cleveland Clinic executive in February, patients expressed confusion and anger about the fees. Dr. Rishi Singh, vice president and chief medical officer of the Cleveland Clinic Martin North and South Hospitals in Martin County, Florida, told the patients that they were now receiving 'hospital-level care' that independent doctors don't offer. 'We are required to have various ways of sterilizing things, to inspect our facilities, to make sure they're clean, to have air handling, to do all these special things,' he said. 'That's a big difference in the way that the cost is for that.' Among those who pressed Singh was Virginia MacDonald, who lives in Stuart. She posted in the Facebook chat that her husband had been charged hundreds of dollars worth of facility fees for weekly health care appointments. In response to her and others, Singh advised patients to talk with their insurance companies about facility fees, which MacDonald said she felt was 'ridiculous.' 'There's always this push and shove over what insurance companies are going to cover,' she said in a recent phone interview. 'I just think they found this little hidden charge where they can get away with it.' MacDonald said Florida Blue, a Blue Cross Blue Shield plan, left the couple responsible for a 'huge portion' of her husband's facility fees. Insurers argue that facility fees for outpatient visits burden patients and insurance companies with costs that do not improve the quality of care. In an interview with NBC News, a Blue Cross executive criticized them as a way for hospitals to drive up health care costs. 'These fees are tacked on to patient bills with vague descriptions, virtually no transparency as to why, or why they're being charged,' said David Merritt, a Blue Cross Blue Shield Association senior vice president. 'They shouldn't be tacked on simply to raise revenue for hospitals.' A push for regulations The dissatisfaction over facility fees in Florida is mirrored across the country, with patients fuming on social media about the dominant hospital chains in their area, advocates raising concerns that facility fees too often surprise patients, and state legislators seeking to impose limits. Nineteen states have passed laws related to facility fees, according to the health policy advocacy group United States of Care. Some require only that hospitals warn patients about the fees in advance; others, such as Connecticut, ban facility fees for certain outpatient services. Ohio prohibits facility fees just for telehealth appointments, and other states, such as Indiana, require hospitals to submit annual reports that include their facility fees. On the federal level, the Trump administration has pushed for protections to shield Medicare patients against some facility fees. A bipartisan proposal expected to be introduced in Congress this year would extend those reforms, requiring Medicare to pay the same rate for common outpatient services whether the doctor's office is independent or owned by a hospital. The American Hospital Association opposes efforts to limit facility fees, as does the Florida Hospital Association. In a phone interview, Florida Hospital Association President and CEO Mary Mayhew said hospitals are struggling to cover expenses, especially because Medicaid reimbursement 'doesn't come anywhere close to covering the cost' of many services that Florida hospitals provide. She said facility fees are critical to keeping doctors' offices and hospitals open and said insurers should cover them. In Florida, then-House speaker Paul Renner, a Republican, championed legislation last year to clamp down on surprise health care costs, including by requiring medical offices to disclose a patient's facility fees in advance. 'Unlike going to the grocery store where you can look at price per gallon of milk or the price per pound of an item, in health care, we know what we're told and we pay what we're told, but not before the fact,' Renner said in a recent interview. 'We get that explanation of benefits afterwards that's very opaque and hard to follow what you pay, your insurance pays, and it disempowers patients.' Existing Florida law requires facilities to share good-faith cost estimates with patients who request them. Eventually, the law will require these doctors' offices to notify all patients about their estimated facility fee costs before they see medical providers — but that portion of the law is not yet in effect. As patients discover the facility fees on their bills, some are switching to independent doctors to avoid the extra costs. In many cases, that means traveling farther for care: Dr. Evelio Sardiña, who practices concierge medicine in Jupiter about 45 minutes from Port St. Lucie, has heard these patients' frustrations firsthand. 'If you're being charged a new fee, you expect there to be a new service,' Sardiña said of his conversations with patients. 'It comes right down to, 'What is the service I'm getting for the money that I'm now being charged?' And the answer is, 'I'm not getting any new service — I'm just paying more, so I'm feeling a little more taken advantage of.'' One of the few Cleveland Clinic patients NBC News spoke to who remembered receiving notice in advance to expect a facility fee was Cindy Aaron, 68, who lives in Fort Pierce. A bladder and kidney cancer survivor, Aaron must see a urologist every six months to make sure she is still in remission. After receiving a letter in the mail from the Cleveland Clinic informing her of the new facility charges, she called to request an estimate ahead of her appointment in April. The 15-minute urologist appointments, which previously cost her only a $35 co-pay, would now cost an estimated $300, the Cleveland Clinic told her. She canceled the appointment. 'This is a rip-off,' Aaron said. 'I've never seen anything like this before.' Elizabeth Chuck reported from Port St. Lucie, Florida; Maite Amorebieta reported from New York. This article was originally published on Solve the daily Crossword
Yahoo
18-07-2025
- Yahoo
'Cold-blooded killer'; grand jury indicts man in slaying of woman in St. Lucie County
ST. LUCIE COUNTY − A grand jury July 9 indicted a man on first-degree murder and other charges following the death in March of Toni Lynn Marie Trabb, 58, of Port St. Lucie, according to the St. Lucie County Sheriff's Office. Along with the murder charge, Carlos Tito Caban, 52, faces charges of grand theft of a motor vehicle, fraudulent use of a credit card, and criminal use of personal identification following the slaying. Prosecutors intend to seek the death penalty in the case, according to the Sheriff's Office. 'This guy's a cold-blooded killer as far as I'm concerned, and he is exactly where he needs to be right now,' Sheriff Richard Del Toro said at a July 10 media briefing. Trabb was found March 24 by cleaning staff at the Best Western hotel, in the 7900 block of South U.S. 1, in a second-floor room. Rescue and sheriff's officials arrived at the scene before Trabb was pronounced dead. Del Toro said Trabb was found with "severe blunt trauma and ultimately strangled to death." He said Caban checked into the hotel under his name, but used her credit card. Sheriff's officials on March 25 identified Caban, a sex offender, as 'officially our suspect' following the homicide. Investigators March 25 were notified by authorities in Tifton, Georgia, that Caban was stopped in Trabb's Toyota Corolla there. Tifton is about 370 miles from Port St. Lucie. A bulletin was put out for the vehicle, Del Toro said, and police officers coming out of a gym spotted it based on the bulletin and took Caban into custody. Caban was with another woman. 'Details were later learned from Georgia authorities that the woman that was with Mr. Caban met him in the Orlando, Florida area," Del Toro said. "And he told her at that time he was traveling to New York and she just decided to go along for the ride because she had nothing pretty much better going on.' Lt. Andrew Bolonka, sheriff's spokesperson, said at the time that Caban faced charges out of Florida related to the conditions of his sex offender status. According to the Florida Department of Law Enforcement, Caban in January 2021 was convicted in Indian River County of sexual battery by an adult on an adult with aggravating circumstances. He was released from prison in 2023, according to the state Department of Corrections. Sheriff's officials said a variety of items reportedly were dumped in a field in Georgia, and a person there looked through it and found Trabb's name on some paperwork. That person notified law enforcement officials there. Trabb's father, Anthony Borello, in an interview at his Port St. Lucie home, said shortly after the slaying that his daughter was a smart, special woman who enjoyed cooking and was 'pretty fluent' in Spanish. Borello said Trabb was born in New York. She was twice married, and has a daughter, who teaches school, and a son in college, both in the New Jersey area. She has a sister and a half-sister. Borello said his daughter struggled with alcohol, and that "every now and then she'd fall off.' Borello said Trabb 'was seeing a lot of' Caban over the past two months before her death. 'First time I met him, I didn't like him,' Borello said. 'Second time I met him, I didn't like him even more.' Borello said he last saw Trabb March 21, before she left early the next morning as he slept. He assumed it was to meet with Caban, and she texted him over the weekend. 'She said, 'Oh, we're out having a good time, and the beach was nice, and we're gonna get a bite,'' Borello said. 'So, I'm assuming it was this guy.' Del Toro said his understanding is that Caban and Trabb met on a dating website about a month and a half before the incident occurred. 'He started, according to a friend of Ms. Trabb that had spoken with her before her death, exhibiting some signs of violent behavior towards her,' Del Toro said. Alleged improper med spa: 'Facial paralysis' and 'illegal backyard shed med spa' found in Port St. Lucie, police say Update in deadly encounter: Arrest made in slaying of 19-year-old woman from Fort Pierce Del Toro said investigators spoke to Caban, and he was able to see the death penalty was being pursued. Caban 'basically says you guys pretty much know what happened, and I want an attorney," Del Toro said. To determine whether capital punishment is warranted, the state is required to identify the aggravating circumstances, or reasons why a sentence of death is legal and appropriate. Prosecutors cited six statutory aggravators related to Trabb's murder including: The killing was especially heinous, atrocious, or cruel The capital felony was committed by a person previously convicted of a felony and under sentence of imprisonment or placed on community control or on felony probation. The defendant was previously convicted of another capital felony or of a felony involving the use or threat of violence to the person. The capital felony was committed for pecuniary gain. The felony was a homicide and was committed in a cold calculated and premeditated manner without any pretense of moral or legal justification. The capital felony was committed by a person designated as a sexual predator pursuant to (Florida statute) 775.21 or a person previously designated as a sexual Predator who had the sexual predator designation removed. Prosecutors weigh such aggravators against any potential mitigating evidence, such as substance abuse, neurological troubles or diminished mental health. (This story has been updated with more information and video) Will Greenlee is a breaking news reporter for TCPalm. Follow Will on X @OffTheBeatTweet or reach him by phone at 772-267-7926. E-mail him at This article originally appeared on Treasure Coast Newspapers: Sex offender charged with murder in death of 58-year-old woman
Daily Mail
10-07-2025
- Health
- Daily Mail
Florida woman's decision to get Botox in grubby garden shed ends in DISFIGUREMENT
A Florida woman was left with facial paralysis after receiving Botox injections at an illegal spa operating out of a backyard shed, according to police. In May, an unidentified woman contacted the Port St. Lucie Police Department (PSLPD) with concerns about a medical treatment she had recently received from a woman named Rosa Mena, who was allegedly running a covert spa out of a backyard shed, according to a statement posted by the department on Facebook. The victim claimed the procedure left her with lasting facial paralysis - raising alarming suspicions that the makeshift med salon was operating without a license. A multi-agency investigation into the woman's claims uncovered an 'overwhelming amount of evidence,' ultimately leading to the arrest of 50-year-old Rosa Mena on Thursday. 'We want to remind the public to research the facility and individual prior to performing procedures,' the department wrote to the post. 'In order to perform injectable procedures like Botox, it needs to be performed by a licensed professional.' On May 17, encouraged by coworkers' recommendations, the victim visited Rosa's Miracle Hand and Spa, hoping for Botox injections, CBS 12 News reported. The woman was then led by Mena into an outdoor shed, allegedly outfitted to resemble a legitimate medical spa - complete with injectable supplies and a CoolSculpting machine visible inside. After receiving a staggering 62 units of Botox, the victim paid Mena $325 and left - unaware that those injections could potentially alter the course of her life forever. While the number of units needed varies by individual, professionals typically recommend 15 to 30 units for horizontal forehead lines and up to 40 units for '11 lines' - or glabellar lines - between the eyes, according to Healthline. According to the American Academy of Facial Esthetics, the average cost per unit of Botox ranges from $10 to $30. A typical treatment involves 20 to 40 units, which translates to a total cost between $325 and $600. Soon after the bizarre backyard session, the woman began suffering partial facial paralysis. Worried, she returned to Mena's spa seeking a follow-up treatment. During the follow-up visit, Mena injected the woman with a B-vitamin complex before sending her on her way - but the woman's symptoms only worsened, according to the department's statement. By this point, the alleged victim had no choice but to confront Mena, who quickly refunded her hundreds of dollars and urged her to come back for more vitamin injections - claiming they would 'reverse' the damage. As her symptoms only persisted with no relief, she demanded Mena's credentials and proof of qualifications to perform such a risky procedure. Mena never provided any legitimate records, and instead presented a clearly forged phlebotomy certificate, according to the police department. Alarmed by the suspicious credentials, the victim contacted the issuing agency - and soon discovered the license had expired in February 2024. When confronted with the expired license, Mena brushed off the woman's concerns, insisting instead that she was a doctor in the Dominican Republic. Ultimately, the victim contacted the Port St. Lucie Police Department, triggering a months-long investigation that brought together multiple agencies - PSLPD, Code Enforcement, the Building Department, Business Tax Division and the Florida Department of Health. On July 9, authorities executed a search warrant at Mena's residence, uncovering a trove of evidence that corroborated the victim's claims, according to police. Neighbors described as a chaotic scene - with several police cars swarming the area and loudspeaker announcements blaring in both English and Spanish, CBS 12 reported. Once inside, authorities discovered medical beds, fat-sculpting machines, laser hair removal and liposuction equipment, as well as injection devices used for both fillers and Botox. The residence also contained needles, vials, and prescription medications - further evidence of unlicensed medical procedures taking place inside, the department said. Mena's Instagram account was also uncovered, which was filled with photos of her performing various procedures on other individuals - though, so far, no additional victims have come forward, according to police. With clear evidence of unlicensed and unregulated medical treatments being performed out of the backyard shed, Mena was taken into custody. 'There was probably like 10, 15 police cars and some wagon - I didn't know what that was for,' neighbor John Jones told the CBS 12, recalling the scene. 'Then all of a sudden, I see a girl come out in handcuffs,' he added. Mena is now facing several felony charges, including three counts of aggravated battery causing bodily harm, three counts of practicing medicine without an active license and one count of fraud-swindle involving property valued under $20,000. She is also charged with one count of fraud-swindle involving property valued at $300 and one count of using a two-way communication device to facilitate a felony. On Thursday morning, Mena appeared in court and was held on a $95,000 bond, according to WPTV News. She is currently being held at the St. Lucie County Jail.
Daily Mail
08-07-2025
- Entertainment
- Daily Mail
Former Mets star lists $30M ranch where now-infamous 'wild boar' injury took place
After officially retiring from his baseball playing days, a former New York Mets star is selling his mega mansion that was built around the corner from the team's spring training base. Former outfielder Yoenis Cespedes hasn't played in the MLB for five years and is now ready to let go of his massive mansion in Port St. Lucie, Florida - at the price of $30million. Sitting on 400 acres, Cespedes' sprawling home features creature comforts and lavish luxuries. However, Mets fans will remember this house as the site of a well-publicized run-in with a wild boar that led to the star missing playing time. Called 'La Potencia II' (translated to 'The Power'), the 16,000-square-foot main residence features six bedrooms and five bathrooms. Additionally, on the inside, you'll find a massive main living room with a fire place, a massive eat-in kitchen, a games room with a pool table, and an extravagant all-glass wine room next to an ornate bar. Multiple other living rooms are dotted throughout the residence - which also features the likes of walk-in closets and elegant bathrooms. Outside, there's a gorgeous patio - complete with its own kitchen, eating space, and a wet bar. There's also a decadent heated pool - with a separate hot tub and an attached water feature. But there's also plenty of features that indicate this was the home of a professional athlete. Not only is there a stocked barber shop, there's also a well-equipped gym as well as a separate batting cage. Finally, when you step out of the enclosure, you'll find a stable for 12 horses as well as a training facility for the equine creatures attached to the property. Of course, Mets fans remember this mansion as the site of an infamous injury that Cespedes sustained from a 'wild boar' in 2019. While the Mets general manager at the time said that Cespedes sustained a broken ankle in a 'violent fall', it was later reported that the two-time All-Star actually had a run-in with the wild animal. Cespedes tried mounting an MLB comeback in 2024, but that was unsuccessful. The 39-year-old won a Gold Glove award, a Silver Slugger award, and two Home Run Derby competitions throughout his eight year career in the majors.
Yahoo
07-07-2025
- Yahoo
Port St. Lucie man dies after being injured in June crash
PORT ST. LUCIE − An 80-year-old man injured in a June 19 crash on Northwest St. James Drive succumbed to his injuries July 6, according to Port St. Lucie Police. Nicolas Gomez, of Port St. Lucie, was taken to HCA Florida Lawnwood Hospital in Fort Pierce following the two-vehicle crash. He died about 2 a.m. July 6, police stated. Police about 8:37 p.m. June 19 went to the scene at Northwest St. James and Northwest Manville drives, Sgt. Dominick Mesiti, police spokesperson, has said. Police reported a preliminary investigation found an 80-year-old man drove a Mitsubishi on Northwest Manville Drive. He was turning left to go north onto Northwest St. James Drive. Meanwhile, a 23-year-old woman drove a four-door Infiniti south on Northwest St. James Drive, and the crash occurred at the intersection, Mesiti has said. The Infiniti rolled over after the crash, Mesiti stated. Fatal fire under investigation: One person dead after house fire in St. Lucie County Two gunfire incidents: Separate shooting incidents under investigation in Fort Pierce The driver of the Infiniti sustained non-life threatening injuries and also was taken to Lawnwood, police stated. No passengers were in the vehicles, and the drivers showed no signs of impairment, police stated. Those who saw the crash or have video are asked to contact Traffic Homicide Investigator Nikki Tomczyk at 772-871-5001 or Treasure Coast Crimestoppers at 800-273-8477. Will Greenlee is a breaking news reporter for TCPalm. Follow Will on X @OffTheBeatTweet or reach him by phone at 772-267-7926. E-mail him at This article originally appeared on Treasure Coast Newspapers: An 80-year-old man died after being injured in June 19 crash
