The Memorial Hospital gains critical access status

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The Memorial Hospital received approval from The Center for Medicare and Medicaid Services Wednesday to become a critical access hospital, which means an annual increase in revenue of more than $1 million.

TMH Administrator Randy Phelps said the conversion to critical access would benefit the hospital in the long and short term.

"In the long term we will be a more financially viable hospital," he said. "Because of the increased revenue it will allow us to do more innovative things."

One of those innovations might be construction of a new hospital, he said.

"We can cover more debt service without relying on tax dollars to build a new hospital," he said.

The board of trustees voted last fall to convert TMH to critical access status, which makes the hospital eligible for cost-based reimbursements from the federal government for Medicare patients.

The federal government in 1998 created the program to aid rural hospitals.

To qualify for critical access status a hospital must:

Be a rural hospital at least 35 miles from another hospital.

Participate in Medicare.

Provide 24-hour emergency room service.

Have an annualized average length of stay per patient of less than four days.

Have a maximum of 15 acute care inpatients at one time.

TMH met all of those requirements, but one concern was the daily 15 inpatient maximum.

"Two times in the past year we were at or above 15 patients," Phelps said.

The two days occurred in January when several people had the flu, he said, but several strategies will be implemented to help insure the inpatient census is not more than 15.

One strategy is a swing bed program, which will allow for 10 more patients than the maximum 15 to be cared for in the hospital at one time.

"In January we didn't have our strategies in place yet," Phelps said. "We could have managed our patients differently if we had needed."

A piece of legislation introduced by U.S. Rep. Scott McInnis, R-Colo., could lessen the concern regarding the 15-patient maximum if it is passed.

McInnis' bill, HR4112, introduced Tuesday in the House, addresses an array of rural health concerns.

"Rural Coloradans deserve access to quality health care," McInnis said. "When I travel through Colorado, an area of growing concern amongst constituents is having quality and access to health care. Because of this feedback, I sat down and worked to create a reasonable proposal that will address these important safety net issues in rural Colorado."

The bill addresses the concern of the 15-inpatient maximum by allowing hospitals to keep their critical access status as long as they do not exceed a 12-patient average for the year.

Blain Rethmeier, press secretary for McInnis, said, "if the flu bug went through an area where there is a critical access hospital, it might be the only place people can go in the area and the hospital might go over that (15-inpatient) limit. Whereas other times of year, the hospital might only have one or two patients at a time."

Rethmeier said the legislation was proposed to directly address the concerns of hospitals like TMH.

"This type of situation reflects what could happen in Craig," he said. "We've worked closely with the administration at TMH and I know our staff here has kept in close contact with them throughout the process."

The chances of the legislation passing are good, Rethmeier said.

"We certainly feel good about this legislation," he said. "We've worked closely with the health committee on this issue. We're feeling positive we've done our homework and have proposed something that will benefit rural health care."

Regardless of what happens with the legislation, TMH is already a critical access hospital.

Although word of the approval just came Wednesday, the conversion is effective March 1.

"The finances from last month will reflect whatever impact this will have," Phelps said.

Nothing will change in patient care, he said.

"For the patients there will be no visible changes in the way we operate," Phelps said.

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