To keep doors open, PRC Hospital has plan B

Published 8:32 am Tuesday, November 24, 2015

News of the closure of the Pioneer Community Hospital in Newton, Mississippi has a number of other critical access hospitals thinking about their own future, including Pearl River County Hospital and Nursing Home.

The closure occurred because of a re-interpretation of the Centers for Medicare and Medicaid Service’s distance requirement regulation to designate a rural hospital as a critical access hospital, according to a press release from the Pioneer Community Hospital.

Now, administrators at the Pearl River County Hospital and Nursing Home wonder if the federal government will re-classify its status as well. The hospital is up for review in 2018, and a change in status could mean less federal revenue and that could jeopardize the hospital’s financial health. If the hospital closes, residents of Poplarville could lose life-saving medical care and an important economic engine in the community. However, hospital administrators believe they have found a way to ensure that hospital doors will remain open even if their status changes.

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As a designated a critical access hospital, the facility receives

reimbursement for the full cost of care provided to Medicare patients, said Pearl River County Hospital and Nursing Home Administrator Steve Vaughn. Without that reimbursement, the Poplarville hospital may have to close or resort to an alternate plan of what care to provide.

But a recent change to the distance requirement, which states that if a rural hospital is too close to another hospital, could mean Pearl River County Hospital and Nursing Home will no longer be a critical access hospital, and thereby would not be eligible for Medicaid reimbursement.

Some of the services the Pearl River County Hospital and Nursing Home provides includes emergency room care, rehabilitation and nursing home services to residents in the northern end of Pearl River County.

Dr. James Aiken, Pearl River County Hospital’s Chief of Medical Operations, said the hospital also provides swing care to patients of other hospitals. Swing care is when a patient receives medical treatment at a major hospital but is sent to a hospital closer to their home to receive continued treatment or rehabilitative services.

Another benefit of having the hospital in Poplarville is the facility provides emergency care to patients suffering from a stroke, heart attack or other ailments that need immediate stabilization before being moved to another facility. Aiken said that some of those ailments, including strokes and heart attacks, could lead to serious brain damage if care is not provided quickly enough. Since permanent damage can occur within seconds, the sooner blood supply is restored, the better chance a medical team has to not only stop, but possibly reverse brain death, Aiken said.

For situations that would require a specialist’s expertise, the hospital uses a service called Telehealth. Similar to holding a video chat with a friend or family member, nurses at the Poplarville medical facility can get advice from a specialist from the University of Mississippi Medical Center when needed.

The hospital received its Critical Care designation in 2010, Vaughn said.

The hospital has the beds for 20 emergency room patients, and 120 nursing home patients.

Healthcare is not the only thing the Pearl River County Hospital and Nursing Home provides to residents in the north end of the county. Aiken said the hospital is one of the major employers in the county, providing an economic foundation to the area.

Only a handful of years ago the emergency room census was averaging 120 patients per month. Aiken said the average these days is 300. That boost in patients is due to positive word-of-mouth references, Aiken said.

Another service the hospital provides is a physician or nurse practitioner on duty 24 hours a day, seven days a week. Vaughn said one of the requirements to be determined a Critical Access Hospital is to have a registered nurse on call who can be at the facility within 30 minutes.

But the change to Medicare regulations is threatening access to care provided by these rural hospitals, says Vaughn. There are currently more than 30 in Mississippi, including Poplarville’s, that could close unless something is done.

For now, the Pearl River County Hospital and Nursing home is proceeding as business as usual, since they have another three years before their facility is reassessed to see if they meet the requirements.

Should the worst happen and the hospital’s reevaluation is not approved before the regulations are changed, Vaughn said the facility has a plan to remain operational, but not as it currently exists.

During their year-long transition phase after a theoretical unsuccessful re-designation as Critical Access Hospital, they will move to prospective payment care, which means a lower volume of patients.

That will mean no more swing bed patients, but the change will allow them to focus more on geriatric patients, which is a need in the area.

The hospital already offers geriatric care, along with psychological services such as counseling, a psychiatrist, social workers and care for addiction and depression.

If they are not recertified as a Critical Access Hospital, Dr. Micelle Haydel said the staff is looking at other areas the facility could provide care in to remain viable.

Hospital administrators say they are fighting to keep their designation by sharing the news with those who will listen, including policy makers. Vaughn said a grassroots effort is working to reverse the change by speaking with state and regional politicians about the concern.

These hospitals are at risk in Mississippi because states in the southeast of the United States did not make changes to Medicare and Medicaid like most of the rest of the nation, Vaughn said.

“If we don’t act now, it’ll be too late,” Vaughn said.