Absent a Hail Mary, Glenn County’s solely hospital is ready to shut its doorways in October.
Tucked between two nationwide forests, the agricultural county is residence to twenty-eight,000 individuals. And not using a native emergency room, they’ll as an alternative should journey not less than 40 minutes to a neighboring county for essential care. 100 and fifty well being staff will lose their jobs; they’re already resigning to hunt work elsewhere.
The deliberate closure of Glenn Medical Heart follows a choice by the U.S. Facilities for Medicare and Medicaid Companies to strip the hospital’s federal “essential entry” designation, a standing that has supplied Glenn Medical elevated reimbursement and regulatory flexibility. With out that standing, the hospital’s $28 million in web annual income will take successful of about 40% — a spot too massive to fill some other means than closing the hospital, stated Lauren Nonetheless, the hospital’s chief govt.
“It’s heartbreaking that we come to this. I’m nonetheless type of praying for that Eleventh-hour miracle to return by,” Nonetheless stated. “However actually, we simply should be real looking, and that is the hand we’ve been dealt.”
Over the final a number of months, Nonetheless and her staff have been trying to make their case with the federal well being company, even flying to Washington, D.C., in July in an try and foyer their case.
On the crux of the problem is a federal rule, newly reinterpreted, that requires essential entry hospitals to be not less than 35 miles from the subsequent closest hospital when touring by most important roads. Officers at CMS now say that the subsequent closest hospital, Colusa Medical Heart, is just 32 miles away — three miles in need of the required distance.
Glenn Medical Heart and county well being officers argue that most individuals and ambulances take a unique route, I-5 to Freeway 20. That route is 35.7 miles, a distance that may qualify.
“We actually felt that by getting all of our tales on the market … displaying all the totally different individuals that may be impacted by this choice, we actually thought that may be sufficient info for them [CMS] to contemplate the human and sensible issues of their choice,” Nonetheless stated. “Sadly, the one factor that issues is how they’re measuring the gap on the roads.”
The feds first notified Glenn Medical in April {that a} recertification evaluate discovered the hospital was not eligible for the essential entry program. Hospital officers clung to hope that an enchantment and communication with the company would make clear the state of affairs. However in a letter dated Aug. 13, the company informed the hospital it was standing by its authentic choice.
“After reviewing the hospital’s extra info, CMS discovered that the hospital continues to not meet the gap requirement,” the letter reads.
The areas of Glenn Medical Heart and its neighbor a county over haven’t modified since Glenn Medical first grew to become eligible for the essential entry program in 2001. CalMatters requested the federal company why it was looking for to revoke the hospital’s designation now after greater than twenty years of eligibility on the identical distance. The company didn’t instantly reply the query, however in an e mail merely reiterated the necessities to qualify for this system.
CMS stated Glenn Medical Heart might convert to a different supplier kind so as to proceed collaborating within the Medicare program. However Nonetheless stated no different Medicare reimbursement mannequin would pay the hospital at a financially sustainable price. Underneath the essential entry program, the federal authorities pays hospitals 101% of their prices for inpatient and outpatient providers supplied to Medicare sufferers.
U.S. Rep. Doug LaMalfa, a Richvale Republican who represents Glenn County, stated he continues to have conversations with Dr. Mehmet Oz, the administrator at CMS. He stated they final spoke final week.
“We’re not giving up by any stretch; we’re going to tug out all of the stops,” LaMalfa stated. “We had a extremely good dialog with Dr. Oz and are in search of a technique to make it work as a result of the closure is just not acceptable. It’s a technical difficulty that we must discover a technique to work by.”
LaMalfa stated he’s contemplating introducing a invoice that might replace the mileage requirement or give CMS extra discretion when evaluating rural hospitals. Nevertheless it’s unclear that one thing might get carried out earlier than October.
Glenn Medical Heart and its workers can’t look forward to for much longer. The hospital introduced it will hold its clinics open, however inpatient providers will stop Oct. 21. Nonetheless stated that’s when she expects to not have sufficient workers to have the ability to function.
“We needed to begin speaking to workers and telling workers that, “Hey, we don’t have a future right here. There’s no viable path ahead for us with out that essential entry designation,’” Nonetheless stated. “At that time, we began getting workers resignations.”
With the introduced closure, most Glenn County residents should search emergency providers both on the hospital in Colusa County or additional away at Butte County’s Enloe Medical Heart, a bigger Stage II trauma middle in Chico.
“We’re actively reviewing out there assets to make sure our readiness to soak up anticipated elevated affected person volumes on the Enloe Well being Emergency Division,” wrote Enloe Well being in an unsigned assertion.
Glenn County’s two ambulances may even should journey additional and be outdoors the county for longer durations of time, leaving residents with much more restricted emergency assets.
The introduced closure is a stark reminder of the precarious state of California’s rural hospitals. Even with elevated Medicare reimbursement, Glenn Medical Heart’s annual monetary statements present that the hospital persistently operated within the purple.
Two years in the past, the state bailed out 17 rural and neighborhood hospitals – Glenn Medical was not one in every of them – by loaning them near $300 million altogether. That mortgage program was largely prompted by the closure of Madera Neighborhood Hospital, which additionally left a complete county with out emergency providers. After chapter proceedings, Madera Neighborhood is now owned and operated by American Superior Administration, a for-profit firm that has made a enterprise out of rescuing distressed and shuttered hospitals. The corporate additionally owns Glenn Medical Heart.
“It’s devastating for our group from a private perspective as a result of we actually do satisfaction ourselves in being any individual who is available in and reopens hospitals,” Nonetheless stated. “After we go right into a neighborhood, we make that promise to the neighborhood that we’re not going to bail on them.”
Ana B. Ibarra writes for CalMatters.
