Absent a Hail Mary, Glenn County’s solely hospital is about to shut its doorways in October.
Tucked between two nationwide forests, the agricultural county is dwelling to twenty-eight,000 individuals. Without an area emergency room, they’ll as a substitute must journey not less than 40 minutes to a neighboring county for crucial care. One hundred and fifty well being employees will lose their jobs; they’re already resigning to hunt work elsewhere.
The deliberate closure of Glenn Medical Center follows a call by the U.S. Centers for Medicare and Medicaid Services to strip the hospital’s federal “crucial entry” designation, a standing that has supplied Glenn Medical elevated reimbursement and regulatory flexibility. Without that standing, the hospital’s $28 million in web annual income will take successful of about 40% — a niche too massive to fill another approach than closing the hospital, mentioned Lauren Still, the hospital’s chief government.
“It’s heartbreaking that we come to this. I’m nonetheless type of praying for that Eleventh-hour miracle to come back by way of,” Still mentioned. “But truthfully, we simply must be real looking, and that is the hand we’ve been dealt.”
Over the final a number of months, Still 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 to foyer their case.
At the crux of the difficulty is a federal rule, newly reinterpreted, that requires crucial entry hospitals to be not less than 35 miles from the following closest hospital when touring by essential roads. Officials at CMS now say that the following closest hospital, Colusa Medical Center, is simply 32 miles away — three miles wanting the required distance.
Glenn Medical Center and county well being officers argue that most individuals and ambulances take a unique route, I-5 to Highway 20. That route is 35.7 miles, a distance that might qualify.
“We actually felt that by getting all of our tales on the market … displaying all the completely different individuals that might be impacted by this choice, we actually thought that might be sufficient data for them [CMS] to contemplate the human and sensible issues of their choice,” Still mentioned. “Unfortunately, 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 overview discovered the hospital was not eligible for the crucial entry program. Hospital officers clung to hope that an enchantment and communication with the company would make clear the state of affairs. But in a letter dated Aug. 13, the company informed the hospital it was standing by its unique choice.
“After reviewing the hospital’s further data, CMS discovered that the hospital continues to not meet the gap requirement,” the letter reads.
The places of Glenn Medical Center and its neighbor a county over haven’t modified since Glenn Medical first turned eligible for the crucial entry program in 2001. CalMatters requested the federal company why it was in search of to revoke the hospital’s designation now after greater than 20 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 mentioned Glenn Medical Center might convert to a different supplier kind to be able to proceed taking part within the Medicare program. But Still mentioned no different Medicare reimbursement mannequin would pay the hospital at a financially sustainable charge. Under the crucial entry program, the federal authorities pays hospitals 101% of their prices for inpatient and outpatient companies supplied to Medicare sufferers.
U.S. Rep. Doug LaMalfa, a Richvale Republican who represents Glenn County, mentioned he continues to have conversations with Dr. Mehmet Oz, the administrator at CMS. He mentioned they final spoke final week.
“We’re not giving up by any stretch; we’re going to tug out all of the stops,” LaMalfa mentioned. “We had a extremely good dialog with Dr. Oz and are on the lookout for a strategy to make it work as a result of the closure shouldn’t be acceptable. It’s a technical challenge that we should discover a strategy to work by way of.”
LaMalfa mentioned he’s contemplating introducing a invoice that might replace the mileage requirement or give CMS extra discretion when evaluating rural hospitals. But it’s unclear that one thing might get accomplished earlier than October.
Glenn Medical Center and its employees can not await for much longer. The hospital introduced it could hold its clinics open, however inpatient companies will stop Oct. 21. Still mentioned that’s when she expects to now not have sufficient employees to have the ability to function.
“We needed to begin speaking to employees and telling employees that, “Hey, we don’t have a future right here. There’s no viable path ahead for us with out that crucial entry designation,’” Still mentioned. “At that time, we began getting employees resignations.”
With the introduced closure, most Glenn County residents should search emergency companies both on the hospital in Colusa County or additional away at Butte County’s Enloe Medical Center, a bigger Level II trauma middle in Chico.
“We are actively reviewing obtainable sources to make sure our readiness to soak up anticipated elevated affected person volumes on the Enloe Health Emergency Department,” wrote Enloe Health in an unsigned assertion.
Glenn County’s two ambulances can even must journey additional and be outdoors the county for longer intervals of time, leaving residents with much more restricted emergency sources.
The introduced closure is a stark reminder of the precarious state of California’s rural hospitals. Even with elevated Medicare reimbursement, Glenn Medical Center’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 Community Hospital, which additionally left a whole county with out emergency companies. After chapter proceedings, Madera Community is now owned and operated by American Advanced Management, a for-profit firm that has made a enterprise out of rescuing distressed and shuttered hospitals. The firm additionally owns Glenn Medical Center.
“It’s devastating for our group from a private perspective as a result of we actually do satisfaction ourselves in being any person who is available in and reopens hospitals,” Still mentioned. “When 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.
