A proposal authored by a U.S. Congress super committee established by the Budget Control Act of 2011 could eliminate the Critical Access Hospital designation within 15 miles of another licensed hospital facility.
“If they pass this, not only us, but Marion has the potential to close,” Hillsboro Community Hospital Chief Executive Officer Cheri Barton said Monday.
Rep. Tim Huelskamp (R-Fowler) responded in a written statement.
“There have been rumors about a number of changes that could affect critical access hospitals, but those concerns remain pure speculation because everything the Super Committee is doing happens behind closed doors,” Huelskamp said. “I am very concerned about the lack of transparency of the Super Committee. Nevertheless, I have signed onto a letter asking the Super Committee to protect current policies and funding for critical access hospitals.”
Hillsboro Community Hospital and St. Luke Hospital in Marion are designated as critical access hospitals and receive funding for 100 percent of inpatient services and a percentage of outpatient services from Medicare.
St. Luke CEO Jeremy Armstrong calculated that the hospital would lose $1.1 million per year under the proposal. The affect of that funding loss would force the St. Luke Board of Directors to double the mill levy to avoid a default of bond payments and close services like home care, emergency room, cardiac and pulmonary rehab, and skilled nursing services
“Even with the increased tax revenue, we would still need to cut nearly $400,000 from our operating budget,” Armstrong said. “If we don’t get the mill levy, we would default on our bond. If we default on our bond, nothing good will come out of it.”
St. Luke would need to lay off 10 to 15 full-time employees, about 10 percent of the hospital staff, he said.
“The indirect economic impact on Marion and the surrounding communities is estimated at a loss of $3.3 million per year,” Armstrong said.
Originally, the Critical Access Hospital designation was created by the Balanced Budget Act in 1997 to financially assist rural hospitals. To qualify as a CAH, a hospital needs to be 35 miles from another health care facility or be designated by the state as a necessary health care provider.
The necessary provider of health care services requirements are:
- The hospital is located in a county where the percentage of the population age 65 or older exceeds the current state average of 13.83 percent
- The hospital is located in an area which meets the federal criteria for designation as a health care professional shortage area.
- The hospital is located in a county where the percentage of families with incomes less than 200 percent of federal poverty level in higher than the current state average of 31.2 percent,
- The hospital is located in a county whose population density meets the federal frontier definition of less than six persons per square mile.
Marion County meets all those requirements except frontier.
“The federal government trumps everything,” Armstrong said. “That’s part of the reason we are upset. You allow the states the authority and now you’re changing the rules on us.”
Kansas has 83 critical access hospitals, the most of any state. Several of those hospitals fall within 15 miles of one another.
Barton said cutting critical access hospitals would not even save the government that much money. She said CAHs account for 2 to 3 percent of Medicare expenditures.
Although he said Kansas representatives and senators have been supportive of their local hospitals, Armstrong requested St. Luke patients, employees, and Marion County residents to write congressional leaders.
“Let them know about the situation,” he said.
Huelskamp responded in his statement about writing to the committee.
Barton said HCH is working with the Kansas Hospital Association to prevent the 15-mile rule from going into affect.
“We’re positioning ourselves with new hospital to survive in this environment we’re currently in,” Barton said.