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 folks. With out a native emergency room, they’ll as a substitute should journey no less than 40 minutes to a neighboring county for vital 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 Middle follows a choice by the U.S. Facilities for Medicare and Medicaid Companies to strip the hospital’s federal “vital 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 a success of about 40% — a niche too giant to fill another means than closing the hospital, mentioned Lauren Nonetheless, the hospital’s chief govt.
“It’s heartbreaking that we come to this. I’m nonetheless form of praying for that Eleventh-hour miracle to come back by way of,” Nonetheless mentioned. “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 workforce have been making an attempt 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 vital entry hospitals to be no less than 35 miles from the subsequent closest hospital when touring by foremost roads. Officers at CMS now say that the subsequent closest hospital, Colusa Medical Middle, is simply 32 miles away — three miles in need of the required distance.
Glenn Medical Middle and county well being officers argue that most individuals and ambulances take a special 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 the entire totally different folks that may be impacted by this determination, we actually thought that may be sufficient info for them [CMS] to contemplate the human and sensible issues of their determination,” Nonetheless mentioned. “Sadly, the one factor that issues is how they’re measuring the space on the roads.”
The feds first notified Glenn Medical in April {that a} recertification overview discovered the hospital was not eligible for the vital entry program. Hospital officers clung to hope that an attraction and communication with the company would make clear the scenario. However in a letter dated Aug. 13, the company informed the hospital it was standing by its unique determination.
“After reviewing the hospital’s further info, CMS discovered that the hospital continues to not meet the space requirement,” the letter reads.
The areas of Glenn Medical Middle and its neighbor a county over haven’t modified since Glenn Medical first grew to become eligible for the vital 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 similar distance. The company didn’t straight reply the query, however in an e mail merely reiterated the necessities to qualify for this system.
CMS mentioned Glenn Medical Middle might convert to a different supplier kind to be able to proceed taking part within the Medicare program. However Nonetheless mentioned no different Medicare reimbursement mannequin would pay the hospital at a financially sustainable charge. Beneath the vital 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 drag out all of the stops,” LaMalfa mentioned. “We had a extremely good dialog with Dr. Oz and are on the lookout for a technique to make it work as a result of the closure shouldn’t be acceptable. It’s a technical subject that we should discover a technique 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. Nevertheless it’s unclear that one thing might get performed earlier than October.
Glenn Medical Middle and its employees can not look forward to for much longer. The hospital introduced it could maintain its clinics open, however inpatient companies will stop Oct. 21. Nonetheless mentioned that’s when she expects to 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 vital entry designation,’” Nonetheless mentioned. “At that time, we began getting employees resignations.”
With the introduced closure, most Glenn County residents must search emergency companies both on the hospital in Colusa County or additional away at Butte County’s Enloe Medical Middle, a bigger Degree II trauma middle in Chico.
“We’re actively reviewing accessible 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 exterior the county for longer intervals 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 Middle’s annual monetary statements present that the hospital persistently operated within the crimson.
Two years in the past, the state bailed out 17 rural and group hospitals – Glenn Medical was not one among them – by loaning them near $300 million altogether. That mortgage program was largely prompted by the closure of Madera Group Hospital, which additionally left a complete county with out emergency companies. After chapter proceedings, Madera Group 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 Middle.
“It’s devastating for our group from a private perspective as a result of we actually do delight ourselves in being any individual who is available in and reopens hospitals,” Nonetheless mentioned. “Once we go right into a group, we make that promise to the group that we’re not going to bail on them.”
Ana B. Ibarra writes for CalMatters.
