One other California county is dropping its solely hospital after feds refuse to step in

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 dwelling to twenty-eight,000 folks. With no native emergency room, they’ll as an alternative should journey at the least 40 minutes to a neighboring county for crucial care. 100 and fifty well being employees 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 Providers to strip the hospital’s federal “crucial 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 some other method than closing the hospital, stated Lauren Nonetheless, the hospital’s chief government.

“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 stated. “However actually, we simply should be practical, and that is the hand we’ve been dealt.”

Over the final a number of months, Nonetheless and her group 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 to foyer their case.

On the crux of the problem is a federal rule, newly reinterpreted, that requires crucial entry hospitals to be at the least 35 miles from the subsequent closest hospital when touring by predominant roads. Officers at CMS now say that the subsequent closest hospital, Colusa Medical Middle, is just 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 all the completely different folks that may be impacted by this determination, we actually thought that may be sufficient data for them [CMS] to think about the human and sensible concerns of their determination,” 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 evaluation 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. However in a letter dated Aug. 13, the company advised the hospital it was standing by its unique determination.

“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 Middle 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 searching for to revoke the hospital’s designation now after greater than twenty years of eligibility on the similar distance. The company didn’t immediately reply the query, however in an e-mail merely reiterated the necessities to qualify for this system.

CMS stated Glenn Medical Middle may convert to a different supplier sort in an effort to proceed collaborating within the Medicare program. However Nonetheless stated no different Medicare reimbursement mannequin would pay the hospital at a financially sustainable charge. Beneath 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, 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 strategy to make it work as a result of the closure just isn’t acceptable. It’s a technical difficulty that we should discover a strategy to work by way of.”

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 may get completed earlier than October.

Glenn Medical Middle and its employees can not await for much longer. The hospital introduced it will preserve its clinics open, however inpatient companies will stop Oct. 21. Nonetheless stated 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 crucial entry designation,’” Nonetheless stated. “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 heart in Chico.

“We’re actively reviewing out there sources 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 can even should journey additional and be exterior 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 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 neighborhood hospitals – Glenn Medical was not considered one 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 whole county with out emergency companies. 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 Middle.

“It’s devastating for our group from a private perspective as a result of we actually do satisfaction ourselves in being anyone who is available in and reopens hospitals,” Nonetheless stated. “Once 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.