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LCGH could see $3m benefit from designation change, report states

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LOWVILLE — Lewis County General Hospital could see a roughly $3 million annual benefit over the next few years by gaining a critical-access designation, according to a consultant’s report.

However, the county-owned hospital’s board of managers plans to hold off on a final decision for a couple of weeks to review the Stroudwater Associates study and obtain more information on potential impacts.

“We want to make sure we don’t limit our capability to the point where we can’t take more patients,” hospital CEO Eric R. Burch told board members Wednesday after distributing copies of the consultant’s report. “But it certainly warrants more discussion.”

While now licensed for 54 acute-care inpatient beds, the hospital, if designated as a critical-access facility, would be limited to no more than 25 inpatients at any given time.

Some of the current beds could be designated for observation patients who stay for only one day or less without counting against the 25-bed limit, but hospital officials still are researching specifics on how that could be done, Mr. Burch said.

While state officials have said the hospital could exceed the patient limit temporarily as long as it reports such occurrences, Director of Acute-Care Nursing David L. Wood said he still would like to find out how much leeway the facility would have before the status could be revoked. Mr. Wood said he also hopes to find out whether observation beds would have to be in a single designated area or could be spread throughout the facility.

Mr. Burch said he wants to find out how difficult it would be to return to the current status, if so desired.

At the suggestion of board President William H. Wormuth, the board set a special meeting for 5 p.m. Nov. 14 to discuss and possibly take action on the matter, rather than waiting one month until its next regular meeting.

“As a board, we’ve committed many resources to this report,” he said.

The hospital in 1999 was granted sole-provider status, which allowed for higher Medicare and Medicaid reimbursement than in previous years. A change to critical-access would offer even higher reimbursement.

The Stroudwater report, assuming that the hospital would not need to reduce any inpatient services and making other patient- and finance-related projections, suggested a switch would result in an extra $3.13 million of federal reimbursement in 2013, $2.72 million in 2014 and $3.35 million in 2015.

“Based upon this analysis, Stroudwater recommends that LCGH begin” the critical-access hospital (CAH) application process “as soon as possible,” the report stated.

That process is expected to take about three months, Mr. Burch said.

Noting a decline in admissions over the past several years, Stroudwater officials suggested the 25-bed limit likely could be met without cutting services.

“Historically, LCGH inpatient utilization has been sufficiently high to preclude looking into the option of converting to CAH status,” the report stated. “However, recent inpatient census has decreased and is currently at levels that are reasonable for CAH consideration.”

Hospital officials, in a fact sheet compiled on critical-access designation, noted that the facility staffs only 29 of the 54 beds “and it is rare that those 29 beds are occupied at the same time.”

A critical-access hospital also must be at least 15 miles from the next closest facility if the two hospitals are connected by secondary roads. The report indicated that Lewis County General is 15.9 miles from Carthage Area Hospital, based on Google maps, but that the first step in the application process should be to verify that it meets the distance requirement.

The hospital has a year-to-date operating loss of more than $1 million, Mr. Burch reported Wednesday.

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