Greenwood Leflore Hospital, as part of a long-term strategy to avoid closure, has decided to pursue a designation that would increase its Medicare payments.
In his weekly update to the hospital’s employees Wednesday, Gary Marchand, the interim CEO, announced that the hospital had decided to move forward with seeking a designation either as a “critical access” or “rural emergency” hospital.
He later elaborated to the Commonwealth that the “critical access” designation appears to be the more favorable option but that both possibilities are still being evaluated.
The designations do come with trade-offs.
To qualify for either designation, the hospital would have to reduce its bed count. It is currently licensed for 208 beds, although it hasn’t needed anywhere near that many for years. In 2019, the year before the COVID-19 pandemic, the average patient census was 67, according to hospital records. This past year, the average was 33, and most recently, the hospital has been staffing only 12 to 16 beds. A critical access hospital can have no more than 25 inpatient beds, and a rural emergency hospital no more than 50.
As a critical access hospital, it would be unlikely that Greenwood Leflore Hospital would reopen its labor and delivery unit, which it shut down in August as a cost-cutting move. Neither of two nearby critical access hospitals, Tyler Holmes Memorial Hospital in Winona and North Sunflower Medical Center in Ruleville, operate maternity wards.
The decline in maternity services in the Delta has been a concern to Mississippi health officials, who note the region’s high incidence of infant and maternal mortality.
The Greenwood hospital also would have to obtain a waiver from the federal government on the rule that says critical access or rural emergency hospitals cannot be within 35 miles of another hospital. Greenwood’s hospital is within 35 miles of the hospitals in Winona and Ruleville, as well as South Sunflower County Hospital in Indianola. The University of Mississippi Medical Center in Grenada is right on the edge of the distance limit.
U.S. Rep. Bennie Thompson has said he would be willing to help Greenwood obtain a waiver. He said he has been previously successful in assisting two other hospitals in his district do just that in receiving the critical access designation.
The Greenwood hospital has a payer mix that is heavily skewed toward Medicare, which covers the elderly, and the other government insurance program, Medicaid, which covers the poor and disabled. About 50% of the hospital’s patients are on Medicare, and 25% on Medicaid.
Increasing the reimbursements from both programs, say industry officials, is a critical component to addressing a crisis with rural hospitals that has pushed a number of them toward the brink of insolvency. While Medicare reimbursements are decided at the federal level, changes with Medicaid would have to be made by the Mississippi Legislature or the state Division of Medicaid, which administers the federal-state program.
The Greenwood hospital, which is jointly owned by Greenwood and Leflore County, has been losing millions of dollars annually for years, a condition that has been exacerbated by the pandemic’s upward impact on costs and downward impact on revenues. Nearly out of cash, the hospital is projected to be facing closure at the end of December or early January without a financial infusion. This week, the Leflore County Board of Supervisors agreed to put up $2.25 million to keep the hospital in operation at least through the end of March, and the Greenwood City Council is expected to do the same.
During this time, it is hoped that the Mississippi Legislature will act to address the hospital crisis. Lawmakers are being asked to expand Medicaid to cover more of the uninsured, reduce or eliminate the state taxes hospitals pay on Medicaid revenues and increase the Medicaid supplemental funding.
Greenwood’s hospital would be concurrently pursuing the more favorable Medicare designation. Marchand warned, though, that the change won’t happen overnight, as “this will require time to position all the pieces of this effort into a comprehensive approach.”
Contact Tim Kalich at 662-581-7243 or tkalich@gwcommonwealth.com.
