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Friday, March 14, 2014 - 7:00am

State May Allow Struggling Rural Hospitals To Offer Only Basic Services

Updated: 1 year ago.
Stewart Webster Hospital is among the rural medical centers that have closed in Georgia over the last year. Now state regulators are considering allowing a hospital to downsize its services. Clyde Reese, commissioner of the Department of Community Health, said Thursday he would ask the board of the agency to promulgate rules for such a “step-down” facility. (Photo Courtesy of Georgia Health News.)

Rural health care may get a needed boost under a proposed regulation change that would allow a hospital to downsize its services, the commissioner of a Georgia health agency said Thursday.

Clyde Reese, commissioner of the Department of Community Health, said he would ask the board of the agency to promulgate rules for such a “step-down” facility. Reese, speaking at a meeting of the board, said Gov. Nathan Deal would make an announcement on rural health care next week.

Reese did not expand on those remarks. But industry officials told GHN that the Community Health proposal likely would allow a rural hospital that has recently closed — or one that’s currently struggling to survive — to downsize to a facility that includes an emergency room, surgery and childbirth services.

Rural health care has turned into an important topic at the General Assembly this year, fueled by the closing of four financially struggling rural hospitals in the state over the past two years. A total of eight have shut since 2000.

Jimmy Lewis of HomeTown Health, an organization of rural hospitals in Georgia, said rural health care “has become a major issue,” with hospital closings and the potential shuttering of others.

The state may be able to change licensing rules and regulations to allow rural communities to create a facility from “a buffet of options they may choose from,” Lewis said.

“This is a very necessary, forward-thinking proposal for the future of rural health care,” he added.

But while a “step-down” hospital may be allowed simply through regulatory changes, it may take action by legislators to allow a community that lost a hospital more than a year previously to build a facility such as a standalone emergency room.

Experts say many rural hospitals — which have large numbers of uninsured patients — would be helped financially under an expansion of Medicaid, because many of those people would get coverage. But the governor, backed by the Republican leadership in the Legislature, has said “no” to expansion, citing the costs to the state.

Rural health care was raised as an issue at the outset of the General Assembly session, with state Rep. Sharon Cooper (R-Marietta), who chairs the House Health and Human Services Committee, telling WABE that “there are some of those rural hospitals that need to close.”

Two days later, Cooper backtracked on that comment, saying that closing rural hospitals is an “unthinkable proposition,” according to the AJC. Cooper said closing hospitals “would have serious consequences on the affected community, hurting it economically and limiting access to acute care for Georgians.”

Sen. David Lucas (D-Macon) introduced legislation that would help rural areas such as Hancock County — where the hospital closed several years ago — to build “stabilization centers.” Such a center would have the mission of stabilizing the condition of a patient whose life may be at risk.

A stabilization center, for instance, would be able to give quick treatment to someone who has been in an industrial accident, Lucas told GHN on Thursday.

“In order to get economic development [in an area], you’ve got to have health care,” he added.

And Sen. Jeff Mullis (R-Chickamauga) said a hospital in his district, Hutcheson Medical Center, is “struggling tremendously.” Mullis told GHN that he has talked with Gov. Deal’s staff about assistance for rural hospitals, and that he is hopeful that the state can offer help.

Lewis of HomeTown Health said other state moves to help rural health care could include improving reimbursements to rural hospitals and incentivizing collaborations between facilities.

South Carolina recently raised the Medicaid reimbursements that it pays struggling rural hospitals. Gov. Nikki Haley’s administration called it a way to improve the health of the Palmetto State’s most vulnerable residents.

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