Five Rivers adapts to new status
Pocahontas facility is state’s first designated ‘rural hospital’
A month after it became the state’s first hospital to take advantage of a new designation allowing it to receive enhanced federal support in exchange for eliminating most inpatient services, St. Bernards Five Rivers Medical Center has adjusted well to the shift, said Mitchell Nail, spokesman for St. Bernards Healthcare.
“The transfer process between St. Bernards Five Rivers Medical Center in Pocahontas and St. Bernards Medical Center in Jonesboro has worked well,” Nail said.
“Patients at St. Bernards Five Rivers have inpatient beds ready when they need it. We prepared heavily to ensure transfers occurred smoothly, but it’s still relieving to see them working as planned.”
The Pocahontas hospital’s new designation as a Rural Emergency Hospital has been in effect since Sept. 1.
When a hospital converts to the designation, it is required to keep transfer agreements with non-Rural Emergency Hospitals to mitigate the loss of inpatient services, Nail said.
Though it no longer provides inpatient care, St. Bernards Five Rivers still provides observational care for patients who don’t need to be transferred to St. Bernards Medical Center, Nail said.
“We can maintain somebody in observation care typically, and you hold them for a brief amount of time that can be upwards of up to 24 hours, but the care is not an acute type of care of what someone is expecting if they’re like in a triage in the emergency department. We may just be keeping an eye on them until they’re stable,” he said.
For St. Bernards Five Rivers, educating the community of Pocahontas about the care and the staff on answering questions has been important, Nail said.
“From the perspective of patients and visitors, we’re fielding quite a few questions about inpatient versus observation care, especially if that observation care extends overnight. Observation care is just kind of a little bit different setting,” he said.
He said the hospital is still waiting on the Centers for Medicare and Medicaid Services to finalize its Rural Emergency Hospital designation.
“These processes can take time, so we recommend other facilities considering the change to factor in how long it might take to finalize their status in addition to approving it,” Nail said.
“If there’s a facility that finds itself in financial straits, they need to be prepared for the process. We’re not talking about a matter of a few weeks, it can take months.”
The Rural Emergency Hospital designation was
established by Congress through a covid relief and omnibus spending bill signed by then-President Donald Trump in December 2020.
Federal regulations on the designation took effect in January of this year, and the Arkansas Legislature passed a bill in February allowing the state Department of Health to create regulations allowing hospitals to apply for the status.
State lawmakers approved an emergency Department of Health rule on Rural Emergency Hospitals in May that took effect for 120 days. A permanent rule cleared the Legislative Council in August.
To receive the designation, hospitals must have no more than 50 beds, provide 24/7 emergency services, keep the average length of patient stays to 24 hours or less and have a transfer agreement with a Level I or II trauma center.
In exchange, hospitals receive a 5% increase in their Medicare reimbursement for outpatient services. Medicare also pays them a monthly facility fee, which this year is $272,866.
Administrators at other small hospitals said they don’t see the Rural Emergency Hospital designation as a good fit.
Scott Taylor, administrator for Ozarks Community Hospital in Gravette, said changing its status was a “non-starter.”
“I see how it could make sense if you had an inpatient census that floated around with two or three — which several within the state do have that as kind of their average census,” he said. “Ours tend to float around 15 to 20. … We just thought, ‘Yeah, that’s not a viable solution for us.’”
Like St. Bernards Five Rivers, hospitals that are a part of a larger system may benefit more from converting to a rural emergency hospital, Nail said.
However, Baptist Health has no plans to pursue Rural Emergency Hospital status for any of the hospitals in its system, CEO Troy Wells said.
“Based on our current situation, we wouldn’t see a benefit to make a change. We are pleased that the Centers for Medicare and Medicaid Services have created the Rural Emergency Hospital designation. This could be really helpful for some hospitals in Arkansas,” he said.
To receive the designation, hospitals must have no more than 50 beds, provide 24/7 emergency services, keep the average length of patient stays to 24 hours or less and have a transfer agreement with a Level I or II trauma center.