Changes in government regulations, Medicare reimbursements, along with the sequestration, and simply the way a hospital does business are being considered by the Williamsburg Regional Hospital Board of Trustees as they lean toward converting from Critical Access to Perspective Payment System. During an October 2, meeting, the board approved a motion to authorize the administration to move forward in the process. Discussions regarding the move have been on the table since 2012.
In 1997, the Balanced Budget Act created the Critical Access program to provide citizens in rural communities access to health care. In 2004, Williamsburg Regional converted from Acute Care to Critical Access. Five Critical Access Hospitals currently operate in South Carolina.
In order for a hospital to be designated as a Critical Access Hospital (CAH), it must meet two location-related requirements, have fewer than 25 beds and maintain an annual average length of stay. Williamsburg Regional met the criteria. However, as health care initiatives expand so have patient stays and failing to meet or exceeding the guidelines affects Medicare reimbursement. Mix that with the expansion of services coming at a time of cuts in Medicare reimbursements and the implementation of the mandated Medical Health Records, collectively they are impacting the hospital's cash flow. The hospital's year-to-date net loss through July is $1.109 million.
However, administration is "teeing the ball up" and the first thing is by finalizing the necessary paperwork for an additional 15 beds. "It's not costing us anything to move forward - to at least tee the ball up," said Dr. Troy Gamble, the hospital's chief medical officer. "We can always withdraw our request in a minute and make the drastic cuts and do the other things." The hospital recently underwent a reduction in employee hours.
Gamble projected a six month struggle ahead. "I really studied this...Look at this hospital. There is good stuff going on here. There're sick people that had to get their care elsewhere. They're now getting it right here and surviving and going home." CEO Sharon Poston contiues to be optimistic. "We’re up over $300,000 for September (over August) so that is encouraging," Poston said in an email. "We anticipate October to be even better. Looks like the up swing is beginning."