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The Llano County Hospital Authority faces a tight deadline in getting Llano County Memorial Hospital approved for a designation that could cover 100 percent of its Medicare patients’ bills.
The authority reviewed the hospital’s application for a Critical Access Hospital designation during a meeting Monday, Sept. 21. Along with the application, the process requires an intensive survey of hospital operations that can take up to 30 days and require weeks of preparation.
The U.S. Congress established the CAH designation in 1997 to help financially bolster rural hospitals. The Centers for Medicare and Medicaid Services determines if a facility meets CAH requirements. The designation would mean that Medicare patients’ bills who get care at the Llano hospital are paid in full. Currently they are not, which places a financial strain on the already stressed institution and patients.
In July, Baylor Scott & White Health notified the LCHA it was not renewing its operational contract for the Llano hospital when it expires at the end of 2020. The health care system has managed the Llano facility for 10 years.
BSW officials said they were not renewing the contract, in part, because the hospital doesn’t make enough of a profit.
Mid Coast Health Systems has emerged as a frontrunner to take over management of the Llano hospital.
Even if Baylor Scott & White Health does not continue its contract with the Llano County Hospital Authority, the health care system has a role in the Critical Access Hospital designation.
“This is a little bit quirky. It’s going to be Baylor’s responsibility to get its team ready for a survey that they have no interest in whether it passes or not unless they’re really on board with the transition,” said Brett Fuller, a CPA that works for Discovery Health Care, which is working pro bono for the LCHA.
Under the CAH process, a third-party contractor assisting the hospital authority has up to 45 days to review the application. Then, the state has 45 more days to look it over, with the Centers for Medicare and Medicaid Services’ review taking up to another 60 days.
“We’re still pressing against that December 31 deadline. Hopefully, we can have some sort of determination before that,” Fuller said. “I do know that at least the communications with CMS have been positive at least in expediting their review.”
As for managing the Llano hospital, Mid Coast Health Systems has issued a letter of intent to oversee it beginning in 2021. The hospital authority recommended Mid Coast — a two-hospital, 15-clinic system based out of El Campo — to the Llano County Commissioners Court. The commissioners court will have final approval in contracting with Mid Coast to manage Llano County Memorial Hospital.
Though Baylor Scott & White Health is stepping away from the hospital, it had not planned to step away from operating the county’s emergency medical services. The hospital board, however, has recommended the county sign an agreement with the Hamilton County Hospital District to take over EMS.