Eighty-five percent of the patients are Native American
SIOUX FALLS, S.D. (AP) – The governor's office is brokering a deal to keep the doors open at Bennett County Hospital, an isolated critical-care facility on the Nebraska border that has been plagued by financial problems.
But hospital administrators say the deal won't fix the underlying problems that have pushed the Martin facility into insolvency.
Last spring the South Dakota Department of Social Services gave Bennett County a one-time payment of around $300,000 to help meet payroll.
However, it was a short-term fix, and the hospital is at the brink again. The problem is twofold, hospital CEO George Minder said: Medicaid reimbursements from the state have dropped in recent years, and Indian Health Services refuses to reimburse the hospital for most treatment of tribal members.
“It's the hand we've been dealt here,” Minder said. “You're sandwiched between a couple of the poorest communities in America” – Shannon County, home to the Pine Ridge Reservation, and Todd County, home to the Rosebud Reservation.
In 2010, the year Minder arrived at the hospital, it gave away almost $1 million a year in free care, he said. That dropped to $200,000 in 2011, he said, but the hospital continues to hemorrhage money at a staggering rate – $78,000 in February alone.
The county used to own the hospital, but it's now run by a nonprofit board.
Closing the hospital would leave a 200-mile stretch of U.S. Highway 18 from Winner to Hot Springs without emergency medical care.
After Martin, the closest hospital is in Gordon, Neb., but figuring out who pays for a Medicaid patient who lives in one state but is treated in another is a tangled issue, Minder said. Philip is 80 miles away, Rapid City 150.
“Honestly? We need somebody to give us a couple of million dollars,” said David Jones, chairman of the hospital board.
The hospital doesn't offer high-dollar surgical services, which could boost income, and it sees 200 emergency-room patients a month – 92 percent of whom don't have commercial insurance, Minder said.
Eighty-five percent of the patients are Native American, and the Oglala Sioux Tribe has been helpful in lobbying the IHS to pay its bills, Minder said.
“This is their hospital,” he said.
Martin, population 1,071, is in the La Creek District of the Oglala Sioux Nation, and Tribal Councilor Craig Dillon said the tribe has been trying to get IHS to agree to at least pay for initial hospital visits.
“We've been fighting this fight for more than a year. ... The state has been really good through this,” he said.
Tribal members went to Washington to meet with IHS Director Yvette Roubideaux, but Dillon said the agency has been less than honest with them.
“We really need to hold IHS accountable,” he said. “I'm tired of them telling us what they can't do. I want to hear what they can do.”
A regional IHS spokeswoman in Aberdeen said the agency would respond to questions but had not by late Friday.
“It isn't a white issue, it isn't an Indian issue. It's a people issue,” Dillon said. “If we lose this, it's never going to get opened again.”
In the meantime, the hospital is working with several state agencies to find a way to stay open. Last week, hospital administrators had a conference call with state officials to outline a deal.
“We don't have a deal worked out yet,” Jones said. “They're proposing to maybe work on some enhanced reimbursements for us. It isn't a definite deal.”
One point of dispute seems to be the extent to which federal Medicaid definitions are exacerbating the hospital's financial problems. Minder said the hospital has been lumped in with larger hospitals because of its high rate of Medicaid discharges; consequently, it's not eligible for a higher reimbursement rate from the state.
Tony Venhuizen, a spokesman for Gov. Dennis Daugaard, said it's not that simple. Still, the state sent a team to Martin to go over the hospital's books and found a way to provide its nursing home an additional $30,000 a month.
“The state is doing what it can to keep it open,” Venhuizen said.
Minder said the extra money will help, but “It's still a stopgap measure. It's a three- to six-month deal.”
“This is their hospital,” he said.
Martin, population 1,071, is in the La Creek District of the Oglala Sioux Nation, and Tribal Councilor Craig Dillon said the tribe has been trying to get IHS to agree to at least pay for initial hospital visits.
“We've been fighting this fight for more than a year. ... The state has been really good through this,” he said.
Tribal members went to Washington to meet with IHS Director Yvette Roubideaux, but Dillon said the agency has been less than honest with them.
“We really need to hold IHS accountable,” he said. “I'm tired of them telling us what they can't do. I want to hear what they can do.”
A regional IHS spokeswoman in Aberdeen did not immediately respond to requests for comment.
“It isn't a white issue, it isn't an Indian issue. It's a people issue,” Dillon said. “If we lose this, it's never going to get opened again.”
In the meantime, the hospital is working with several state agencies to find a way to stay open. Last week, hospital administrators had a conference call with state officials to outline a deal.
“We don't have a deal worked out yet,” Jones said. “They're proposing to maybe work on some enhanced reimbursements for us. It isn't a definite deal.”
One point of dispute seems to be the extent to which federal Medicaid definitions are exacerbating the hospital's financial problems. Minder said the hospital has been lumped in with larger hospitals because of its high rate of Medicaid discharges; consequently, it's not eligible for a higher reimbursement rate from the state.
Tony Venhuizen, a spokesman for Gov. Dennis Daugaard, said it's not that simple. Still, the state sent a team to Martin to go over the hospital's books and found a way to provide its nursing home an additional $30,000 a month.
“The state is doing what it can to keep it open,” Venhuizen said.
Minder said the extra money will help, but “It's still a stopgap measure. It's a three- to six-month deal.”
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Information from: Argus Leader, http://www.argusleader.com