City Council, SGH Discuss Future
SISTERSVILLE – Dozens of people attended a City Council meeting Monday to discuss the future of Sistersville General Hospital.
John May, SGH chief executive officer, said due to nature of health care, rural hospitals are at risk of closing as they struggle with government red tape and finances.
The city owns the hospital, so that creates roadblocks toward and limits opportunities that are not granted to government managed enterprises, May said.
“I want to cooperate with city council,” he said. “We all want the same thing. We want to have a facility that is sustainable in our community and that provides the right level of service. We all believe that includes an emergency room. I think tonight (Monday) has provided us a pathway to get there. I’m optimistic for the future. We have a lot of support from our local community and I think that bodes well for the future of our hospital.”
Mayor Bill Rice expressed concern that if the hospital were to transform itself into another legal entity, then the city and Tyler County may be at risk for losing its health care provider.
“What I to find out is can we make this thing work?” he asked. “If we let it go, do we get a new medical facility or we at least get something for letting it go. I’m not in favor of letting the hospital go and not see anything out of it. I’m not quite sure how that is going to happen yet, what the answer is.”
Council and hospital administrators agreed to study options about how to preserve the hospital in this challenging health care environment. Council approved a motion to form an exploratory committee comprised of the SGH administration, City Council and affected parties. May sand Rice said they think the exploratory committee will enhance communication between SGH and City Hall. May said he plans to talk more with City Council during future meetings.
SGH Chief of Staff Amanda Nichols made a presentation that addressed some of the hospitals problems.
“Health care has changed dramatically during the past 20 years, the past 10 years, the past five years, event the past two years,” she said. “It is forever changing. What causes the fluctuations? Government regulations, insurance reform and especially state Medicaid and Medicare restrictions.”
She said there is no “nice way” to say it, but the government doesn’t like small rural hospitals.
“A lot of these people in big cities believe that we should be able to find our way into a big city hospital if were to become sick or injured,” she said. “We know that is just not possible in our place in this world.”
Nichols said critical access hospitals are closing in drastic numbers nationwide. She said more than 70 have closed since 2010 and at least 700 more are at risk for closing.
“Not only do they not want to see us here, but they want to keep finding ways genius ways to not pay us for our services,” she said.
Nichols said not only has government reimbursement for uncompensated care sharply decreased in past years, but the state changed the formula so much so that hospitals have to repay money it believes it overpaid. She said SGH owes the state $880,000.
“Who can afford that? Who can pay that kind of money back?” she asked. “Not us. We are a small critical access hospital with a very small room for a margin of error. We have a very small budget and we just can’t afford things like that. These kinds of things hit us all the time, but we don’t lay down and die.”
Nichols said though the hospital is drastically outdated with systems in place that are considered archaic, the health care provided is top quality. That said, the hospital’s lack of resources and more have left SGH in a financial crisis.
May spoke of SGH having around $5 million dollars of liabilities.
Nichols said, “If we are to sustain and thrive, change has to be made.”
May said the city would ultimately be responsible for that debt.
Nichols said SGH doesn’t blame the city for the hospital’s woes, but current state of healthcare regulations.
“At this point, we are seeking to get financially stable, plan for the future and continue the excellent medical care the city of Sistersville has,” she said.
May said, “We’re coming to a point where we’re going to have a severe financial crisis. We’ve got to do something to avoid having that happen to us. We’re asking for flexibility in moving forward. We’ve never really asked the city council for anything. We just talked to them; gave them some talking points and said this is what we would like to do. If there is a way we can do it and keep it in the city’s name, and keep it in the city’s name, I have no objection to that.”
West Virginia University Hospitals approached SGH about the possibility of entering into a partnership to cooperatively develop a new health care facility.
May said WVU was considering building an ambulatory care center in or near Sistersville. WVU Medicine has provided a list of intended services and minimum staffing levels for the proposed center. He said SGH is the second largest employer in Tyler County, so any possible staff reduction from 110 employees to 50 employees would be felt.
There was uncertainty as to whether an emergency department would be in the cards because WVU favors a primary care approach, but that SGH strongly endorses an emergency room because the numbers were there to support that service, May said. If there is no emergency room, ambulance service could be affected, perhaps eliminated.
Nichols said these potential plans are stalled because of the city’s ownership of the hospital a complex problem involving government-ownership and control.
“Because we are tied to our governmental affiliation, those talks stalled and we were not able to move forward and we could not come to an agreement,” Nichols said. “The proposal was not signed and things did not move forward in that direction. Those talks are frozen, but we continue to stay in close communication and conversation with WVU. They are still very interested in becoming a partner with us as a management type of agreement.”
Rice said when WVU was interested, he was all “on board,” but now he is worried about who would control the hospital if the city gave up ownership.
Nichols said if the hospital were to partner with WVU, it would maintain its independence as other hospitals have who have chosen to affiliate themselves with WVU. She said an agreement would benefit the hospital.
“Who are we to think that we can remain island among ourselves in this oppressive health care environment,” she said.
Nichols said because SGH is tied to City Hall, the hospital is unable to apply for grants for equipment upgrades and is unable to attract the investment needed to build a new facility.
May said that it would cost $25 million to upgrade equipment and facilities. If SGH were outside the city’s domain, it has a better chance to secure funding, May said. Otherwise, a bond issue might be necessary to provide the necessary funding.
“If that was what the bill is going to be, would the city be willing to float a bond issue for that kind of money to pay that?” he asked. “I don’t know if we can sell a bond issue for that.”
Mayor Rice asked how SGH would get that kind of investment.
May answered, ” “I think we have an opportunity to get money through grants. There’s a lot of people willing to invest in that type of arrangement that maybe wouldn’t do it through the city.”
Councilman Alex King said a plan is needed to move forward.
“What we’re needing is something in writing,” he said. “We’re needing a game plan – something step by step that we can see. I’ll be glad to work with you on it. I would be glad to work with you on it and learn as much as I can. As a council if we have the choice to let you have the hospital and then it falls through, that comes back on us. That was our decision and people are going to question that then. We have to make sure…”
Nichols said SGH wants what City Council wants.
“That is a hospital that continues to be here and to thrive and to provide the excellent medical that we have in Sistersville,” she said. “I know change can be hard, but I’m asking for your full support.”