SPH works on critical access certification

Posted: Friday, May 16, 2008

State delay in certifying South Peninsula Hospital as Critical Access Hospital is costing the Homer medical facility roughly $60,000 a month in lost Medicare reimbursement payments, according to the hospital's CEO, Bob Letson.

The hospital applied for Critical Access Hospital (CAH) status last July and received an approval letter in August. But eligibility for receiving reimbursements under CAH rules awaits an unannounced inspection of the facility that must be conducted by the Alaska Department of Health and Social Services, Letson said in a March note to Rep. Paul Seaton.

A lack of staff, however, has prevented the department from conducting the facility survey. The absence of a CAH status already has cost the hospital about $480,000, a figure that could reach $720,000 a year unless corrected.

"This situation will eventually cause extra costs for South Peninsula Hospital Service Area taxpayers and citizens," the hospital's board of directors said in a resolution sent to state officials in March, along with a letter appealing for help from Kenai Peninsula legislators, Gov. Sarah Palin, and Borough Mayor John Williams, as well as the Kenai Peninsula Borough Assembly and the city of Homer.

Letson was unavailable for comment this week, according to hospital staff, but on Wednesday, the hospital learned that a proposed avenue around the bureaucratic dilemma would meet state approval, and that a survey of a somewhat different variety could be conducted as early as June and quickly put a CAH in place, hospital spokeswoman Derotha Ferraro said Wednesday.

Furthermore, the CAH may be made retroactive to July 1, 2007, effectively allowing the hospital to recover the reimbursement funds it has lost.

"The state, in the last day, has agreed to request that (retroactivity) on our behalf," Ferraro said.

Further delay of the survey could mean limited access to care for patients and possible cuts in staff and resources and a reduction in services, hospital officials have warned. It could also affect non-reimbursable programs such as home health and education.

In the letter to state officials, Walt Partridge, president of south Peninsula Hospital Inc.'s board of directors, said the hospital had waited patiently for seven months for the unannounced inspection. The Department of Health and Social Services could give no time frame in which the inspection could be expected to occur, and that what inspectors were available were engaged in inspection duties of higher priority.

When it was evident an inspection was not imminent, the hospital board began pursuing another option, a survey by a private organization created in 1951 called the Joint Commission (until recently called the Joint Commission on Accreditation of Healthcare Organizations). As Letson explained in his note to Seaton, such a procedure involved a "different level of compliance" and would require about four months prep time by the hospital. That prep began in April.

"We are rapidly preparing as we speak," Ferraro said.

The survey covers every service the hospital offers. Initially, it was determined the Joint Commission survey could not conduct the swing bed portion of hospital services. Ferraro said the rules have been reinterpreted, and the commission survey can include swing bed services.

Calls to Beverly Wooley, director of the state Division of Public Health, who is working on the problem from the state's end, were not immediately returned.

Hal Spence can be reached at hspence@ptialaska.net.

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