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HUD, local officials debate Strother facility

By FOSS FARRAR
Traveler Staff Writer
reporter@arkcity.net

The $25 million project to build a new hospital to replace the one in Arkansas City could depend on what type facility is built. The proposed new hospital would be near Strother Field and would replace the one in Arkansas City.

Local hospital officials have pinned their hopes on a Department of Housing and Urban Development grant. HUD now wants them to change the type of hospital that would be built. Local officials want a full-service hospital while HUD prefers a more limited type operation.

Officials at South Central Kansas Regional Medical Center want a full-service hospital, known in hospital jargon as an acute-care facility. But the Department of Housing and Urban Development now is pushing for a redesignation of the hospital as a critical access facility.

The "critical access" status "would simply promote the inefficiencies of health care and not advance the vision that hospital officials have for the future of the community's health care," a SCKRMC spokesman said in a press release.

If Arkansas City builds a critical access facility, it would have to follow government regulations limiting patient stay in the hospital, the number of beds and the types of costs reimbursed under Medicare, Joe Jirinec, chief executive officer of SCKRMC, said today.

"The problem (with being an acute-care hospital) is that every one of the programs are reimbursed on cost basis, and cost-basis reimbursement fosters inefficient operation," Jirinec said.

At one time cost-basis reimbursement seemed like a bonanza to rural hospitals, he added. But in recent years, the government has "ratcheted down" the medical costs that can be reimbursed.

Officials from SCKRMC are currently working towards resubmitting data to HUD to verify their findings favoring designation as an acute care or full-service hospital, Jirinec said.

"The problem is they have only funded critical-access facilities in the past," he said. "Funding us as a full-service hospital is something new to them."

Jirinec said HUD now wants comparison data between the Arkansas City hospital and others in the area, such as Cedar Vale.

Arkansas City has had a full-service hospital since it first built one 100 years ago. By contrast, Caldwell is a critical-access facility, he said.

To be considered a critical-access hospital a facility must meet several state and federal regulations. They include never having more than 25 inpatients, limiting patients' average length of stay to 96 hours or less, and beginning in 2006, critical-access hospitals may not be located within 35 miles of another facility, Clayton Pappan, SCKRMC marketing director, said in a press release.

"Board members and local physicians agree (being a critical-access facility) just doesn't fit us," Jirinec said. "Hopefully, we can get them to see our point of view."

In 2004, SCKRMC submitted its final application to HUD for a 242 loan to finance hospital construction. Since that time, HUD officials have traveled to Arkansas City to see for themselves the state of the current hospital and the location of the replacement facility, two miles north of town.

HUD's application process involves completion of several requirements, Pappan said. They include the conducting of an independent feasibility study, market analysis and documentation of support from the local community.

"To date, the medical center has received over 1,000 letters of support for the replacement facility project," he said.

As the application process proceeded, more information was requested by HUD, Pappan said. In the past, areas that required verification have included questions concerning the percentage of physician ownership, the City's role in the replacement facility, and the timing of the utilities.

SCKRMC will continue to work toward construction of a replacement facility, he added. It will be a facility that will be capable of providing services far beyond those limited to the current hospital.

"The allure of a new facility makes ... attraction of new physicians to the area much more likely," Pappan said. "Recruiting specialists to a rural area continues to be one of the most difficult tasks for community hospitals."

Several specialty physicians are committed to bringing their skills to the Arkansas City community, he said, "in order to practice in a modern facility filled with state-of-the-art equipment."

"The benefits of the project are already visible with the early additions of several new physicians in 2004 including an orthopedic surgeon, podiatrist, and ear, nose and throat specialist," Pappan said.

The latest medical equipment will be used to provide the replacement facility's physicians with the advantages of new technology, he said. State-of-the-art equipment allows for shorter exam and recovery times, less invasive procedures and a greater understanding of a patient's symptoms.

In 2004, SCKRMC significantly upgraded its radiology department by bringing in an MRI, magnetic resonance imaging, three times more powerful than the hospital's previous machine. The hospital also was equipped with a CAT scanner that is four times faster.

"As health care has progressed from inpatient care to outpatient procedures, the current hospital no longer allows for the efficient delivery of care," Pappan said. "Along with an inefficient layout, the current facility also suffers from numerous physical deficiencies, and outdated equipment.

"The SCKRMC board of trustees closely examined the possibility of renovating the current facility. However, the construction expense and the negative impact that the remodeling would have on the current operation ended up totaling millions of dollars more than the replacement facility project estimates."