Cole pushes 'critical' button

The complexities and shortcomings of government reimbursements for health care have caused leaders at Charles Cole Memorial Hospital to take a radical step.

Cole has applied for designation as a "critical access hospital" (CAH), based largely on economics and its commitment to survive as an institution far into the 21st century. Among the noticeable changes will be a reduction from 65 licensed beds currently in use at three sections of the hospital to a strict limit of 25.

Affected areas are medical/ surgical (49 beds), obstetrics (10) and intensive care (6).

Hospital officials hasten to add that the average patient census for the three sections combined has been 26 in recent times, and the CAH rules allow for the 25 beds to be moved from one unit to another, based on need.

Beyond that, they say, the CAH status will have little impact in terms of health care and employment at Cole.

Recognizing the need to allay concerns and respond to inquiries, Cole's senior leaders will be traveling to communities throughout the hospital's service area for public meetings. They'll be at the Westfield Borough Building on Tuesday at 6:00 p.m.; and Austin Area School on Thursday at 6:00 p.m.

Other public meetings are scheduled for Tuesday, May 8, at the Port Allegany Gethsemane Lutheran Church and Thursday, May 17, at the Emporium Health Center, both at 6:00 p.m.

Meetings will also be scheduled soon in Coudersport, Shinglehouse, Galeton, Ulysses, Smethport and Eldred.

CAM is currently in place at more than 1,400 rural hospitals nationwide.

"Rural health care in this country has encountered a great number of challenges over time," said Ed Pitchford, Cole's chief financial officer. "Of increasing concern to a hospital the size of Charles Cole are the changes Congress made to the Medicare program in the mid- 1980s and through the Balanced Budget Act of 1997."

Those actions changed the way hospitals are paid for providing services to Medicare patients, Pitchford noted:

"Medicare no longer pays small, rural hospitals for the actual cost of providing care to patients; rather, Medicare pays established fees based on our volumes of services. We have reached a point where these established fees and our Medicare service levels, more times than not, do not cover our fixed costs."

Congress addressed the dilemma by creating the CAH process, which allows Medicare to use a different method to pay small rural hospitals for services.

"The result is greater financial stability and predictability of Medicare revenues for the hospital," Pitchford pointed out.

"This will allow us to continue providing the highest quality and scope of health care services," added David Acker, Cole's chief executive officer. "CAH acknowledges how critical the hospital is to the community it serves. Without the health care services provided by our hospital, our patients would be forced to travel long distances to seek health care."

He added that most people will not even notice the differences under CAH, because the majority of the change will come from internal operations.