In an exclusive interview, Tim Fry, manager of government affairs for the National Rural Health Association in Washington, tells Modern Healthcare reporter Jessica Zigmond about the revised guidance from the federal government on criteria for the relocation of critical-access hospitals.
[00:00:01.23] Woman’s voice: Welcome to this edition of Special Report Extra, brought to you by Modern Healthcare, and powered by Martopia. With each edition of Special Report Extra, listeners hear directly from key healthcare executives involved in the major events shaping the industry.
[00:00:29.11] Jessica Zigmond: This is Jessica Zigmond, and I’m a reporter with Modern Healthcare magazine. Today we’re talking with Tim Fry, government affairs manager with the Natural Rural Health Association. The topic is critical-access hospitals, which was featured in a special report in the May 5 issue of Modern Healthcare. Thanks for being with us today, Tim.
[00:00:47.00] Tim Fry: Thanks for having me, Jessica.
[00:00:48.20] Jessica Zigmond: My first question is, last September, the Centers for Medicare and Medicaid services issued and implemented a revised guidance for critical-access hospitals interested in relocating. NRHA said the guidance, which supersedes guidelines from November 2005, is a move in a positive direction. Why is that?
[00:01:04.25] Tim Fry: The new interpretive guidelines are a step in a very positive direction. The previous interpretive guidelines had a very onerous burden for critical-access hospital “necessary provider” status, to relocate; so much so that it was nearly impossible for these hospitals to secure financing, begin planning and implementing a relocation or a rebuilding project. These guidelines go a long way toward helping to fix that problem and begin to address concerns by allowing hospitals more flexibility in proving they still meet the same criteria.
[00:01:43.11] Jessica Zigmond: Hospitals that have been grandfathered as necessary providers have expressed serious concern about having to meet both CMS’ 75% test and also state criteria. Could you please describe the 75% test and explain why the NRHA believes this test alone is an adequate measure to determine critical-access hospital status?
[00:02:02.16] Tim Fry: As I stated previously, the new interpretive guidelines go a long way to improve the 75% rule, or 75% test. This test is intended to make sure a relocated facility is serving the same patients and the same community, and that’s what it does. It counts the number of providers, the number of patients being served, and the number of services being offered, and as long as three-fourths of the same community patients and services are being provided, that’s a facility that’s allowed to relocate. This test’s intention is to make sure a newly relocated hospital is serving that same community and this test does that very well by making sure to count that type of three-fourths of the community. We think that is all that is needed; having additional tests, as you referenced in the question, is just additional burdens on hospitals.
[00:02:56.26] Jessica Zigmond: The revised guidance could be seen as an effort on the part of CMS to ensure that a critical-access hospital program is not abused. What would be examples of hospitals that should no longer qualify as critical-access hospitals?
[00:03:09.17] Tim Fry: I would say that hospitals that should not qualify as critical-access hospitals typically are not going to be in the program any longer; they’ve grown too large or they’re in communities that no longer need that designation to exist. And in most cases, those hospitals have begun to upgrade, have begun to become hospitals paid under the prospective payment system. We think that’s a healthy process, we think that should continue. But for critical-access hospitals that need to rebuild their locations, increase their capabilities at their hospital, they need a process to be allowed to rebuild and relocate, and some of the concerns that are still left in the guidance are not going to allow that to happen.
[00:03:51.03] Jessica Zigmond: Thanks for your time today, Tim.
[00:03:53.10] Tim Fry: Jessica, thanks for having me with you today.
[00:03:55.22] Jessica Zigmond: Again, this has been Jessica Zigmond with Modern Healthcare magazine, and I’ve been talking with Tim Fry, with the National Rural Health Association about critical-access hospitals.
[00:04:07.26] Woman’s voice: Thank you for listening to this edition of Special Report Extra, brought to you by Modern Healthcare and powered by Martopia. Listen to other editions of Special Report Extra by visiting the multimedia section of Modern Healthcare Online at ModernHealthcare.com
Running Time: 4 minutes, 30 seconds